DUTIES AND RESPONSIBILITIES OF COMMUNITY MEDICINE
作者：John.Smith
国籍：English
出处：Community Medicine
原文正文：
Community medicine has general specialist, managerial and advisory responsibilities in the fields of promotion of health, preventive medicine and environmental health.
Promotion of health The community medicine department of the DHA will be the recognized source of infor marion on relevant local, national and inernational epidemiological data and studies and on epidemiological techniques and will be responsible for advising on their application in the district. The full range of techniques of health education will be used to inform the population of the district about steps that can be taken to improve health, to avoid hazard and to make appropriate use of health services.
Preventive medicine
The community medicine department in the DHA will be the recognized source of information and advice on studies and techniques; will carry particular responsibility for initiating,maintaining and evaluating preventive medicine programmes in the district in cooperation with other departments, specialists and nursing staff; and will advise on the priority to be accorded to such programmes.
In the field of primary prevention, it will be necessary to ensure that existing programmes for vaccination and immunisation are efficient; reach the maximum number of the at-risk population and are effective in preventing communicable disease.
Additional programmes will need to be developed as proven, tested vaccines become available.
Secondary preventive programmes using screening techniques for the early detection of disease will need to be evaluated against agreed criteria of effectiveness before resources are committed to the implementation of new programmes. Similarly, existing programmes will need to be reviewed using the same criteria. Screening for breast cancer is an example of the former and screening for cervical cancer an example of the latter.
Tertiary prevention includes the mitigation of the effects of existing, often chronic
disease, in the individualand the prevention of further disability and handicap by appropriate health education, the provision of aids, and assistance from other statutory, voluntary and informal sources.
The preventive medicine aspects of the health of the children of the district merit special attention. The classical primary preventive effect of vaccination and immunisation programmes requires no elaboration. The prevention of accidents is, however, another important area for action. In secondary prevention, screening programmes concerned with the early detection of deviation from normal development in the preschool child, and with the health of the school child in the context of his or her education will require monitoring and evaluation in terms of their efficiency and effectiveness, as will existing programmes for the prevention of non-accidental injury.
Environmental health
The statutory duty to provide matching district councils with a ~roper Officer' for environmental health matters will lie with DHAs. One or more community physicians will need to be designated for this task which carries a responsibility to the district council for advising on and coordinating measures for the containment and management of outbreaks of communicable disease which may be indigenous or imported. The list of communicable diseases is a long one ranging, for example, from food poisoning, meningitis, hepatitis and tuberculosis to Legionnaire's disease and exotic diseases. Outbreaks may occur in institutions or in the community and, when they arise, can be extremely time-consuming and disruptive of other work. These duties require 24-hour cover for 365 days a year. Other duties relate to Section 47 of the National Assistance Act, 1948, and to the provision of advice on all aspects
of environmental health.
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