Community Medicine

1. NUR IZZATUL NAJWA BINTI
SHARUPUDDIN (036)

2. WHAT IS POVERTY ?
• It is a state of poor economical status, opposed
to richness
• The poor are those who are below poverty line
(BPL)
• Poverty impedes progress all factors of human
life :
– Housing
– Sanitation
– Getting health care services
– Dietary intake and etc.
• Resulting in increased in morbidity and mortality

3. CAUSES OF POVERTY

4. HOW TO MEASURE THE
SOCIOECENOMIC STATUS ?
• Based on three variables :
– Education
– Occupation
– Income
• Based on three methods
– BG Prasad’s method
– Kuppuswamy method
– Pareek’s method

5. BELOW POVERTY LINE (BPL)
• Its defined as a cut-off line of per capita
monthly income, below which it is not
possible to purchase food as to obtain
minimum desirable limit of energy ;
– 2400kcal per person per day in rural areas
– 2100 kcal in urban areas
• They fall below class V according to BG
Prasad’s

6. • Poverty also associated with social factors :
– Illiteracy
– Ignorance
– Lack of knowledge
– Poor living condition
– Overcrowding
– Blind beliefs, taboos
POVERTY SICKNESS

7. HEALTH HAZARDS OF POVERTY
•Water-borne disease
•Food- borne disease
•Respiratory disease
•STI’s including HIVs
COMMUNICABLE
DISEASE
•Malnutrition
•Anaemia
•Vitamin and mineral deficiency
NON-
COMMUNICABLE
DISEASE
•Prostitution
•Drug addiction
•Alcoholism
•Family disintegration
•Antisocial behaviour – beggary, violence, delinquency, terrorism
SOCIAL PROBLEM

8. • Depression
• Loneliness
• Inferiority complex
• Suicidal tendency
MENTAL
PROBLEMS
• Scabies
• Dental caries
• pediculosisOTHERS

9. POVERTY IN WORLD VIEW
– based on THE WORLDBANK GROUP
• According to the most recent estimates, in 2015, 10 percent of the world’s
population lived on less than US$1.90 a day, compared to 11 percent in 2013.
That’s down from nearly 36 percent in 1990.
• Nearly 1.1 billion fewer people are living in extreme poverty than in 1990. In 2015,
736 million people lived on less than $1.90 a day, down from 1.85 billion in 1990.
• While poverty rates have declined in all regions, progress has been uneven:
– Two regions, East Asia and Pacific (47 million extreme poor) and Europe and Central Asia
(7 million) have reduced extreme poverty to below 3 percent, achieving the 2030 target.
– More than half of the extreme poor live in Sub-Saharan Africa. In fact, the number of poor in
the region increased by 9 million, with 413 million people living on less than US$1.90 a day in
2015, more than all the other regions combined. If the trend continues, by 2030, nearly 9 out
of 10 extreme poor will be in Sub-Saharan Africa.
– The majority of the global poor live in rural areas, are poorly educated, employed in the
agricultural sector, and under 18 years of age.

10. Cont.
• The work to end extreme poverty is far from over, and many challenges
remain. The latest projections show that if we continue down a business-
as-usual path, the world will not be able to eradicate extreme poverty by
2030. That’s because it is becoming even more difficult to reach those
remaining in extreme poverty, who often live in fragile countries and
remote areas.
• Access to good schools, health care, electricity, safe water, and other
critical services remains elusive for many people, often determined by
socioeconomic status, gender, ethnicity, and geography.
• Moreover, for those who have been able to move out of poverty, progress
is often temporary: Economic shocks, food insecurity and climate change
threaten to rob them of their hard-won gains and force them back into
poverty. It will be critical to find ways to tackle these issues as we make
progress toward 2030

11. POVERTY IN INDIA

12. HOW THEY OVERCOME ? (IN INDIA)
BPL CARD (YELLOW CARD)
• Janani Suraksha Yojana (JSY) for pregnant mothers aged 19 years and
above
• National Maternity Benefit Scheme (NMBS) - provide better diet for
pregnant women
• Insurance of women workers
• Bhagyalakshmi scheme – Rs 10,000 deposit will be made for first two
female children, and will be returned with interest, after they attained 18
years old
• Social assistance – Old age pension scheme, more family benefit scheme,
widow pension scheme (should be 18years)
• Prasooti araike – promote antenatal care by giving Rs1,000 at 6th monthof
pregnancy and another Rs1,000 at 9th month, total of Rs2,000

13. WHAT IS INEQUALITY IN HEALTH ?
• Health inequalities
or disparities can
be defined as
differences in
health status or in
the distribution of
health
determinants
between different
population groups

14. DISPARITIES MEANS
UNEQUAL TREATMENT GIVEN TO THE PATIENTS
• Disparities are found even
– when clinical factors, such as stage of disease
presentation, co-morbidities, age, and severity of
disease are taken into account
– across a range of clinical settings, including public and
private hospitals, teaching and non-teaching hospitals,
etc.
• Disparities in care are associated with higher
mortality rates

17. SCENARIO OF INEQUALITY

19. How could well-meaning and highly educated
health professionals, working in their usual
circumstances with diverse populations of
patients, create a pattern of care that
appears to be discriminatory?

21. INEQUALITIES IN MALAYSIA
• Public- private dichotomy
• Human resources
• Health of marginalized population
• Escalation of health cost
• Consumer expectation

22. HOW TO OVERCOME POVERTY AND
INEQUALITY IN HEALTH ?
• Increase health care providers’ awareness of disparities.
• Legal, regulatory, and policy recommendations
– Avoid fragmentation of health plans along socioeconomic lines, and take measures to strengthen the
stability of patient-provider relationships in publicly funded health plans
• Health systems interventions
– Structure payment systems to ensure an adequate supply of services to minority patients
– Enhance patient-provider communication and trust by providing financial incentives for practices
that reduce barriers
• Education
– Patient education programs should be implemented to increase patients’ knowledge of how to best
access care and participate in treatment decisions.
• Data collection and monitoring
– Collect and report data on health care access and utilization by patients’ race, ethnicity,
socioeconomic status, and where possible, primary language
• Research

23. Sustainable Development Goals
(SDG)
• A universal call to action to end poverty, protect the
planet and ensure that all people enjoy peace and
prosperity.
• were born at the United Nations Conference on
Sustainable Development in Rio de Janeiro in 2012.
• The objective was to produce a set of universal goals
that meet the urgent environmental, political and
economic challenges facing our world.

24. • The SDGs replace the Millennium Development
Goals (MDGs), which started a global effort in
2000 to tackle the indignity of poverty.
• MDG achievements
– More than 1 billion people have been lifted out of
extreme poverty (since 1990)
– Child mortality dropped by more than half (since
1990)
– The number of out of school children has dropped by
more than half (since 1990)
– HIV/AIDS infections fell by almost 40 percent (since
2000)

25. • The SDGs came into effect in January 2016,
and they will continue to guide UNDP policy
and funding until 2030. As the lead UN
development agency, UNDP is uniquely placed
to help implement the Goals through our
work in some 170 countries and territories.

27. SUMMARY

28. REFERENCES
• COMMUNITY MEDICINE WITH RECENT ADVANCE, AH
SSURYAKANTHA
• https://www.worldbank.org/en/topic/poverty/overview
• https://www.healthknowledge.org.uk/public-health-
textbook/medical-sociology-policy-economics/4c-equality-
equity-policy/inequalities-distribution
• http://www.undp.org/content/undp/en/home/sustainable-
development-goals.html