Semester-1

MPH-801 Foundations of Public Health

Course Title: Foundations of Public Health

Course Credits: 3

Introduction:

Public Health Science is a multidisciplinary field that has changed over the years. However,

an effective public health system is as urgent as it has ever been. A public health

professional receives education and training in a wide range of disciplines but aim at

improving health through a population focus. Public Health education and training not only

includes the five long-recognized core components of public health (i.e., epidemiology,

biostatistics, environmental health, health services administration and social and

behavioural sciences) but new areas are also considered these days as essentials of public

health: disease-control, reproductive and child health, informatics, genomics,

communication, cultural and social diversity, community-based participatory research,

policy and law, global health and ethics. Public health professionals’ education and

preparedness should be of concern to everyone for this will improve the health of the

populations

Learning Goal:

The goal of this course is to introduce the MPH students to the various facets of public

health concepts, the problem solving paradigm and prepare them for the multi-disciplinary

approach of public health.

Learning Objectives:

By the end of the course participants should be able to:

1. Examine public health through its historical context and use this information in the

evaluation of current public health issues

2. Analyze a public health problem and evaluate interventions and policy alternatives

using the problem-solving methodology

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MPH PROGRAMME

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Contents:

The following areas will be covered during the course:

1. Definition of public health in a historical perspective

2. Recent developments in public health and future directions of public health

3. Problem-solving methodology applied to public health

Defining the problem

Measuring the magnitude of the problem

Developing a conceptual framework for understanding the key determinants

Identifying and developing strategies (policies and interventions)

Setting priorities and recommending intervention or policies

Implementing interventions or policies and evaluation plan

Developing a communication strategy

4. Research in public health and importance of evidence-based decision making

5. Overview of public health programs in Pakistan

Teaching Methodology:

The methodology used ranges from didactic and participative lectures, discussions to

practical problem solving exercises.

Recommended Readings:

1. Basch PF. Textbook of international health, 2ndEd. New York, NY:OxfordUniversity

Press.

2. Brownson RC, Baker BA, Leet TL, Gillespie KN. Evidence-based public health. New

York, NY: OxfordUniversity Press; 2003.

3. Detels R, McEwen J, Beaglehole R, Tanaka H, (eds.). Oxford textbook of public health:

the practice of public health, 4th ed. Oxford: Oxford University Press; 2002.

4. Malin N, Wilmot S, Manthorpe J. Key concepts and debates in health and social policy.

Philadelphia, PA: Open University Press; 2002.

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5. Porter D. Health, civilization and the state, 1st ed. New York, NY: Chapman and Hall

Routledge; 1999.

MPH PROGRAMME

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6. Rohde J, Wyon J. Community-based health care lessons from Bangladesh to Boston, 1 st

ed. Cambridge, MA: Management Sciences for Health in collaboration with the Harvard

; 2002.

7. Schneiderman N, Speers MA, Silva JM, Tomes H, Gentry JH (eds.). Integrating

behavioral and social sciences with public health, 1st ed. WashingtonDC: American

Psychological Association; 2001.

8. Tulchinsky TH, Varavikova EA. The new public health: an introduction for the 21st

century. San Diego, CA: Academic Press; 2000.

Students’ Evaluation:

Formative (20%)

Class participation

Group work (group performance and group report)

Summative Assessment (80%)

Based on the end of the course examination

MPH PROGRAMME

MPH-803: Basic Epidemiology

Course Title: Basic Epidemiology

Course Credits: 3

Introduction:

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Epidemiology is an essential discipline for public health practice. The importance of thisscience is
demonstrated by the inclusion of epidemiology courses in most medical, nursingand public health
curricula. Basic Epidemiology lays stress on the basic epidemiologicalprinciples and their application to
research methodology developing on the understandingof the fundamental principles and on the
development of the practical skills and conceptsrather than on athematicalcalculations.This core course
is offered in the first session of the MPH programme. This is particularlylinked with the courses on
Health Informatics and Computer Applications in Public Health.

Learning Goal:

The goal of this course is to enable health professionals to understand the concepts andapply the
epidemiological and statistical methods to design, conduct, analyze and applyinterventions for
evaluation, making use of computer statistical software and informationtechnology.

Learning Objectives:

By the end of the course, the participants must be able to:

1. Define Epidemiology and its uses in Public Health and Research

Importance of epidemiological investigations

Developments in modern Epidemiology

Uses of Epidemiology in health and disease

2. Apply and design strategies commonly used for epidemiological studies

Describe Descriptive and Analytical studies, the principals of various study designs

with their merits and main outcome measures highlighted for each study design:case report and case
series (description), cross-sectional studies(prevalence), cohortstudies (incidence, relative risks), case
control studies (Odds Ratio), experimentalstudies/clinical trials, intervention studies

Describe each study design with its uses, strengths and limitations

3. Assess the burden of disease using the measures of disease frequency e.g.:

Define rates, ratios, proportions in relation to vital statistics. Calculate incidence,prevalence, morbidity
and mortality rates in human populations.

Apply these measures in defining population dynamics

4. Describe the validity and reliability of a study design:internal and external validity
anditsmeasure,Hawthorne effect etc.Reliability and its measures.

5. Investigate association in terms of strength of association and causality. Make 2x2 tables.

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Calculate Relative risk, Attributable risk, population attributable risk percentandpopulation attributable
risk fraction. Interpret these measures.

6. Identify Risk and risk factors: definition and characteristics. Define Causality and judge

cause-effect relationship:

Examine the epidemiological evidence

Examine the statistical evidence

Examine biological plausibility

7. Drawing Inference from study results (alternative explanations):

Define confounding, its characteristics and effects on the results and how to control

for it.

Define Bias, its characteristics and effects on results and how to control for it.

Define Chance, its characteristics and effects on results and how to control for it.

8. Apply screening in disease control:

Define Screening, uses, screening tests, their validity and yield discussing the biasassociated with
Screening.

Contents:

The following are the contents of the course:

1. Definition of Epidemiology

2. Importance of Epidemiology

3. Types of study designs: their importance, uses and limitations.

4. Outcome measures for each study design e.g. Relative risk, Odds ratio etc.

5. Causality and association

6. Inferential Epidemiology

7. Validity and Reliability

8. Measuring the Disease burden: Rates, Ratios, Incidence, Prevalence

9. Role of Chance, Confounding and Bias in interpretations.

10. Screening in disease control.

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Recommended Readings in Epidemiology:

1. Beaglehole R, Bonita R, Kjellstrom T. Basic epidemiology. Geneva: World Health

Organization; 1993.

2. Gordis L. Epidemiology. Philadelphia, PA: WB Saunders Company; 2008.

3. Greenberg RS, Daniels SR, Flanders WD, Eley JW, Boring JR. Medical Epidemiology, 2nd

ed. New York, NY: McGraw Hill; 1996.

4. Hennekens CH, Buring JE. Epidemiology in medicine. Boston, MA: Little Brown andCompany; 1987.

5. Holford TR. Multivariate methods in epidemiology. New York, NY: OxfordUniversity

Press; 2002.

6. Last JM. A dictionary of epidemiology, 2nd ed. New York, NY: OxfordUniversity Press;

1988.

7. Lilienfeld AM, LilienfeldDE. Foundations of epidemiology,3rd edition. New York, NY:

OxfordUniversity Press; 1994.

8. MacMahon B, Thomas FP. Epidemiology: principles and methods, 1st ed. Boston, MA:

Little, Brown and Company; 1970.

9. Mausner JK, BahnAK. Epidemiology: an introductory text, 2nd ed. Philadelphia, Pa: WB

Saunders Company; 1985.

10. Olsen J, Saracci R, Trichopoulos D, (eds.). Teaching epidemiology: a guide for teachers in

epidemiology, public health and clinical medicine, 2nd ed. Oxford: Oxford University

Press.

11. Fletcher RH, Fletcher SW, Wagner EH. Clinical epidemiology: the essentials, 3rded.

Philadelphia, PA: Williams & Wilkins Publishers; 1996.

12. Szklo M, Neito FJ. Epidemiology: beyond the basics. Boston, MA: Jones and Bartlett

Publishers; 2000.

13. Vetter N, Matthews I. Epidemiology and public health medicine, 1sted. Edinburgh:

Churchill Livingstone; 1999.

14. Dupont WD. Statistical Modelling for Biomedical Researchers. A simple introduction to

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the analysis of a complex data. 2nd edition.CambridgeUniversity Press; 2008.

Teaching Methodology:

Interactive (scenario-based learning) and other teaching tools, discussions and practical

examples (exercises), lectures.

MPH-805: Basic Biostatistics

Course Title: Basic Biostatistics

Course Credits: 3

This discipline plays a fundamental role to prepare the students to apply basic statisticalmethods in
designing the scientific studies, data collection, data analysis and drawinferences. This will introduce
essential statistical tools to the students of Public Health toconduct and interpret quality research.

Learning Goals:

The following are the learning goals of this course:

1. Introduce important statistical concepts to thestudents of Public Health to solveeveryday problems

2. To prepare the students to design studies/trials including the sample size, samplingtechniques, data
analysis, tests of significance etc.

3. To prepare the student to interpret collected data and draw inferences.

Learning Objectives:

The following are the objectives of the course:

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1. Define and give the rationale for statistics in medicine

2. Define variables and their types:

What are variables, different type of variables, classify variables into qualitative,quantitative, discrete
and continuous variables

Define dependent and independent variables

Breakdown the range of a series of quantitative measurements into intervals andspecify which
measurement belongs to which intervals.

3. Define the data types and the scales of measurements

Continuous and discrete data sets

Ordinal and nominal data sets

Interval scales

Composite scales

4. Interpret a given data: Apply descriptive statistics for continuous variables in terms

of:

Measures of central tendency: Calculate the mean, median and mode and interpretthem.

Measures of dispersion: variance, standard deviation, coefficient of variation

Measures of shapes: regarding the distribution of the data sets

5. Apply frequency distribution to a given data and its interpretation. What arepercentiles, their uses
and limitations in a dataset

6. Apply the concepts of probability. Recognize the algebraic notations used in statisticsto differentiate
between parameters and statistics.

7. Define Probability, types of probability with examples.

8. Describe the common probability distributions especially Normal and Binomialdistributions.

List the descriptive properties of a normal distribution with mean μ and standarddeviation σ

Use tables of normal distribution function to estimate the area under a normal curvewith mean μ and σ
for one and between 2 values of the variable.

Define Binomial distribution: use the normal approximation to the binomialprobabilities and use of
continuity correction to improve the estimates.

9. Describe Population and its relation to sample:

10. Define Sampling and its techniques:

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Distinguish between probability and non-probability sampling

Define various types of probability and non-probability sampling

Why sampling errors arise in a sample estimate of a parameter.

Describe the sampling distributions of a mean and a proportion.

Interpret and explain quantitatively the effect of the standard deviation and samplesize on the
sampling distributions

11. Calculate the sampling errors; Calculate the standard error of a mean and aproportion and its
interpretation.

12. Calculate and interpret confidence intervals for a parameter. Explain why it isnecessary to calculate
confidence interval in a data

13. Apply concepts of comparing data (Inferential statistics):

Learn about the basics of hypothesis development

What is a Null hypothesis and Alternate Hypothesis

Describe the rationale of a significance test

Define Alpha and Beta errors

Calculate the Power of a study

14. Apply various tests of significance: their rationale and use.

15. Calculate Confidence Intervals

16. Explain the meaning of ‘p’ in statistical terms and its interpretation.

17. Apply the steps of Hypothesis testing

Choosing an appropriate test of significance

Use the tests of significance for parametric data: for a single mean, for two means ofunpaired
observations, two means of paired observations, three or moreindependent means (ANOVA).

Use the tests of significance for categorical data: for one proportion, two independentproportions, two
paired proportions, several proportions, analyzing frequency tables(2x2, 2xk tables), large tables with
ordered categories.

18. Investigate the association between two continuous variables: using a scattergram to:

Identify dependent and independent variables

Apply correlation–calculate correlation coefficients,

interpretation and presentation of correlation.

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19. Investigate the relationship of two continuous variables using regression, calculatinglinear regression
of y on x and draw line of regression, interpreting and presentingregression.

When to choose –regression or correlation?

Contents:

The following are the contents of the course:

1. Introduction to Biostatistics

2. Types of statistical applications

3. Variables

4. Scales of measurements

5. Descriptive Statistics

6. Measures of central tendencies

7. Measures of variability

8. Measures of shapes

9. Probability

10. Probability Distributions: Normal, Poisson, Binomial

11. Sampling techniques, sampling errors/ Confidence Intervals

12. Concepts of analytical statistics: Hypothesis testing:

13. Alpha and Beta errors

14. Tests of Significance: Normal test, t test, Chi square test etc.

15. Correlation

16. Regression

17. Sampling and various sampling techniques

18. Data presentation: Figures, graphs, tables

Teaching Methodology:

Interactive (scenario-based learning) and other teaching tools, discussions and practicalexamples
(exercises), lectures

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Recommended Readings:

1. Altman DG. Practical statistics for medical research, 3rd ed. London, UK: Chapman &Hall; 1991.

2. Colton T. Statistics in medicine, 1st ed. Boston, MA: Little Brown and Company ; 1994.

3. Daniel WW. Biostatistics: a foundation for analysis in the health sciences, fifth edition.New York, NY:
John Wiley & Sons; 1991.

4. Kirkwood BR. Essentials of medical statistics, 2nd ed. Oxford, UK: Blackwell Scientific

Publications; 1988.

5. Selvin S (ed.). Statistical analysis of epidemiologic data, 3rd edition. New York, NY:OxfordUniversity
Press; 1991.

6. Dupont WD. Statistical Modelling for Biomedical Researchers. A simple introduction tothe analysis of
a complex data.2nd edition.CambridgeUniversity Press; 2008.

Articles:

1. Bashir A, Yaqoob M, et. al. Prevalence and associated impairments of mental retardation

in six to ten year old children in Pakistan: a prospective study. ActaPaediatr 2002:91;

833-37.

2. Beasley RP. Hepatitis B virus as the etiologic agent in hepatocellular carcinoma –epidemiologic
considerations.Hepatology 1982:2; 21S-26S.

3. Bentley ME. Household behaviors in the management of diarrhea and their relevance for

persistentdiarrhea. ActaPaediatr 1992: 381(suppl.); 49-54.

4. Bhutta ZA. Beyond informed consent. Bull World Health Organ2004:82; 771-778.

5. Brahmbhatt H, GrayRH.Child mortality associated with reasons for non-breastfeedingand weaning: is

breastfeeding best for HIV-positive mothers?AIDS 2003:17; 879-85.

6. ButteNF, Villalpando S, et. al. Higher total energy expenditure contributes to growthfaltering in
breast-fed infants living in rural Mexico. J Nutr 1993;123:1028-35.

7. Cravioto A, Reyes RE, et. al. Prospective study of diarrhoeal disease in a cohort of ruralMexican
children: incidence and isolated pathogens during the first two years of life.EpidemiolInf 1988:101;123-
34.

8. DeWitt TG, Humphrey KF, et. al. Clinical predictors of acute bacterial diarrhea in young

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children. Pediatrics 1985: 76; 551-56.

9. Farr W, Humphreys NA. Vital statistics:a memorial volume of selections from thereports and writings
of William Farr. Bull World Health Organ 2000;78:88-95.

10. Gordis L. Challenges to epidemiology in the next decade. Am J Epidemiol 1988:128;1-9.

11. Grunberg SM, Cefalu WT. The integral role of clinical research in clinical care. N Engl J

Med2003: 348; 1386-8.

12. Keusch GT, Thea DM, Kamenga M, Kakanda K, et al. Persistent diarrhoea associatedwith AIDS.
ActaPaediatrSuppl 1992:381; 45-8.

13. Khalil K, Lindblom GB, Mazhar K, Sjogren E, Kaijser B. Frequency andenterotoxigenicity of

campylobacter jejuni and C. coli in domestic animals in Pakistan ascompared to Sweden. J Trop Med Hyg
1993 Feb;96(1):35-40.

14. Rose G. Sick individuals and sick populations. Int J Epidemiol 1985:14; 32-38.

15. Saleemi MA, Zaman S, et. al. Feeding patterns, diarrheal illness and linear growth in 0-24

months old children. J Trop Pediatr 2004:50; 164-9 .

16. Schulz KF, Grimes DA. Blinding in randomized trials: hiding who got what. Lancet2002:359; 696-700.

17. Scrimshaw N. The new paradigm of public health.Amer J Public Health 1995:85; 622-24.

18. Wagstaff A. Socioeconomic inequalities in child mortality: comparisons across nine

developing countries. Bull World Health Organ 2000;78:19-29.

19. Watkins PJ. Cardiovascular disease, hypertension and lipids. Br Med J 2003:326; 874-6.

20. Williams IT, Milton JD, et. al. Interaction of socioeconomic status and provider practices

as predictors of immunization coverage in Virginian children. Pediatrics 1995;96: 439-

446.

21. Wylie I, Griffiths S, Hunter DJ. Everywhere and nowhere: aSocratic dialogue on the new

public health. Br Med J 1999:319; 839-40.

Students’ Evaluation:

Formative (20%)

Ongoing assessment through class participation and class exercises

Summative Assessment (80%)

Summative assessment consists of: MCQs and short essay questions

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 MPH-807: Communicable and Non-communicable Disease Control

Course Title: Communicable and Non-communicable Disease Control

Course Credit: 3

Introduction:

Communicable diseases continue to be major problem in Pakistan and its surroundingregion. However, non-
communicable diseases are on the rise at the same time and thusconstitute a double burden for these
countries undergoing transition. Injuries and disabilityadd to the burden on health systems to mount a
response through inter-sectoralcollaborations. Effective control programmes and projects need to be in place
to reduce theburden of disease. In this context the economic, social science and policy aspects of thedisease
need to be explored and discussed.

Learning Goal:

The goal of this course is to equip the students with knowledge and skills to prevent andcontrol
communicable and non-communicable diseases including injury prevention.

Learning Objectives:

By the end of the course, the participants will be able to:

1. Describe key concepts of communicable and chronic non-communicable disease (NCD)epidemiology with
reference to developing countries in general and Pakistan inparticular.

2. Conduct an outbreak investigation with a relation to microbiological information.

3. nduct surveillance for communjjicable and non-communicable diseases and injuries.

4. Design and conduct a disease control programme for any disease /injury.

Contents:

The following areas will be covered during the course:

1. Introduction to Communicable and Non-communicable Diseases: concepts and

strategies

2. Epidemiology of communicable diseases: Basic Concepts

3. Surveillance

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4. Outbreak Investigation

5. Polio Eradication: New challenges and strategies

6. Biological principles to development of disease prevention and control or management

programmes, including immunology and microbiology

7. Burden of Diseases

8. Communicable and Non-Communicable Diseases Trends and Policies

9. Injury and injury prevention.

10. Private Public Partnership in disease control: Integration of non-communicable disease

prevention and control within the context of primary and secondary health care

11. Role of NGOs in disease control

12. Disease Early Warning System

13. Epidemiology of Genetics and its role in Communicable and Non-communicablediseases

14. Epidemiology of NCDs in Pakistan

15. The National Action Plan for NCD prevention, control and health promotion: concepts,

theory and practice

Teaching Methodology:

Interactive discussions, individual assignment, exercises and group discussions

Recommended Readings:

1. Bender AP, Williams AN, Johnson RA, Jagger HG. Appropriate public health responsesto clusters: the art of
being responsibly responsive. Am J Epidemiol 1990;132:S48-52.

2. BenensonAS. Control of communicable diseases in man, 15th ed. WashingtonDC:American Public Health
Association; 1990.

3. Caldwell GG. Twenty-two years of cancer cluster investigations at the Centres forDiseaseControl.Am J
Epidemiol 1990;132:S43-7.

4. Dicker RC, et. al. Principles of epidemiology:an introduction to applied epidemiology

and biostatistics, 2nd ed. Atlanta, GA, USA: Centers for Disease Control and Prevention,

1992. Self-study course 3030-G. Available from: URL:http://www.phppo.cdc.gov/PHTN//catalog/pdf-

file/Epi_Course.pdf

5. Fiore BJ, Hanrahan LP, Anderson HA. State health department response to disease

cluster reports: a protocol for investigation. Am J E pidemiol 1990;132:S14-22.

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6. Fraser DW, Tsai TY, Orenstein W. Legionnaires’ disease: description of an epidemic of

pneumonia. N Engl J Med 1997;297: 1189-97.

7. Gross M. Oswego Country revisited. Public Health Rep 1976;91:168-70.

8. Hertzman PA, Blevins WL, Mayer J, Greenfield B,tingM,GleichGJ.Association of the

eosinophilia-myalgia syndrome with the ingestion of tryptophan. N Engl J Med

1990;322:869-73.

9. Hutchins SS, Markowitz LE, Mead P. A school-based measles outbreak:the effect of a

selective revaccination policy and risk factors for vaccine failure. Am J Epidemiol

1990;132:157-68.

10. Jamison DT, Mosley HW, Measham AR, Bobadilla JL. Disease control priorities in

developing countries. New York, NY: OxfordUniversity Press; 1993.

11. Khan OA, Hyder AA. Research report-Responses to an emerging threat: HIV/AIDS

policy in Pakistan. Health Policy Plan. 2001;16(2):214-218

12. Kuh D, Ben-Shlomo Y, editors. A Life Course Approach to Chronic Disease

Epidemiology. Oxford: Oxford Medical Publications; 1997.

13. MacDonald KL, Spengler RF, Hatheway CL. Type A botulism from sautéed onions. J Am

Med Assoc. 1985;253:1275-8.

14. Ministry of Health, Government of Pakistan, World Health Organization, Heartfile.

National action plan for prevention and control of non-communicable diseases and

health promotion in Pakistan: a public-private partnership in health. Islamabad,

Pakistan: tripartite collaboration of the Ministry of Health, Government ofPakistan;

WHO, Pakistan office, and Heartfile; 2004. Available from: URL:

http://www.heartfile.org/pdf/NAPmain.pdf

15. Murray CJL, Lopez AD. Mortality by cause for eight regions of the world:Global Burden

of Disease Study. Lancet 1997; 349:1269-76

16. Murray CJL, Lopez AD. Regional patterns of disability-free life expectancy and

disability-adjusted life expectancy: Global Burden of Disease Study. Lancet

1997;349:1347-52.

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17. Neutra RR. Counterpoint from a cluster buster. Am J Epidemiol 1990;132:1-8.

18. Nishtar S. Cardiovascular disease prevention in low resource settings: lessons from the

Heartfile experience in Pakistan.Ethn Dis. 2003 Summer;13(2 suppl. 2):S138-48.

19. Nishtar S. Prevention of coronary heart disease in South Asia. Lancet 2002 Sep;360: 1015-

20. Nishtar S. Public-private partnerships in health: a global call to action. Health Res Poliy

Syst 2004 Jul;2(1): 5.

21. OmranAR. The epidemiology transition theory revisited thirty years later. Wldhlth

statist.quart. 1998;99-119.

22. RosenbergMD, Hazlet KK, Schaefer J, Wells JG ,Pruneda RC. Shigellosis from

swimming. J Am Med Assoc. 1976;236:1849-52.

23. Ryan CA , Nickels MK, Hargrett-Bean NT.Massive outbreak of antimicrobial-resistant

salmonellosis traced to pasteurized milk. J Am Med Assoc. 1987;258:3269-74.

24. Schulte PA, Ehrenberg RL, Singal M. Investigation of occupational cancer clusters:

theory and practice. Am J Public Health 1987;77:52-6.

25. Taylor DN, Wachsmuth IK, Shangkuan Y-H. Salmonellosis associated with marijuana: a

multistate outbreak traced by plasmid fingerprinting. New Engl J Med 1982;306:1249-53.

26. Webber R. Communicable disease epidemiology and control: a global perspective, 2 ed. Wallingford:
nd

CABI Publishing; 1996.

Students’ Evaluation:

Formative (20%)

Ongoing assessment through class participation and class exercises

Summative Assessment (80%)

Summative assessment consist of: MCQs and Short essay questions

MPH-809: Environmental Health & Disaster Management

(Environmental and Occupational Health)

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Course Title: Environmental Health

Course Credits: 3

Introduction:

The MPH programme is targeted at enabling the participants to use applied research tools

and techniques applying to the study of the environment in relation to health. The course

presents concepts, principles, and applications of the main natural and social science

disciplines that form the basis of environmental health and describes how these disciplines

and their practitioners interact in the environmental health paradigm. The course examines

health issues, scientific understanding of causes, and possible future approaches to control

of the major emerging environmental health problems in industrialized and developing

countries.

Learning Goal:

The overall goal of the course is to enable the participants to identify and describe the

important current and emerging environmental problems that pose risk to public health and

apply the multidisciplinary environmental health approach to their solution.

Learning Objectives:

By the end of the course the participants should be able to:

1. Describe the core issues in Environmental Health

2. Define the major sources and types of environmental agents

3. Identify the carriers or vectors that promote the transfer of these agents from the

environment to the human

4. Describe how these agents interact with biological systems, and the mechanisms by

which they exert adverse health effects

5. Describe the existing situations and remedies in developing countries

6. Identify and define the steps in the risk-assessment and risk-management processes

7. Describe the sources, pathways of exposure and methods of control of the principal

physical, chemical, biologic and psychosocial hazards that impact human health in

ambient, indoor and occupational environments.

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8. Explain the processes associated with the translation of scientific and health data into

public health policy and environmental law.

MPH PROGRAMME

39

9. Identify and describe important current and emerging environmental problems that

pose a risk to public health

Contents:

The following areas will be covered during the course:

Course Contents

During this course, the following course contents will be covered in the specific environmental

health areas;

A. General Contents

1. Introduction to Environmental Health Issues

2. Environmental Health Issues of Pakistan

3. Human Impacts on Environment

4. Environmental Impacts on Human Health

5. Sanitation Status and Options in Pakistan

B. Water Pollution

1. Surface and Groundwater Resources of Pakistan

2. Drinking Water Supply Sources

3. Drinking Water Quality Situation in Pakistan

4. Pesticides and Fertilizers

5. Arsenic, Fluoride and Nitrate contamination in Drinking Waters

6. Water Born Diseases in Pakistan

7. Water Supply Agencies, their Capacity and Performance

8. Present Drinking Water Treatment Practices

9. Waste Water Availability and its Treatment

C. Air Pollution

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1. Air Pollution Sources

2. Air Quality Monitoring Network in Pakistan

3. Present Status of Air Pollution in Pakistan

4. Health Effects of Air Pollution

5. Air Pollution Control Devices

6. Legal Regulations

D. Noise Pollution

1. Sources of Noise Pollution

2. Effect of Noise Pollution on Health and Behavior

3. Noise Mitigation

4. Legal Requirements

E. Solid and Hazardous Waste Management

1. Solid Waste Sources and Quantitative Estimates

2. Methods of Disposal

MPH PROGRAMME

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3. Waste Handling and Transport

4. Waste Management Concepts

5. Technologies

6. Hazardous Waste Generation

7. Hazardous Waste Management

8. Hazardous Waste Storage

9. Common Hazardous Waste incineration Facilities

F. Environmental Impact Assessment (EIA)

1. Objectives of EIA

2. Types of EIA

3. Basic EIA Principals

4. Types of Environmental Impacts

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5. Risk Assessment

6. Environmental Management Plan

7. Stakeholders Roles and Responsibilities

G. Climate Change and Its Effect on Health

1. Pakistan’s Vulnerability to Climate Change

2. Effect on Floods and Droughts

3. Human Health

H. Environment Policy and Law

1. Air Quality and Noise

2. Waste Management

3. Water Supply and Management

4. Forestry

5. Poverty and Environment

6. Health and Environment

7. Natural Disaster Management

8. Legislation and Regulatory Framework

I. Healthy Cities and Villages

Teaching Methodology:

1. Didactic inactive class room instruction primarily through multimedia presentations

2. Practical field work with demonstration on class room-based instructions

3. Group exercises and roleplays

Recommended Reading:

1. Aron JL, Patz JA (eds.). Ecosystem change and public health: a global perspective.

Baltimore, MD: JohnsHopkinsUniversity Press; 2001.

2. LaDou J. Current occupational and environmental medicine, 3rd ed. New York, NY:

Lange Medical Books/McGraw-Hill; 2004.

MPH PROGRAMME

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3. Lippmann M, Cohen BS, Schlesinger RB. Environmental health science, 2nd ed. New

York, NY: OxfordUniversity Press; 2003.

4. Moeller WD. Environmental health, 2nd ed. Cambridge, MA: Harvard University Press;

1997.

5. Moore GS. Living with the earth: concepts in environmental health science, 2nd ed. Boca

Raton, FL: Lewis Publishers; 2002.

6. Nadakavukaren A. Man and environment: a health perspective, 3rd ed. Prospect

Heights, IL: Waveland Press;1990.

7. Sellers CC. Hazards of the job: from industrial disease to environmental health science.

Chapel Hill: University of North Carolina Press; 1997.

8. Steiner GA, Miner JR, Gray ER. Management policy and strategy. New York, NY:

Macmillan Education Ltd; 1986.

9. Vesilind PA, Peirce JJ. Environmental pollution and control, 4th ed. Boston, MA:

Butterworths Publishers; 1983.

10. Yassi A, Kjellström T, de Kok T, Guidotti T. Basic environmental health. New York, NY:

OxfordUniversity Press; 2001.

Students’ Evaluation:

Formative (20%)

Ongoing assessment through class participation and class exercises

Summative Assessment (80%)

Summative assessment consists of: MCQs and short essay questions

MPH PROGRAMME42

Occupational Health

Introduction:

Pakistan is basically an agricultural country with a population of 150 million, 65% of which

lives in rural areas. Our National workforce is distributed both in formal and informal

sectors. Globally, it is evident that about 45% of the world’s population and 58% of the

population over 10 years of age, belong to the global workforce. Recent occupational health

21
data indicates that 40-50% of the world’s population is exposed to hazardous condition in

the workplace. Over 120 million occupational accidents occur worldwide each year, with

200,000 fatalities. The magnitude of the occupational diseases and injuries is not less than the

reportable diseases. In Pakistan, there is a dire need to address the occupational health and

safety issues as we are rapidly progressing to a middle income country and the

industrialization and increase in working force demands more emphasis and concrete

actions taken for the health and safety of the occupational group of both formal and informal

sectors.

Learning Goal:

The overall goal of the course is to improve the capacity of health managers in occupational

health in terms of their knowledge, attitude and skills.

Learning Objectives:

By the end of the course, the participants will be able to:

1. Define occupational health that encompasses the main aspects of problem-solving

typically faced by health managers;

2. Define and describe essential concepts, principles, methods and terms in occupational

health;

3. Apply certain techniques in the resolution of selected occupational health issues and

4. Describe basic methods of quantitative and qualitative analysis being used by health

managers in occupational health.

Contents:

The following areas will be covered during the course:

MPH PROGRAMME

43

1. Workplace and Health

2. Scope of Occupational Health and Safety

3. Occupational Health Issues in Low-income Countries

4. Industrial Hygiene

22
5. Anticipation

6. Recognition

7. Evaluation

8. Control

9. Clinical Occupational and Environmental Medicine

10. Legal and Regulatory Issues

11. Labour Laws

Teaching Methodology:

Lectures, discussions, walk through examination of the industries, panel discussion and role

plays and assignments.

Recommended Readings:

1. Jeyaratnam J, Koh D (eds.). Textbook of occupational medicine practice. Singapore:

World Scientific Publishing Co; 1996.

2. Sellers CC. Hazards of the job: from industrial disease to environmental health science.

Chapel Hill: University of North Carolina Press; 1997.

3. Reich MR, Okubo T (eds.). Protecting workers' health in the third world: national and

international strategies. New York, NY: Auburn House.

4. Merchant JA, Boehlecke BA, Taylor G, Pickett-Harner M (eds.). Occupational respiratory

diseases. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health

Service, Centers for Disease Control, National Institute for Occupational Safety and

Health, DHHS (NIOSH); 1986.Publication No. 86-102.

Students’ Evaluation:

Formative (20%)

Ongoing assessment through class participation and class exercises

Summative Assessment (80%)

Summative assessment consist of: MCQs and Short essay question09. Social and

Behavioural Sciences in Public Health

MPH-811: Computer Application in Public Health

23
Course Title: Computer Applications in Public Health

Course Credits: 3(2-1)

Introduction:

Computer skills in public health schools are a prime necessity. Not only the applications and

skills are needed for the word processing for proposal writing and creating a

questionnaire/proforma, but also for using statistical analysis and report writing. Currently,

the available computer software are user friendly and can be easily operated by the

professionals. Public health professionals are expected to have a thorough insight into the

available software and be capable of producing the required results. The successful use of

internet can make the communications easy and efficient. Moreover the efficient utilization

of online resources for literature review and research depends on the respective skill

attainment by the concerned researcher.

Learning Goal:

The learning goal of the course is to provide the public health professionals with skills to

operate the computers and utilize the software and related resources efficiently.

Learning Objectives:

By the end of the course, the students will be able to:

1. Use internet efficiently for research purposes.

2. Use a word processor like Microsoft Word for writing their research proposal and

dissertation.

3. Develop presentations using Microsoft Power point.

4. Enter and handle the data using statistical software, like Excel, Access, Epi Data, Epi

Info, SPSS and Stata.

5. Analyze data and generate results by using these statistical software.

6. Present data in graphical and tabulated forms using appropriate software.

7. Use citation software like End Note

Contents:

The following are the contents of the course:

24
MPH PROGRAMME

31

1. Introduction to Computers.

2. Types of Computers

3. Computer Operating System

4. Use of Input out Devices

5. Accessing to PDF Files

6. Basics in word processing

7. Advanced functions in Word, Power point and Excel

8. Literature search using internet

9. Advance Search Tools (Google, Bing)

10. Ability to use citation software like End Note

11. Introduction to Epi Data &Epi Info:

Data entry and cleaning procedures

Data processing procedures

Data analysis procedures

Graphics in Epi Info

12. Introduction to SPSS:

Data entry procedures

Data processing procedures

Data analysis procedures

Graphics in SPSS

13. Introduction to STATA:

Data entry procedures

Data processing procedures

Data analysis procedures

Recommended Readings:

1. Stata Corporation. STATA release 8: user’s guide. College Station, Texas: Stata Press;

25
2003.

2. SPSS for Dummies 2007

3. Other manuals for statistical software

4. Help options in the software programs

MPH PROGRAMME

32

Students’ Evaluation:

Formative (20%)

Ongoing assessment through class participation and individual computer-based

exercises

Summative Assessment (80%)

Summative assessment consistsofshort essay questions, computer-based exercises

testing the ability to utilize various software

MPH PROGRAMME

Semester-2

MPH-802: Applied Epidemiology and Biostatistics

Course Title: Applied Epidemiology and Biostatistics

Course Credit: 3

Introduction:

This is a core course offered after the students have attended the basic courses inepidemiology and
biostatistics in the first term. This deals with the application of theirconcepts and numerical skills to different
public health issues. Some new concepts areintroduced and students are given datasets to work on with the
help of statistical software.The skill of interpretation of the applications is inbuilt.Learning Goal:The goal of
the course is to improve the epidemiological and statistical skills for use inresearch and evaluation in public
health and to enable the students to understand and applythe basic epidemiological and statistical
knowledge and skills in addressing and solvinghealth and public health issues and developing research
strategies using advanced statisticalmethods and statistical software/s.

26
Learning Objectives:

At the end of the course, the student should be able to:

1. Apply measures of disease frequency in Public Health.

2. Describe further statistical procedures in Cohort and case-control studies.

3. Interpret the results of a study investigating the effects of Confounding and Interaction

4. Describe the methods adopted to control for Bias, Chance and Effect Modification in astudy

5. Apply screening in disease control.

6. Analysis of survival times

7. Applications of Standardization

8. Use the tests of significance for parametric data: three or more independent groups ofobservations
(ANOVA).

9. Use the tests of significance for categorical data:

several proportions,

analyzing frequency tables (22, n k tables),

large tables with ordered categories.

10. Use non-parametric tests for a single or more than one samples e.g. Wilcoxon’s Rank

sum tests, Mann-Whitney U-tests etc.

11. Investigate the relationship of two or more continuous variables using correlation –

partial correlation coefficients, coefficient of determination, interpretation andpresentation of correlation.

12. Investigate the relationship between several variables using:

Multiple regression and

Logistic regression.

13. Evaluation of interventions or programmes using appropriate epidemiological andstatistical methods.

Contents:

The contents of the course are as follows:

1. Disease frequency: Incidence and Prevalence

2. Proportional Morbidity and mortality

3. Details of measures of association and inference in cohort and case control studies

27
4. Further applications of Chance, confounding and bias in studies.

5. Interaction and effect modification.

6. Issues in screening.

7. Survival time analysis.

8. Standardization techniques in epidemiological studies.

9. Parametric test: ANOVA

10. Non Parametric tests: Chi square test for several proportions, n k tables and tables with

ordered data, Fisher’s exact test, non-parametric tests for a single or more than onesamples e.g. Wilcoxon’s
Rank sum tests, Mann-Whitney U-tests.

11. Partial correlation coefficients, coefficient of determination.

12. Multiple regression and

13. Logistic regression

Teaching Methodology:

1. Interactive discussions

2. Exercises

3. Group discussions

Recommended Readings:

Same as for Basic Epidemiology and Basic Biostatistics plus:

1. Baumgartner TA, Strong CH. Conducting and reading research in health and humanperformance, 2nd ed.
Boston, MA: Edward E. Bartell publishers; 1997.

2. Bennet J, Azhar N, Rahim F, Kamil S. Further observations on ghee as a risk factor forneonatal
tetanus.International Journal of Epidemiology 1998; 24: 643-47.

3. BhargavaSK, Sachdev HS, Fall CHD, et. al. Relation of serial changes in childhood body

mass index to imparired glucose tolerance in young adulthood. N Eng J Med 2004;350:

865-75.

4. Brown KH, Black RE. Infant feeding practices and their relationship with diarrhoeal and

other diseases in Huascar (Lima) Peru. Pediatrics 1989;83:31-40.

28
5. Clemens JD, Stanton S, Stoll B. Breast feeding as a determinant of severity in shigellosis.

Evidence for protection throughout the first three years of life in Bangladeshi children.

American Journal of Epidemiology 1986;123: 710-720.

6. Cochran WG. Sampling techniques, 3rd ed. New York, NY: Singapore: John Wiley &

Sons; 1909.

7. Deitz WH, Robinson TN. Overweight children and adolescents. N Eng J Med 2005;352:

2100-09.

8. Furness S, Connor J, Robinson E, Norton R. Car colour and risk of car crash injury:population based case
control study. British Medical Journal 2003;327: 1455-56

9. Jousilahti P, Toumilehto J, Vartialnen, Eriksson J and Puska P. Relation of adult height tocause-specific and
total mortality: A prospective follow up study of 31,199 middle-agedmen and women in Finland. Amer J
Epidemiol 2000;151: 1112-20.

10. Khan SR, Zaman S, Jalil F, Lindblad BS, Karlberg J. Early child health in Lahore: X.Mortality.
ActaPaediatrSuppl 1993;390: 109-17.

11. Kruijshaar ME, Barendregt JJ, Hoeymans N. The use of models in the estimation ofdisease epidemiology.
Bull WHO 2002; 80: 622-28.

12. Lindblad BS, Patel M, Zaman S. Age and Sex are important factors in determiningnormal retinol levels. J
Trop Paediatr 1998;44: 96-99.

13. Mahalanabis D, Alam AN, Rahman N, Hasnat A. Prognostic indicators and risk factors

for increased duration of acute diarrhea and for persistent diarrhea in children. Int J

Epidemiol 1991;20: 1064-72.

14. Petro R, Darby S, Deo H, Silcocks P, Whitley E, Doll R. Smoking, Smoking cessation and

lung cancer in the UK since 1950: combination of national statistics with two case-controlstudies. British
Medical Journal 2000; 321: 323-329.

15. Stevens A, Raftery J (eds.). Health care needs assessment, Vol. 1:the epidemiologicallybased needs
assessment reviews. Oxford: Radcliffe Medical Press; 1994.

16. Vella V, Tomkins A. et al. Determinants of Stunting and Recovery from stunting inNorthwest Uganda. Int J
Epidemiol 1994; 782-86.

17. Yaqoob M, Cnattingius S, Jalil F, Zaman S. Risk factors for mortality in young childrenliving under various
socio-economic conditions in Lahore, Pakistan: with particularreference to inbreeding. Clin Gen 1998;54: 426-
34.

29
Students’ Evaluation:

Formative (20%)

Ongoing assessment through class participation and class exercises

Summative Assessment (80%)

Summative assessment consist of: MCQs and Short essay questions

MPH-804: Child Health and Preventive Pediatrics

(Child Health programs and Interventions)

Course Title: Child Health Programs and Interventions

Course Credit: 3

Introduction:

This course focuses on the integration and building upon the basic concepts as well as to

allow them to use their quantitative and qualitative skills to enhance their understanding of

child health issues. The course will equip them to promote optimal health for the fetus,

newborn and the child in the context of underlying determinants of ill health, trends in

survival, morbidity, nutritional and environmental factors, immunizations, access to health

care and health policies. Injuries and disability will also be discussed.

Learning Goal:

The learning goal of the course is to equip the participants with the skills, knowledge and

principles to explore the risk factors for poor child health outcomes and manage and

evaluate effectively the child health programs at the national, provincial and district levels.

Learning Objectives:

At the end of the course, the participants should be able to:

1. Establish the Public Health perspective on Child Health, primarily focusing on

preventive aspects.

30
2. Describe the historical and current situation of fetal and child health in the country and

the region..

3. Understand the health problems among children using the framework emphasizing the

analysis of underlying principles and theories.

4. Use analytical tools of epidemiology, paediatrics, health services, developmental and

social sciences, demography and policy analysis in identifying problems and solutions in

child health.

5. Establish the current best practices in Child Health in light of the recent developments,

i.e. Millennium Development Goals, Bellagio Child Survival Study Group’s

recommendations, Lancet Neonatal Survival Program etc.

Contents:

The following areas will be covered during the course:

MPH PROGRAMME

62

1. Introduction to Child Health

2. Child Health: The Public Health Perspective

3. Assessing newborn health: The Neonatal Survival

4. Assessment of child health using different tools in Epidemiology, Biostatistics and

Paediatrics.

5. Child Health: The Programmatic Issues in the contextual framework.

6. Strengthening The Health Systems For Child Health

7. Child Health: Global Issues

Teaching Methodology:

The teaching methodology will include Lectures, interactive discussions, group works and

assignments.

Recommended Readings:

1. Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every

year?Lancet. 2003;361:2226-34. Available from: URL:http://www.who.int/child-adolescenthealth/

31
New_Publications/CHILD_HEALTH/CS/CS_paper_1.pdf

2. Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS; Bellagio Child Survival Study Group.

How many child deaths can we prevent this year? Lancet. 2003;362: 65-71.

3. Bryce J, el Arifeen S, Pariyo G, Lanata C, Gwatkin D, Habicht JP; Multi-Country Evaluation

of IMCI Study Group. Reducing child mortality: can public health deliver? Lancet. 2003;362:

159-64.

4. Victora CG, Wagstaff A, Schellenberg JA, Gwatkin D, Claeson M, Habicht JP. Applying an

equity lens to child health and mortality: more of the same is not enough. Lancet. 2003;362:

233-41.

5. Claeson M, Gillespie D, Mshinda H, Troedsson H, Victora CG; Bellagio Study Group on

Child Survival.Knowledge into action for child survival.Lancet. 2003;362: 323-7. Available

from: URL: http://www.who.int/child-adolescenthealth/

New_Publications/CHILD_HEALTH/CS/CS_paper_5.pdf

6. Bawaskar HS. The world's forgotten children [editorial].Lancet. 2003;361: 1224-5.

7. Lawn JE, Cousens S, Zupan J; Lancet Neonatal Survival Steering Team. 4 million neonatal

deaths: when? Where? Why? Lancet. 2005;365: 891-900.

MPH PROGRAMME

63

8. Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L; Lancet Neonatal

Survival Steering Team. Evidence-based, cost-effective interventions: how many newborn

babies can we save? Lancet. 2005;365: 977-88.

9. Knippenberg R, Lawn JE, Darmstadt GL, Begkoyian G, Fogstad H, Walelign N, Paul VK;

Lancet Neonatal Survival Steering Team.Systematic scaling up of neonatal care in countries.

Lancet. 2005;365: 1087-98.

10. Martines J, Paul VK, Bhutta ZA, Koblinsky M, Soucat A, Walker N, Bahl R, Fogstad H,

Costello A; Lancet Neonatal Survival Steering Team. Neonatal survival: a call for action.

Lancet. 2005;365: 1189-97. Available from: URL:http://www.who.int/child-adolescenthealth/

New_Publications/NEONATAL/The_Lancet/Neonatal_paper_4.pdf

32
11. Tinker A, ten Hoope-Bender P, Azfar S, Bustreo F, Bell R. A continuum of care to save

newborn lives [comment]. Lancet.2005;365: 822-5. Available from:

URL:http://www.who.int/child-adolescenthealth/

New_Publications/NEONATAL/The_Lancet/2_The_Partnerships.pdf

12. Zaidi A, Khan T, Akram D. Early child health and survival strategies in Pakistan: a

situational analysis. In: Bhutta ZA (ed.). Maternal and child health in Pakistan: challenges

and opportunities. Karachi: OxfordUniversity Press; 2004.

13. Bhutta ZA, Ali N, Hyder A, Wajid A. Perinatal and newborn care in Pakistan: seeing the

unseen. In: Bhutta ZA (ed.). Maternal and child health in Pakistan: challenges and

opportunities. Karachi: OxfordUniversity Press; 2004.

14. SiddiqiS,Haq IU, Ghaffar A, Akhtar T, Mahaini R. Pakistan’s maternal and child health

policy: analysis, lessons and the way forward. Health Policy 2004;69:117-30.

Students’ Evaluation:

Formative (20%)

Ongoing assessment through class participation and class exercises

Summative Assessment (80%)

Summative assessment consist of: MCQs and Short essay questions

MPH PROGRAMME

64

MPH-806: Health System Analysis, Health Policy & planning

Course Title: Health Systems Analysis, health policy and planning

Course Credits:3

Introduction:

This three-credit course is offered to MPH participants in the first session to familiarize them

with the concepts of Health Systems. Health Systems Analysis is application of the systems

approach in health. It is an approach to examine all aspects of a Health System in a

33
systematic and organized way to learn about its strengths and find out ways to cover the

gaps.

Learning Goal:

The goal of this course is to enhance the participants’ comprehension of the basic concepts of

the health system at micro and macro level, for the purpose of ultimately improving health

service delivery in Pakistan and in other countries.

Learning Objectives:

At the end of the course students will be able to:

1. Understand the various concepts of Health Systems

2. Understand and enlist all essential components of the Health Systems Model

3. Understand and practice the steps of Health Systems Analysis

4. Identify indicators for each component of Health Systems Model

5. Develop a tool for Health Systems Analysis

6. Conduct Health Systems Analysis in the field

7. Analyze and interpret the findings from data collected through the Health Systems

Analysis Tool

Contents:

The following areas will be covered during the course:

1. Definitions of health input, output and outcomes

2. Health System: Conceptual Frameworks

3. Health System: Terms and Concepts

4. Systems Approach

5. Micro Health System: Kielmann Model

MPH PROGRAMME

48

6. Health Indicators and their use

7. Situation Analysis Approach

8. Instrument for Health Systems Analysis

34
9. Macro Health System: WHO model

10. Health Management Information System

11. Field Visits for data collection(applied system analysis)

12. Health system functions

13. Health system outcomes

14. Primary Health Care

15. Linking the Micro and Macro Health models

Teaching Methodology:

Lectures, discussions, group work, presentations, assignments and supervised field trips

Recommended Readings:

1. Berman BA, Bossert TJ. A decade of health sector reform in developing countries:what

have we learned? Boston, MA: Data for Decision Making Project, International Health

Systems Group, Harvard ; 2000. Available from: URL:

http://www.hsph.harvard.edu/ihsg/publications/pdf/ closeout.pdf

2. Kemm J, Parry J, Palmer S (eds.). Health impact assessment: concepts, theory, techniques

and applications. Oxford: OxfordUniversity Press; 2004.

3. Kielmann AA, Siddiqi S, Mwadime RK. District health planning manual: toolkit for

district health managers.Islamabad, Pakistan: Multi-donor Support Unit, Ministry of

Health; 2002.

4. Kielmann, AA, Janovsky K, Annett H. Assessing district health needs, services and

systems: protocols for rapid data collection and analysis.London, UK: Macmillan

Education Ltd and AMREF, 1995.

5. SiddiqiS,Haq IU, Ghaffar A, Akhtar T, Mahaini R. Pakistan’s maternal and child health

policy: analysis, lessons and the way forward. Health Policy 2004;69:117-30.

6. Siddiqi S, Kielmann AA, Khan MS, Ali N, Ghaffar A, Sheikh U, et. al. The effectiveness

of patient referral in Pakistan. Health Policy Plan. 2001:16: 193-198.

MPH PROGRAMME

49

35
7. Stevens A, Raftery J, Mant J, Simpson S (eds.). Health care needs assessment: the

epidemiologically-based needs assessment reviews, 2nd ed., vol. 2. Oxford: Radcliffe

Medical Press; 1994.

8. World Health Organization. The world health report 2000: Health systems – improving

performance. Geneva: World Health Organization; 2000. Available from:

URL:http://www.who.int/entity/whr/2000/en/whr00_en.pdf

Students’ Evaluation

Formative (20%)

Ongoing assessment through class participation and class exercises

Summative Assessment (80%)

Summative assessment consists of: MCQs and short essay questions

MPH PROGRAMME

MPH-808: Health management & Information system

(Health system Management)

Course Title: Health managementand Information system (Health system management)

Course Credits: 3(2-1)

Introduction:

Pakistan has one of the best knitted network health care facilities in public sector. These

facilities mostly, face the problems of underutilization and under functioning along with the

technical and allocative inefficiency. The management of private sector has also been

considered inefficient and not very effective. Specific Management tools and techniques,

such as strategic management, management by objectives, quality assurance methods,

monitoring and evaluation of the health systems outputs and outcomes, and economic

appraisal are not practiced. Insufficient management knowledge, in appropriate attitude and

36
skills are reducing the capacity to improve the system.

Learning Goal:

The overall goal of the course is to enable the participants to describe the principal concerns

in Health Systems management in order to improve the management capacity of health

managers in terms of their knowledge, attitude and skills.

Learning Objectives:

By the end of the course, the participants will be able to:

1. Define management that encompasses the main aspects of problem-solving typically

faced by health managers;

2. Define and describe essential concepts, principles, methods and terms in management;

3. Apply certain techniques in the resolution of selected management issues and

4. Describe basic methods of quantitative analysis being used by health managers.

5. Demonstrate change management, communication and leadership skills.

6. Define what quality means from the standpoint of the variety of stakeholders.

7. Explain the relationship of cost and quality.

Contents:

The following areas will be covered during the course:

1. Introduction to Health System and Scope of Health Systems

2. Managing Health System for Better Outcomes, Global Issues and Priorities for Pakistan

MPH PROGRAMME77

3. Management: Traditional and Contemporary Issues and Challenge

4. Management and the Manager’s Job

5. An Introduction to Systems, Client Orientation, Process Analysis, Problem Identification

6. Evidence-based decision making

7. Use of HMIS in HSM

8. Supportive supervision &leadership

9. Capacity building in human resource management

10. Introduction to Human Resource Management: Competencies and Job Description

37
11. Challenges resolution techniques, staff motivation and performance appraisal

12. Functional and Task Analysis

13. Functional and Task Analysis: Exercise

14. Monitoring and Evaluation

15. Introduction to Financial Management

16. Performance Budgeting and Analysis in HSM

17. Financial Management in HSM

18. Financial Management in HSM: Exercise

19. Logistics Cycle in HSM

20. Quality Management

21. Quality Management:Exercise

22. Tools for Quality Assessment / improvement

23. Tools for Quality Assessment / improvement: Exercise

Teaching Methodology:

Lectures, discussions, assigned individual and group exercises, Role plays

Recommended Readings:

1. Amonoo-Lartson R, Ebrahim GJ, Lovel HJ. District health care: challenges for planning,

organization and evaluation in developing countries, 2nd ed. Hong Kong: Macmillan

Press; 1985.

2. Chanawongse K. Understanding primary health care management: from theory to

practical reality. Bangkok: Buraphasilp Press; 1990.

MPH PROGRAMME

78

3. Gourlay R. Training manual on health manpower management (8 volumes). Geneva:

Division of Health Manpower Development, World Health Organization; 1988.

Document no. WHO/EDUC/88.195.

4. McMahon R, Barton E, Ross F. On being in charge: a guide to management in primary

health care, 2nd ed. Geneva: World Health Organization; 1992.

38
5. Reinke WA. Health planning for effective management (HPEM).New York,

NY:OxfordUniversity Press; 1988.

6. Shortell SM, Kaluzny AD. Health care management, 3rd ed. Albany, NY: Thompson

Delmar Learning; 2000.

7. World Health Organization. The world health report 2000: Health systems – improving

performance. Geneva: World Health Organization; 2000. Available from: URL:

http://www.who.int/entity/whr/2000/en/whr00_en.pdf

Health Information System Syllabus by HEC

Learning Outcomes:
After studying this course, you should be able to:
 To familiarize the students with the basic concepts of health MIS
 To expose the students to the health information data collection, analysis
and interpretation techniques
 To provide the stakeholders basic vital/health information for decision
making
Course Contents:
1. Introduction to Health MIS
2. Contribution of Information technology
 The strategy network in Health Care organizations
 Information strategy related to Enterprise and organizational strategies
1. Organizational Accountability
 Integration of clinical strategy with business strategy
 Information strategy ; Clinical Decision support system
 Aligning information strategy with clinical strategy
2. Information Strategy empowers organizational strategy, Managing data,
Information and Knowledge
3. Information strategy ; Managing information resources
4. Investing in Information technology
5. Managing Information technology services
6. Information Security and ethics
7. Building Health care Information infrastructure
Recommended Readings:
1. Gordon. D Brown, Tamara T. Stone, Timothy B Patrick - Strategic
management of Information systems in Health care (BK-1)

MPH-810: HealthEducation, communication skills

39
 School Health services

(Health Education and Health Promotion)

Course Title: Health Education, communication skills and school health services ( Health education and
Health promotion)

Course Credit:3

Introduction:

Pakistan is in the transitional phase of development with the issues of the fast changing

paradigms in the face of small expenditure on health. Faced with the fact that the health

problems are immense, health promotion is an important intervention to change behaviours

and attitudes of people to deal with largely preventable health problems. It needs the input

in the form of proper planning, implementation and evaluation of Health Promotion

Programmes and projects. Health Promotion is considered as the continuation of the skills

already learnt in the earlier courses.

Learning Goal:

Reorient the students to turn them into health promotion specialists and communicators.

Learning Objectives:

By the end of the course participants should be able to

1. Describe the major approaches to the promotion of health, including the underlying

theories and procedures used in evaluating them.

2. Design a health promotion campaign.

3. Describe the basic principles of behavior change and management, the scientific, social,

cultural and economic bases of health promotion, as well as the political and ethical

issues that affect health promotion activities.

4. Demonstrate the communication skills which public health specialists be called upon to

play in Health Promotion

Contents:

The following areas will be covered during the course:

40
1. Introduction to Health Promotion and Education

Health promotion

Risk transition

Ottawa Charter

Adelaide, Sundsval, Jakarta and Mexico, Bangkok conferences

MPH PROGRAMME

73

Life course perspective

World Health Report 2002

2. Health perspectives and reflections

Health as a continuum

Approaches to Health Education

Orientations for health education

3. Evidence-based Health Promotion and Planning

Principles of Health Promotion

Hierarchy of evidence

Outcome model of Health Promotion

A new evidence paradigm

Health A new evidence paradigm

4. Health Promotion theoretical perspectives

Ecological Models

Community theories

Diffusion of innovations

Community organization theory

Organizational change theory

Interpersonal

Social learning theory

Social cognitive theory

41
Individual

Trans theoretical model / Stages of change model

Health belief model

Consumer information processing Model

5. Models of Health Promotion

Aims of Health Promotion

Towards a more integrated model

Tanahills Model

6. Models of Health Promotion Planning

PRECEDE-PROCEDE

MPH PROGRAMME

74

Social Marketing

Logic Model

7. Health Communication

Types and levels

Principles of effective communication

Message

Audience

HEALTHCOMS 5 step methodology

CDC’s Health Communication Wheel

“A” frame of advocacy

7 C’s of effective communication

“P” process

Health Communication campaign

Planning a comprehensive health communication campaign

8. Steps of the comprehensive health communication campaign

Steps of the comprehensive health communication campaign

42
9. Social Marketing

10. Evaluating Health Promotion Programs

Stages of research and evaluations for Health Promotion programs

Best practices in health promotion

Skills for evaluation

Steps off evaluation process

Teaching Methodology:

Teaching is carried out in form of didactic and participative lectures and individual and

group exercises. The participants are supposed to complete a supervised class assignment

i.e. a mini project based on the PRECEDE-PROCEDE framework which entails fieldwork.

Recommended Readings:

1. Elder JP. Behavior change and public health in the developing world. Thousand Oaks,

CA; SAGE; 2001.

2. Ewles L, Simmett I. Promoting health: a practical guide, third edition. London: Scutari

Press; 1995.

MPH PROGRAMME

75

3. Green LW, Kreuter MW. Health promotion planning: an educational and environmental

approach, second edition. Mountain View, CA: Mayfield Publishing Company; 1991.

4. Naidoo J, Wills J. Health promotion: foundations for practice, 2nd ed. London: Bailliere

Tindall; 1994.

5. Rogers EM, Kincaid DL. Communication networks: towards a new paradigm for

research. New York, NY: The Free Press; 1981.

6. Rogers EM. Diffusion of innovations, third edition. New York, NY: The Free Press; 1983.

7. Valente TW. Evaluating health promotion programs. New York, NY: OxfordUniversity

Press; 2002.

8. World Health Organization. Education for health: a manual on health education in

primary health care. Geneva: World Health Organization; 1988.

43
Students’ Evaluation:

Formative (20%)

Ongoing assessment through class participation, class exercises and individual

assignments, i.e. developing a health promotion programme using PRECEDE-PROCEDE

framework.

Summative Assessment (80%)

Summative assessment consist of: MCQs and Short essay questions

MPH PROGRAMME76

MPH-813: Seminars, Presentations and Field visits

Course title: Seminars, Presentations and field visits

Course credit: 3

SEMESTER -3

MPH-813: Nutrition
Course Title: Nutrition

Course Credit: 3

Introduction:

It is essential that the students of Public Health understand the importance of absence ofgood nutrition as a
measure of physical, social and economic indicators of health anddevelopment of a country. There is a need
to comprehend the role of good nutrition indevelopment and maintenance of a healthy body. This will help in
the identification ofcommon nutritional disorders at individual levels and also in advising mothers in
mattersrelated to nutrition during periods of stress and for the optimal growth of the youngchildren.

Learning Goal:

44
The goal of this course is to create a group of trainees well-equipped in handling nutritional

problems at community and hospital level, enabling them to understand the fundamentals

of nutrition, nutritional deficiencies, preventing and managing nutritional problems in the

community and hospital.

Learning Objectives:

At the end of the module, the trainee should be able to:

1. List the types of foods and the nutritional requirements of the children, mothers and

people of old age.

2. Write a nutritional prescription for a child at different ages and the mothers.

3. Describe the nutritional requirements of the infants and young children.

4. List the nutritional requirements of Mothers during pregnancy and lactation.

5. Describe the nutritional aspects of human milk.

6. Define and Perform nutritional assessment of young children

7. Describe the nutritional effects on growth

8. Examine the development of growth charts and define their uses

9. Plan and perform nutritional surveillance using various indicators.

10. Define nutritional surveillance, indicators and methods.

11. Analyze nutritional data using EPINUT/Nutrisurvey.

12. Counsel mothers on infant feeding

13. Counsel mothers with malnourished child in problem solving in the community and the

hospital.

14. Identify common micronutrient deficiencies, management and prevention

15. Describe common nutritional problems (deficiency or excess of nutrients) and their

management and their prevention.

16. Carry out field visit to a restaurant and describe the food sanitation etc.

17. Write a report on field work and make a presentation of their work for critical appraisal.

45
Contents:

The following are the contents of the course:

A. Normal nutrition

1. Fundamental elements of human nutrition

2. Nutrition during growth and health

3. Nutritional requirements of neonates and infants 0-6 months

4. Nutrition requirements of infants 6-12 months

5. Nutrition requirements of children 1-5 years

6. Nutrition requirements of children 5-12 years

7. Nutrition requirements during physiological stress

8. Nutrition requirements of Adolescents

9. Nutrition requirements during Pregnancy

10. Nutrition requirements during Lactation

11. Household food safety

B. Assessment of Growth and Nutritional status of children:

1. Nutritional status: its assessment by field techniques

2. Nutritional status: Its assessment through anthropometry

3. Using Growth Charts as primary health care tool

4. Nutritional Prescription for children

5. 6-12 months of age

6. 12 months - 5 years of age

7. 5 - 12 years of age

8. Nutritional prescription of the mothers during normal health, pregnancy and

lactation

C. Human Milk and its importance:

1. Optimal Breastfeeding Practices

2. Advantages of breastfeeding and dangers of bottlefeeding

46
3. Exclusive breastfeeding

4. Complementary feeding

5. Perceived insufficiency of breastmilk/Lactation failure

6. Promotion and support of breastfeeding

7. Management of lactation problems

D. Malnutrition

1. Classification of Malnutrition

2. Causes of Malnutrition

3. Risk factors and their assessment

4. Management of Malnutrition

5. Clinical Assessment of Malnutrition

6. Protein energy malnutrition: Marasmus, PEM, Kwashiorkor

7. Micronutrient Deficiencies

8. Nutrition during special circumstances

9. Establishing a Lactation Management clinic

E. Health Education in Nutrition

1. Communication skills

2. Nutritional counselling

3. Nutritional and social rehabilitation

F. Monitoring and Evaluation of nutrition intervention programmes

1. National Nutrition Programmes

2. National Nutrition Surveys

3. Nutrition in IMCI

4. Breastfeeding Policy (International Code for Breastfeeding)

5. Expanded Programme for childhood illnesses and Nutrition

47
6. IDD control programme

G. Nutrition for children living in special situation:

1. Poverty

2. War

3. Natural calamities

4. HIV/AIDS

5. Food safety

6. Storage and Preservation of Foods at local and industrial level

Teaching Methodology:

Lectures, interactive teaching using problem-based learning/discussions, tutorials, seminars

and discussions, assignments and field work, using computer softwares, Practical Skills in

the community and hospital, Clinical Ward assignments.

Recommended Reading:

1. Allen LH. Nutritional influences on linear growth: a general review, Eur J ClinNutr

1994;48(suppl 1): 75-89.

2. Ashraf RN, Jalil F, Khan SR, Zaman S, Karlberg S, Lindblad BS, HansonLÅ. Early child

health in Lahore, Pakistan: V. Feeding patterns. ActaPaediatr 1993;390(suppl.): S48-62.

3. Ashraf RN, Jalil F, Zaman S, Karlberg J, Khan SR, Lindblad BS, Hanson LÅ. Breast

feeding and protection against neonatal sepsis in a high risk population. Arch Dis Child

1991;66:488-90.

4. Atkinson SA, Hanson LA, Chanrdra RK (eds.). Breastfeeding, nutrition, infection and

infant growth in developed and emerging countries.Newfoundland, Canada: ARTS

Biomedical Publishers and Distributors; 1990.

5. Brown KH, Black RE, Lopez de Romana G, Creed de Kanashiro H. Infant feeding

practices and their relationship with diarrhoeal and other diseases in Huascar (Lima),

48
Peru. Pediatr 1989;83:31-40.

6. Cohen RJ, Brown KH, Canahuati J, Rivera LL, DeweyKG. Determinants of growth from

birth to 12 months among breast fed Honduran infants in relation to age of introduction

of complementary foods, J Pediatr 1995;96:504-10.

7. de Onis M, Blössner M. World Health Organization Global Database on Child Growth

and Malnutrition. Geneva: Programme of Nutrition, World Health Organization; 1997.

Available from: URL:

http://www.who.int/nutgrowthdb/database/en

8. Dewey KG, Heinig MJ, Nommsen LA, Peerson JM, Lonnerdal B. Breastfed infants are

leaner than formula-fed infants at 1 year of age: the DARLING study. Am J ClinNutr

1993;57: 140-5.

9. Dewey KG. Infant nutrition in developing countries: what works [comment]? Lancet,

2005 28-Jun 3;365: 1832-4.

10. Diaz S, Herreros C, Aravena R, Casado ME, Reyes MV, Schiappacasse V. Breast feeding

duration and growth of fully breast fed infants in a poor urban Chilean population. Am J

ClinNutr 1995;62:371-6.

11. Gross R, Kielmann A, Korte R, Schoeneberger H, Schultink W. Guidelines for nutrition

baseline surveys in communities. Jakarta: SEAMEO, TROPMED, GTZ; 1997.

12. Hanson L, Ashraf R, Zaman S, Karlberg J, Khan SR, Lindblad B, et al. Breastfeeding is a

natural contraceptive and prevents disease and death in infants, linking infant mortality

and birth rates. Acta Paediatr1994 Jan;83:3-6.

13. Hanson LÅ, Ashraf R, Zaman S, Karlberg J, Lindblad BS, Jalil F. Breast feeding is a

natural contraceptive and prevents disease and death in infants, linking infant mortality

and birth rates. ActaPaediatr 1994;83:3-6.

14. Hanson LÅ, Carlsson B, Jalil F, Hahn-Zoric M, Karlberg J, Mellander L, Khan SR,

Murtaza A, Thiringer K, Zaman S. Antiviral and antibacterial factors in human milk. In:

HansonLÅ (ed.). The biology of human milk, vol. 15. New York, NY:Néstle Nutrition

Workshop Series, Raven Press; 1989. p. 141-157.

49
15. Hanson LÅ, Carlsson B, Zaman S, Adlerberth I, MattsbyBaltzer I, Jalil F. The importance

of breastfeeding in host defense: production of the milk antibodies and the antiinflammatory

function of human milk. Pak Paed J 1992;XV: 155-164.

16. Hanson LÅ, Silfverdal SA, Stromback L, Erling V, Zaman S, Olcen P, Telemo E. The

immunological role of breast feeding. Pediatr Allergy Immunol 2001;12Suppl 14:15-9.

17. Hanson LÅ. Immunobiology of human milk:how breastfeeding protects babies.

Amarillo, TX, USA: PharmasoftPubl; 2004.

18. Karlberg J, Ashraf RN, Saleemi MA, Yaqoob M, Jalil F. Early child health in Lahore,

Pakistan: XI. Growth.ActaPaediatr 1993;390 (suppl):119-49.

19. Karlberg J, Zaman S, HansonLÅ, KhanSR, LindbladBS, JalilF. Aspects of infantile growth

and the impact of breastfeeding: a case control study of the infants from four

socioeconomically different areas in Pakistan.HumLactat 1990;4: 219-47.

20. Pakistan Demographic and Household Survey, 1990-1994. Pakistan Institute of

Population studies and Govt of Pakistan, 1994.

21. Pelto GH, Santos I, Goncalves H, Victora CG, Martines J, HabichtJP.Nutrition

counseling training changes physician behavior and improves caregiver knowledge

acquisition. J Nutrruary 2004; 134: 357–362.

22. Penny ME, Creed-Kanashiro HG, Robert RC, Narro MR, Caulfield LE, Black RE.

Effectiveness of an educational intervention delivered through the health services to

improve nutrition in young children: a cluster-randomised controlled trial. Lancet 2005

28-Jun 3;365: 1863-72.

23. Saleemi MA, Ashraf RN, Mellander L, Zaman S. Determinants of stunting at 6, 12, 24

and 60 months and postnatal linear growth in Pakistani children. ActaPaediatr

2001;90:1304-8.

24. Tulchinsky TH, El Ebweini S, Ginsberg G, Abed Y, Montano-Cuellar D, Schoenbaum M,

et al. Growth and nutrition patterns of infants associated with a nutrition education and

supplementation program in Gaza, 1987-92. Bull WHO 1994;72:869-75.

25. Victora CG, Smith PG, Vaughan JP, Nobre LC, Lombardi C, Teixeira AM, et. al. Evidence

50
for protection by breast-feeding against infant deaths from infectious diseases in Brazil.

Lancet 1987 8;2:319-22.

26. Victora CG, Smith PG, Vaughan JP, Nobre LC, Lombardi C, Teixeira AMB, et. al.

Evidence for protection by breastfeeding against infant deaths from infectious diseases

in Brazil. Lancet 1987;2:319-21.

27. WHO Collaborative Study Team. Effect of breastfeeding on infant and child mortality

due to infectious diseasesin less developed countries: a pooled analysis, Lancet

2000;355:451-55.

28. World Health Organization, UNICEF. Global strategy for infant and young child

feeding. Geneva: World Health Organization; 2003. Available from: URL:

http://www.who.int/child-adolescenthealth/

New_Publications/NUTRITION/gs_iycf.pdf

29. World Health Organization. Effect of breastfeeding on infant and child mortality due to

infectious diseases in less developed countries: a pooled analysis. WHO Collaborative

Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. Lancet

2000 5;355:451-5.

30. World Health Organization. Management of severe malnutrition: a manual for

physicians and other senior health workers. Geneva: World Health Organization; 1999.

Available from: URL:

http://whqlibdoc.who.int/hq/1999/a57361.pdf

31. World Health Organization. Management of the child with a serious infection or severe

malnutrition: guidelines for care at the first-referral level in developing countries.

Geneva: Department of child and adolescent health and development, World Health

Organization;2000. WHO document WHO/FCH/CAH/00.1. Available from: URL:

http://www.who.int/child-adolescenthealth/

publications/referral_care/Referral_Care_en.pdf

32. World Health Organization. Measuring change in nutritional impact of supplementary

feeding programme for vulnerable groups. Geneva: World Health Organization; 1983.

51
33. Zaman S, Jalil F, Saleemi MA, Mellander L, Ashraf RN, Hanson LÅ. Changes in feeding

patterns affect growth in children 0-24 months of age living in socioeconomically

different areas of Lahore, Pakistan. AdvExp Med Biol 2002;503:49-56.

Students’ Evaluation:

Formative (20%)

Ongoing assessment through class participation and class exercises

Summative Assessment (80%)

Summative assessment consist of: MCQs and Short essay questions

MPH-815: Hospital Management& Hospital Attachment

Course Title: Hospital Management& Hospital attachment

Course Credit: 3(2-1)

Introduction:

In the developing countries, the situation becomes even more intimidating as the hospitals

have lesser space, equipment, hospital staff and are frequently overwhelmed and

overcrowded. A more sensitive delivery of care in a more therapeutic environment can

benefit patients and have a positive bottom-line impact on healthcare institutions. Poor

Quality of Hospital Services has been a major problem for Public sector hospitals in

Pakistan. One of the main contributors of the poor quality of hospital services, apparent to

patients and staff alike, is the inefficiency of hospitals’ management and its operations.

Ninth five plan of Pakistan (1999-2003) has documented that there are large variations in the

utilization of hospital services and that at present there are no quality control mechanisms in

52
place within hospital sector, as a result, the public hospitals are generally perceived to be of

low quality.

Learning Goal:

The goal of the course is to enhance the participants’ knowledge regarding management and

other issues faced by hospital managers and to develop their skills to address the managerial

and administrative issues of Public and Private sector hospitals at all levels.

Learning Objectives:

By the end of the course the participants will be able to:

1. Describe the management of hospitals in public and private sectors.

2. Describe the functional departments of a hospital.

3. Apply the management functions such as planning, organizing, staffing and controlling

in hospitals.

4. List out the problems that are being faced by hospitals in implementing effectively these

management functions.

5. Describe the expected role of hospital in the community.

6. Apply the principles and practice of Hospital Management.

7. Construct budgets, financial costing and cost effectiveness of the hospital services.

92

MPH PROGRAMME

8. List the requirements for efficient management of hospital services and utilities like x-

rays, laboratory and indoor facilities.

9. Establish the concept of total quality management in health services.

10. Describe the dynamics of a Hospital as an Organization and the Corporate nature of a

Hospital.

11. Address efficiency issues in the management of a hospital through its resources.

12. Explore possible options for Cost Containment and profitability.

Contents:

53
The contents of the course are as follows:

1. Hospital System and its Role, Components of a Hospital System & Role of Hospitals in

PHC

2. Vision, Mission, Goals and Values of a Hospital

3. Role and Functions of Hospital Managers

4. Hospital Services Management

Nursing Management

Change Management

Infrastructure Management

5. Inventory Management

6. Drugs Management in Hospitals-I and II

7. Human Resource Management

8. Financial Management

Accounting rules and practices in a public & Private Hospital

Financial Management

Hospital Financing for Sustainability

Cost Containment, cost effectiveness and profitability

Costing and Cost implications of Hospital Services

9. RAP Tool

Introduction to Rapid Appraisal Tool for assessment of Emergency of a Hospital

Data Collection in Hospitals using RAP Tool

10. Preparing a Hospital Budget

11. Hospital Waste Management and infection control93

MPH PROGRAMME

Hospital Environment & Hospital Waste Management

Hospital Environment-related issues: lighting, ventilation, Cleanliness and tidiness,

horticulture and

54
greenery, Clean, regular and safe water supply, standards of

personal hygiene, Control measures for hospital associated infections

12. Accident & Emergency /Trauma Management Services

13. Human Resource Management

Human Resource Development: current status and future challenges

14. Infrastructure Management

Hospital Planning and Design

TQM and Medical Audit of the Hospital.

Total Quality Management: key concepts and Introduction to some basic tools of

TQM

Hospital Purchasing Process

Hospital Purchase, Tendering and Processing

15. Hospital Ethical Concerns

Teaching Methodology:

A combination of various teaching methods such as lectures, individual and group exercises,

group presentations, Field visits to Private and Public Hospitals will be used.

Recommended Readings:

1. Barnum H, Kutzin J. Public hospitals in developing countries: resource use, cost,

financing.Baltimore, MD: JohnsHopkinsUniversity Press; 1993.

2. Blanchet KD, Switlik MM. The handbook of hospital admitting management. USA:

Aspen Publications; 1985.

3. Goel SL, Kumar R. Management of hospitals. New Dehli, India: Deep and Deep

Publications; 2002.

4. King M, Lapsley I, Mitchell F, Moyes J. Activity based costing in hospitals: a case study

investigation. London, UK: Chartered Institute of Management Accountants; 1994.

5. McMahon R, Barton E, Piot M, Gelina N, Rose F. On being in charge. Geneva: World

Health Organization; 1992.

6. PrekerAS, Harding A (eds.). Innovations in health service delivery: the corporatization

55
of public hospitals, vol. 1. WashingtonDC: World Bank; 2002.

94

MPH PROGRAMME

7. Shepard DS, Hodgkin D, Anthony Y. Analysis of hospital costs in developing countries:

a manual for managers. Waltham, MA: Institute for Health Policy, BrandeisUniversity;

1997.

8. Willan JA. Hospital management in the tropics and subtropics. London, UK: Macmillan

Education Ltd, 1990.

9. World Health Organization. The hospital in rural and urban districts: report of a WHO

study group on the functions of hospitals at the first referral level. World Health Organ

Tech Rep Ser. 1992;819:1-74.

Students’ Evaluation:

Formative (20%)

Ongoing assessment through class participation and class exercises

Summative Assessment (80%)

Summative assessment consist of: MCQs and Short essay question

MPH-817: Social & Behavioural sciences in Public Health

Course title: Social & Behavioural sciences in Public Health

Course Credit: 3

Introduction:

Psycho-social-cultural and political structures of society affect different spheres of public

health, including the type and distribution of illness and disease. They also determine

modes of intervention used in the prevention of illness, disease, and injury as well as the

organization of health services at the national, international, and community levels.

Learning Goal:

56
The goal of this course is to introduce the MPH participants to the various facets of the

public health in light of the social determinants of health. The main emphasis is on a holistic

view keeping under consideration the social, cultural, ecological, political and economic

factors and their mutual interaction that influences the occurrence of disease and its

management at individual and community level.

Learning Objectives:

By end of the course the participants should be able to:

1. Explain key concepts in the social and behavioural aspects of public health: culture,

race/ethnicity, gender, poverty/disparities,

2. Describe the factors related to behavior change, community, organizational climate and

family structure

3. Demonstrate understanding of the social determinants of health

4. Describe how social determinants influence population health

5. Critically assess the relevance of ethics in public health

Contents:

The following areas will be covered during the course:

1. Role of Social Sciences in Public Health

2. Equity in health care

3. Politics of Health

4. Gender and Health

5. Socio-cultural factors and their impact on health

MPH PROGRAMME

6. Economics and Health

7. Health impact of rapid economic change

8. Role of Civil Society in Health Care

9. Community participation in Health Care

10. Ethics in Public Health

57
11. Public Health and Law

12. Social Policy and Health of Population

Teaching Methodology:

Teaching will be carried out in the form of didactic and interactive lectures and discussions

as well as individual assignments.

Recommended Readings:

1. Anand S, Fabienne P, Sen A. Public health, ethics, and equity, 1st ed. London, UK:

Oxford University Press; 2004.

2. Baldock J, Manning N, Miller S, Vickerstaff S (eds.). Social policy, 3rd ed. Oxford: Oxford

University Press; 1999.

3. Bury M, Gabe J (eds.). The sociology of health and illness: a reader. London, UK:

Routledge; 2004.

4. Danis M, Clancy CM, Churchill LR. Ethical dimensions of health policy. London, UK:

OxfordUniversity Press; 2002.

5. Detels R, McEwen J, Beaglehole R, Tanaka H, (eds.). Oxford textbook of public health:

the practice of public health, 4th ed. Oxford: Oxford University Press; 2002.

6. Doyal L. Gender equity in health: debates and dilemmas. SocSci Med. 2000;51: 931-9.

7. Evans T, Whitehead M, Diderichsen F, Bhuiya A, Wirth M. Challenging inequities in

health from ethics to action. New York, NY: OxfordUniversity Press; 2001.

8. Gostin LO (ed.). Public health law and ethics: a reader. California: University of

California Press; 2002.

9. Hawe P, Shiell A. Social capital and health promotion: a review. SocSci Med. 2000;51:

871-885.

10. Hertzman C, Siddiqi A. Health and rapid economic change in the late twentieth century.

SocSci Med. 2000;51: 809-19.

MPH PROGRAMME

11. Lloyd SP. Population ageing in developed and developing regions: implications for

58
health policy. SocSci Med. 2000;51: 887-895.

12. Tangcharoensathien V, Harnvoravongchai P, Pitayarangsarit S. Kasemsup V. Health

impacts of rapid economic changes in Thailand. SocSci Med. 2000;51: 789-807.

13. Zakus JD, Lysack CL. Revisiting community participation. Health Policy Plan. 1998;13: 1-

Students’ Evaluation:

Formative (50%)

Ongoing assessment through class participation and class exercises

Summative Assessment (50%)

Summative assessment consists of: MCQs and short essay questions.

MPH PROGRAMME

MPH-819: Reproductive Health& MCH

Course Title: Reproductive Health& MCH

Course Credit: 3

Introduction:

Although the economic condition of Pakistan is improving, the health indicators almostremain stagnant with
infant mortality at 76/1000 live births and maternal mortality at 250-340/100,000 live births. One third of
childbearing aged women have an unmet need forcontraception. The country is faced with many problems in
the social and health sectors.The social marginalization of women is reflected not only in their limited
opportunities foreducation and income but also in the health indicators. Not only are mother and
infantmortality rates very high, malnutrition and infectious diseases are particularly widespreadamong
women. This core course provides information on the reproductive health problemsof women and men and
possible solutions.

Learning Goal:

The goal of this course is to enable the students to have the knowledge and skills to address

and provide solutions for a better reproductive health.

59
Learning Objectives:

By the end of the course, the students will be able to:

1. Describe the current reproductive health issues for women and men

2. Identify underlying causes and cross-linkages to different reproductive health outcomes

3. Address the need for improving women’s health status through a multi-dimensional and

inter-sectoral approach, and

4. Construct, design and apply appropriate interventions to address these concerns.

Contents:

The following areas will be covered during the course:

1. Basic concepts and landmark events related to reproductive health and its evolution

Introduction to the course: Historical background of RH

Life course perspective to RH

ICPD, post ICPD, Beijing + 10

Safe Motherhood and Continuum of Care

2. Reproductive behavior in Pakistan

3. Contraception as a preconceptional health intervention

4. Abortion as a public health issue

5. Antenatal and obstetricalcare models

Determinants of maternal mortality

Measurement of maternal mortality ratio and rates.

Obstetrical care (EOC, EmOC, BOC)

Unmet obstetrical need

Delays in obstetrical care provision

Integrated approach to newborn care

6. RH needs of special populations

RH issues of adolescents and young adults

RH needs of and issues for men

Role of males in Safe Motherhood

60
7. Diseases of public health importance in RH, e.g.,

Cancers of reproductive tract, STIs etc

Cancers of breast

Sexually transmitted infections

HIV AIDS

8. Health systems issues, e.g.

Access to services at various levels

Role of the district health system in reproductive health

Role of the tertiary care hospital in reproductive health

Primary health care and reproductive health including community basedinterventions

9. Cross cutting themes, e.g., research, monitoring and evaluation, quality of care

Evidence-based reproductive health interventions

Quality of care in RH

Integrated approach to provision of reproductive health services

Beyond numbers: Determinants of maternal mortality

Socio-economics of Reproductive health care.

10. Data sources in reproductive health:

Websites

Reports, surveys and publications focusing on RH

RH programs at the district level by UNFPA

MIS in reproductive health

Teaching Methodology:

Lectures, discussions, readings, group work, assignments, field trip, plenary,

Recommended Readings:

1. Abou-Zahr CL, Wardlaw TM. Antenatal care in developing countries: promises

achievements and missed opportunities:an analysis of trends, levels and differentials,

61
1990-2001.Geneva: World Health Organization; 2003. Published jointly by WHO and

UNICEF. Available from: URL:

http://www.who.int/reproductive-health/docs/antenatal_care.pdf

2. Askew I, Berer M. The contribution of sexual and reproductive health services to the

fight against HIV/AIDS: a review. Reprod Health Matters. 2003;11: 51-73.

3. Aubel J, Toure I, DiagneM.Senegalese grandmothers promote improved maternal and

child nutrition practices. SocSci Med. 2004;59:945-59.

4. Bale JR, Stoll BJ, Lucas AO. Improving birth outcomes: meeting the challenge in the

developing world. Washington, DC: National Academies Press; 2003.

5. Bertrand JT, Magnani RJ, Knowles JC. Handbook of indicators for family planning

program evaluation. Chapel Hill, NC: The Evaluation Project; 1994. Available from:

URL: http://www.cpc.unc.edu/measure/publications/pdf/ms-94-01.pdf

6. BlancAK, Curtis SL, Croft TN. Monitoring contraceptive continuation: links to fertility

outcomes and quality of care. Stud FamPlann. 2002;33: 127-40.

7. Bobadilla JL. Evaluation of maternal health programs: approaches, methods and

indicators. Int J Gynaecol Obstet. 1992;38 (suppl.):S67-73.

8. Bruce J. Fundamental elements of quality of care: asimple framework. Studies in Family

Planning 1990:21; 61-91.

9. Cleland J, Ali MM. Reproductive consequences of contraceptive failure in 19 developing

countries. Obstetrics &Gynecology 2004;104:314-320. Available from: URL:

http://www.greenjournal.org/cgi/reprint/104/2/314.pdf

10. Cleland JG, Boerma JT, Carael M, Weir SS. Monitoring sexual behavior in general

populations: a synthesis of lessons of the past decade. Sexually Transmitted Infections,

2004;80 (2 suppl.): ii1-7.

11. Creswell JW, Fetters MD, Ivankova NV. Designing a mixed methods study in primary

care. Annals of Family Medicine 2004;2: 7-12.

12. Davies J. The reproductive health staircase. NGORC Journal 2004;5: 21. Available from:

URL: http://www.ngorc.org.pk/journal/Archive/Journal-Mar2004.pdf

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13. Douthwaite M, Ward P.Increasing contraceptive use in rural pakistan: an evaluation of

the lady health worker program. Health Policy Plan. 2005;20: 117-123.

14. GeyoushiBE, Matthews Z, Stones RW. Pathways to evidence-based reproductive health

care in developing countries. BJOG: An International Journal of Obstetrics &

Gynaecology 2003;110: 500-507.

15. Gillespie DG. Whatever happened to family planning, and, for that matter, reproductive

health? IntFam Plan Perspect. 2004;30: 34-8. Available from: URL:

http://www.guttmacher.org/pubs/journals/3003404.html

16. John Snow, Inc. Safe motherhood indicators:lessons learnt in measuring progress.

MotherCare Matters – A Quarterly Newsletter and Literature Review on Maternal and

Neonatal Health and Nutrition 1999:8: 1-26. Available from: URL:

http://mothercare.jsi.com/pubs/mcmatters/pdf/Vol8%201.pdf

17. Johnston HB and Hill K. Induced abortion in the developing world: indirect estimates.

Inter FamPlannPersp 1996; 22: 108-114. Available from: URL:

http://www.guttmacher.org/pubs/journals/2210896.pdf

18. Khalil L, Roudi-Fahimi F. Making motherhood safer in Egypt (MENA Policy Brief).

Washington, DC: Population Reference Bureau; 2004. Available from:

URL:http://www.prb.org/pdf04/MakMotherSaferEgypt_Eng.pdf

19. Koblinsky M. Essential obstetric care and subsets - basic and emergency obstetric care:

what's the difference? MotherCare Policy Brief #1. Arlington, VA: John Snow, Inc.; 1999.

Document no. M750. Available from: URL:

http://www.jsi.com/intl/mothercare/pubs/PolicyBriefs/policy_brief1.htm

20. Koblinsky M. Safe motherhood indicators - measuring progress. MotherCare Policy Brief

#2. Arlington, VA: John Snow, Inc.; 1999. Document no. M751. Available from: URL:

http://www.jsi.com/intl/mothercare/pubs/PolicyBriefs/policy_brief2.htm

21. Koblinsky MA, Campbell O, Heichelheim J. Organizing delivery care: what works for

safe motherhood? Bull World Health Organ. 1999;77: 399-406.

22. Koenig MA, Fauveau V, Chowdhury AI, Chakraborty J, Khan MA. Maternal mortality in

63
Matlab, Bangladesh: 1976-1985. Studies in Family Planning 1988;19: 69-80.

23. Lush L. Service integration: an overview of policy developments. International Family

Planning Perspectives, 2002;28: 71-76.

24. Marston C, Cleland J. The effects of contraception on obstetric outcomes. Geneva:Department of

Reproductive Health and Research, World Health Organization; 2004.Available from: URL:
http://whqlibdoc.who.int/publications/2004/9241592257.pdf

25. McCarthy J, Maine D. A framework for analyzing the determinants of maternalmortality. Studies in Family
Planning 1992;23: 23-33.

26. Medicam. Technologies appropriate and inappropriate. Safe Motherhood – A newsletter

of worldwide activity 1995;18.

27. Rashida G. Unwanted pregnancy and post-abortion complications in Pakistan: findings

from a national study. Islamabad, Pakistan: Population Council.AvailablefromURL:

http://bvs.insp.mx/temas/aborto/unwanted_pregnancy_and_postabortion_complicati

ons_in_pakistan.pdf

28. Seltzer JR. The origins and evolution of family planning programs in developingcountries. Santa Monica:
RAND; 2002.

29. Senlet P, Curtis SL, Mathis J, Raggers H. The role of changes in contraceptive use in the

decline of induced abortion in Turkey. Stud FamPlann. 2001 Mar;32: 41-52.

30. Shelton JD, Fuchs N. Opportunities and pitfalls in integration of family planning andHIV prevention efforts
in developing countries. Public Health Rep. 2004;119: 12-5.

31. Sibley L, Sipe TA, Koblinsky M. Does traditional birth attendant training improvereferral of women with
obstetric complications:areview of the evidence. SocSci Med.2004;59:1757-68.

32. Siddiqi S, Haq IU, Ghaffar A, Akhtar T, Mahaini R. Pakistan’s maternal and child health

policy: analysis, lessons and the way forward. Health Policy. 2004 Jul;69:117-30.

33. Sullivan TM, Bertrand JT (eds.). Monitoring quality of care in family planning by the

quick investigation of quality (QIQ) country reports. Chapel Hill:

CarolinaPopulationCenter, University of North Carolina; 2000. MEASURE Evaluation

and Technical Report Series, No. 5. Available from: URL:

http://www.cpc.unc.edu/measure/publications/pdf/tr-00-05.pdf

34. Thaddeus S, Maine D. Too far to walk: maternal mortality in context. SocSci Med.1994;38: 1091-110.

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35. The MEASURE Program. Investing in population, health and nutrition monitoring andevaluation: lessons
learned. MEASURE Evaluation Bulletin 2003;5. Available from: URL:

http://www.cpc.unc.edu/measure/publications/pdf/bu-03-05.pdf

36. TobinGA, Begley CM. Methodological rigor within a qualitative framework. Journal ofAdvanced Nursing
2004;48: 388-396. Available from: URL:

http://www.ruralhealth.utas.edu.au/gr/resources/docs/tobin-and-begley-rigour.pdf

37. Trussell J, Ellertson C, Stewart F, Raymond EG, Shochet T. The role of emergencycontraception. Am J
ObstetGynecol 2004;190(4 suppl.): S30-8.

38. UNAIDS. The public health approach to STD control: UNAID technical update (UNAIDbest practices
collection). Geneva: World Health Organization; 1998. Available from:URL:
http://www.who.int/entity/hiv/pub/sti/en/stdcontrol_en.pdf

39. UNDP, UNFPA, WHO, World Bank Special Programme of Research, Development andResearch Training in
Human Reproduction (HRP). WHO’s work in reproductive health:the role of the Special Programme. Progress
in Human Reproductive Research 1997;(42):

1-8. Available from: URL:

http://www.who.int/reproductive-health/hrp/progress/42/prog42.pdf

40. VargaCA.Pregnancy termination among south African adolescents. Studies in Family

Planning 2002;33: 283-98.

41. World Health Organization. Care in normal birth: a practical guide – report of atechnical working group.
Geneva: Division of Reproductive Health, World HealthOrganization; 1997. Document no.
WHO/FRH/MSM/96.24. Available from: URL:

http://www.who.int/reproductivehealth/publications/MSM_96_24/care_in_normal_b

irth_practical_guide.pdf

42. World Health Organization. Reproductive health strategy: to accelerate progress toward

the attainment of international development goals and targets. Geneva: World HealthOrganization; 2004.
Available from: URL: http://www.who.int/reproductivehealth/

publications/strategy.pdf

43. World Health Organization. Syndromic case management of sexually transmitteddiseases: a guide for
decision-makers, health care workers, and communicators. Manila,Philippines: WHO Regional Office for the
Western Pacific; 1997. Available from: URL:http://www.cadre.org.za/BAC/BACpdf/WHO_STD.pdf

Students’ Evaluation:

Formative (20%)

Ongoing assessment through class participation and class exercises

65
Summative Assessment (80%)

Summative assessment may consist of: MCQs and Short essay questions

MPH-821: Research methodology and synopsis writing

Course Title: Research methodology and synopsis writing

Course Credit: 3

Introduction:

This is an applied subject utilizing the knowledge and skills acquired in the first

session. This includes the learning of skills of critically assessing the published articles in

medical journals based on the knowledge acquired earlier. Applying the knowledge of

epidemiology and biostatistics, population dynamics, qualitative research methods,

computer skills and health systems analysis, the student will learn the development of a

research question, giving essential background, making statements for objectives, data

collection, analysis applying statistical methods using the computer skills and present their

readings and research projects for the third session.

Learning Goal:

The goal of this course is to create a critical mass of trained persons well-oriented in writing

a research proposals for the dissertations and funding purposes. It will also enable the

health professionals to critically comprehend the concepts and at the same time apply the

epidemiological and statistical methods to develop a research protocol making use of

computer statistical softwares and information technology.

Learning Objectives:

The learning issues relating to the above objectives are as follows:

66
1. The critical analysis of the published scientific paper will be used as baseline to start

with the concept of writing a proposal to enable the students to identify the scientific

requirements of medical writing and the various components of the paper.

2. (This will be critical reading of a published paper in context with the background,

objectives, aims, study designs, data collection tool and their validity, data presentation

and interpretation, in terms of discussion and conclusions. Statistical methods will be

assessed for their applications and validity. The citation and listing of references will

also be examined using the guidelines for critical assessment of scientific papers).

MPH PROGRAMME

The definitions of research and its uses and advantages will be highlighted in context

with its importance in health and disease.

The selection and prioritizing topic for research demands some underlying reasoning

which will be dealt with in this section requiring guidelines to select a topic.

3. Hands-on-training of the students will be made possible in searching for the relevant

literature using hand and web search.

Providing a background to the study will be worked at through exercises using

several examples.

4. Formulation of objectives needs clarity of logical thinking which can focus on the

scientific principals and, at the same time, covering the language issues.

5. Formulation of hypothesis is critical in terms of stating them in measurable terms.

6. Through definitions of objectives and hypothesis, the identification of variables and their

types will be worked at.

7. Once the objectives and variables are identified, the design of the study will be identified

67
based on the prior knowledge of basics in epidemiology.

8. Sampling techniques employed will be qualified appropriate to the objectives and the

study designs. Probability and non-probability techniques will be applied on different

scenario to appropriate their use in research.

9. Sample size estimation based on objectives and study designs will be done using various

statistical applications.

10. Construction of Proforma and questionnaire appropriate to the study objectives and

variables.

Validity of the measurements will be discussed for the documented variables.

Importance of self- and interviewer administered questionnaire.

Pre-testing the methodology of data collection

11. Outlining of the plan for data analysis will be carried out constructing dummy tables

and identifying appropriate statistical analysis.

12. Preparing of the work plan using the pattern of a Gantt chart.

13. Preparing budget and its justification for a proposal when seeking funding.

14. Writing the title of the study topic to include the study design, variables and statistical

analysis.

15. Abstract writing will be done according to different standards.

MPH PROGRAMME

16. Presentation of the project will be the final step

Contents:

Following are the contents of the course:

1. Principles of critical reading of a scientific paper

68
2. Definition of research

3. Importance of research in public health

4. Selection of topic for research

5. Literature Search using internet and library

6. Preparing the background for the proposal writing.

7. Parts of proposal writing.

8. Study design, sampling techniques, inclusion and exclusion criteria.

9. Methodology

10. Choosing the statistical techniques.

11. Reference writing

12. Abstract writing

13. Title writing for the proposals

Teaching Methodology:

Interactive discussions, exercises, group discussions/work and hands-on training

Recommended Reading:

Same as the Basic Epidemiology, Basic Biostatistics, Computer Applications in Public Health,and

Foundations of Qualitative Research courses. Additionally:

1. Abramson JH, Abramson ZH. Survey methods in community medicine, fifth edition.

Edinburgh: Churchill Livingstone; 1999.

2. Altman DG. Practical statistics for medical research. London: Chapman and Hall; 1991.

3. Bowling A. Research methods in health: investigating health and health services, 2nd ed.

Buckingham: Open University Press; 1997.

4. Campbell DT, Stanley JC. Experimental and quasi-experimental designs for research.

69
Boston, MA: Houghton Mifflin Company; 1966.

5. Hall GM. How to write a paper, 3rd ed. London: BMJ Publishing Group; 1996.

52

MPH PROGRAMME

6. Greenhalgh T. How to read a paper: the basics of evidence-based medicine, 2nd ed.

London: BMJ Publishing Group; 1997.

Students’ Evaluation:

Formative (20%)

Ongoing assessment through class participation and class exercises

Summative Assessment (80%)

Summative assessment consist of: MCQs and Short essay questions

MPH-823: Demography

(Population Dynamics)

Course Title: Demography (Population Dynamics)

Course Credits:3

Introduction:

Pakistan is currently going through demographic transition. This transition and the ultimate

effects of the same are needed to be understood and appreciated in terms of policy,

management and research. Not all health managers, policy makers and researchers know

various static and dynamic measures of populations. The country’s annual growth rate

implies effect on its economy and resources. Poverty, population growth and disease is the

vicious cycle that has to be addressed from a local perspective. Changing population

pyramids of the developed world also emphasize to look into a twenty year time for our

70
interventions in future for health.

Learning Goal:

The overall goal of this course is to impart basic knowledge and bring a change in attitude of

the participants towards major issues in population dynamics to enable them to do research

on some of these issues.

Learning Objectives:

By the end of the course, the participants must be able to:

1. Define demography, its tools and vital statistics.

2. Describe demographic transition and historical forces leading to the current situation

3. Explain population pyramid and different profiles of population pyramids

4. Interpret and compute different mortality and morbidity related measures

5. Compute and interpret different fertility related measures such as Crude Birth

Rate, Total Fertility Rate, Age Specific Fertility Rate, Net Reproduction Rate and

Doubling Time

6. Discuss the impact of population growth on development and health issues

7. Demonstrate knowledge and understanding of scientific, evidence based approaches to

the study of population issues.

8. Identify causes and consequences of population change and relate these to underlying

population dynamics.

MPH PROGRAMME

28

9. Demonstrate knowledge and understanding of demographic behavior in social and

policy context

Contents:

The contents of the course are:

1. Introduction to Population dynamics: Various static and dynamic measures of

populations

2. Population and Health: An introduction to Epidemiology

71
3. Visit to Federal Bureau of Statistics

4. Demographic perspective and basic demographic equations

5. Sources of data including census

6. Salient features of population pyramids

7. Concepts and theories of demographic transition

8. World population growth patterns and population momentum

9. Mortality & measures of mortality

10. Global burden of diseases

11. Fertility, natural increase and reproduction rates

12. Characteristics of Pakistani population and other countries

13. Migration and urbanization

14. Population, Poverty and Politics

15. Islam and family planning

16. Population growth and aging

17. Population Policy

Teaching Methodology:

1. Didactic class room instruction on multimedia and white board

2. Interactive discussions and experience exchange

3. Panel discussion

4. Assignment: Library/Internet

5. Role plays

MPH PROGRAMME

29

Recommended Readings:

1. Haupt A, Kane TT. Population handbook. Washington, DC: Population Reference

Bureau; 1997. Available from: URL:http://www.prb.org/pdf/PopHand book_ Eng .pdf

2. Palmore JA, Gardner RW. Measuring mortality, fertility and natural increase: a selfteaching

72
 SEMESTER -4
Dissertation Writing
SUBJECT: Dessertation writing
Practicum (On-the-job Assignment)
Course Title: Practicum (On-the-job Assignment)
Course Credit:6
Introduction:
Public health focuses on monitoring, achieving and improving the health of a
population and is practiced in a variety of settings. The public health professional
applies knowledge and skill from the core content areas of public health

(biostatistics, epidemiology, environmental health, health services management, and

social and behavioural sciences) to design, manage and evaluate solutions to public

health problems. Using the practicum (on-the-job assignment) as the “organizational

laboratory,” the Master of Public Health (MPH) student begins to develop the

necessary skill sets for becoming a successful public health professional. The

practicum is intended to develop direct understanding and experience in public

health or health promotion organizations, thereby exposing the student to

organizational cultures, management systems, operations and resources, programs

and services and target populations. Such knowledge, skills, abilities, and

experiences will continue to develop and grow as each student graduates and

becomes a life-long learner and practitioner of public health.

Learning Goal:

The goal of the practicum is to provide a structured and supervised opportunity for

the student to apply the theories, principles, knowledge and skills of public health

and health promotion, as learned in the classroom, in a practice setting. The practice

experience occurs in a carefully-selected health services organization approved by

the MPH Program Coordinator and is supervised by faculty and an immediate

supervisor/mentor. This takes into account the transition from education to

professional practice.

Learning Objectives:

73
The objectives of the practicum (on-the-job assignment)are to:

Provide a practice setting for the student’s application and integration of the core

public health knowledge.

MPH PROGRAMME•

Prepare the student with inter-disciplinary skills and competencies, including

leadership, communication, professionalism, cultural proficiency, program

planning and assessment and systems thinking.

Upon successful completion of this course, each student will be able to:

Leadership

• Create and communicate mutually-established project goals and objectives.

Communication

• Demonstrate the ability to give, solicit, and receive oral and written information.

Prepare relevant, integrated, and comprehensive written project report(s).

Use various communication methods and media to complete project activities.

Professionalism and Cultural Proficiency

• Demonstrate the ability to manage time and prioritize workload.

Display professionalism, sensitivity, and tact in an organizational/community

setting.

Interact productively with supervisors, colleagues, and community stakeholders.

Program Planning and Assessment

• Plan, manage, and monitor a project plan in order to meet established goals and

deadlines.

Prepare a written proposal for project approval from internal and external

sources.

Identify, collect, and analyze data for a practical public health issue or concern.

Systems Thinking

• Assess the roles and responsibilities within a public health organization.

74
Describe the interactions and inter-dependencies among various public health

organizations.

Demonstrate and integrate knowledge of core public health concepts into a

practice setting.

Evaluate methods of instruction and learning.

MPH PROGRAMME

Prerequisites and Requirements:

• Students must have completed all the course work and defended the dissertation

before registering for the practicum.

In consultation with the practice site or organization, the student must develop a

short, formal proposal of the work or project to be accomplished by the student

during the assignment.

The student will complete 160 hours of public health practicum experience with

the selected organization.

The student will write a well-constructed report (10 – 15 pages, excluding

appendices) detailing their experience, referencing and integrating core public

health knowledge.

The student will be evaluated by an immediate supervisor/mentor of the

participating organization.

Role of Immediate Supervisor/Mentor

• The immediate Supervisor/Mentor is responsible for the student’s learning

during the practicum.

The immediate Supervisor/Mentor serves as a role model for the student and

advises the student routinely.

The immediate Supervisor/Mentor periodically consults with responsible faculty

on the student’s progress.

The immediate Supervisor/Mentor completes a student evaluation form at the

75
end of the practicum.

Role of MPH Program Coordinator

The MPH Program Coordinator serves as the liaison between the student, the

immediate supervisor/Mentor, and the University. He/she assists in the selection of

participating organizations and maintains communication with the student and

immediate Supervisor/Mentor throughout the practicum. The MPH Program

Coordinator determines the completeness of assignments and assigns the course

grade.

MPH PROGRAMME

Course Evaluation

The course is graded on a Pass/Fail basis; the final grade will be determined by the

MPH Program Coordinator and will be based on each student’s performance on the

following criteria:

Evaluation Criteria

Immediate supervisor/Mentor/

Mentor Evaluation

Student Executive Summary and

Internship Report

Relative Weight

40%

60%

To demonstrate application of public health knowledge and skills, summarize

accomplishment of established goals, and assure accountability during the field

experience, each student intern is required to prepare and submit a report based on

the following format.

PRACTICUM (ON-THE-JOB ASSIGNMENT) REPORT

TITLE PAGE

76
EXECUTIVE SUMMARY

Concisely describes the practicum and the salient results and conclusions.

TABLE OF CONTENTS

1.0 INTRODUCTION

1.1 Problem or Issue (Statement of the public health problem(s) or issue(s))

1.2 Objectives (Learning/outcome Objectives)

1.3 Literature review/background (Review of the relevant literature (if any),

organizational context)

2.0 METHODS

2.1 Setting (Description of the site at which you did the practicum)

2.2 Oversight (The role(s) of your immediate Supervisor/Mentor(s))

2.3 Methods (methods used to achieve each project objective in 1.2)

MPH PROGRAMME

2.4 Timeline (outline of key project activities/dates)

3.0 RESULTS

4.0 DISCUSSION AND CONCLUSIONS

(Feel free to add any other relevant items or issues in any section of your report.)

77
78
guide to elementary measures. Honolulu: East-West Population Institute, East-

WestCenter; 1983.

3. Population Reference Bureau. World population: more than just numbers.

WashingtonDC: Population Reference Bureau; 1999.

Students’ Evaluation:

Formative (20%)

Ongoing assessment through class participation and class exercises

Summative Assessment (80%)

Summative assessment consist of: MCQs and Short essay questions

79