Daily Review - 03 Dec 2008

Report: Day 3 (3rd of December 2008)

Students assembled at Seminar Room G1 at 0800 for the classes. Prof Dr. Narayan came in at 0830 and an introductory class was started. Class was interesting and entertaining as he shared his personal experiences. Dr. Kay and Dr. Sapna were in the class as well. Students were taught on how to measure health status. A health survey was to be design by each group. He also mentioned that the group will be further broken down into smaller groups of students consisting of 7-8 students per group for the Village posting in the coming weeks. Dr Sapna and Dr Kay left at 0935 and the students had their break

Seminar then started at 1015. Their topic was Maternal Health care. Seminar was presented by Julius, Kesawan and Laksmanan. Dr Sapna was present for the seminar. Their learning objectives are as follows:

a) Reproductive age group

b) Pre conception age group ( target group and how the program was carried out)

c) Importance of maternal health care

d) What is nurse conversion course?

e) Community health visitors

f) Registration book for maternal health – Where is it done?

g) Record maintenance for maternal health

h) When booking was done?

i) General examination of pregnant woman- include Breast and Thyroid examination

j) Anemia in pregnant women – hematinics (dose? Duration? Route? Name?

k) Follow up

l) Colour codes

The seminar ended at 1115

At 1200 another seminar started. The seminar was attended by Dr Kay. Representatives from group A, Seema, Suvin and Rubashini presented on the Hospital Management Information System (HMIS).

Dr Kay reminded the students to observe and learn more during the posting. The presentation was deemed well by Dr. Kay. Dr. Kay also told that Hospital Selayang was the first hospital to adopt this system. Various positive and negative feedback were given by the hospital staffs at the hospital involved. Learning objectives:

a) Did other hospital around Malaysia adopt the management system?

b) How many hospitals involved?

c) Advantages and disadvantages of the system

d) How to solve the problems faced?

e) Accuracy of usage of the system and improper entry of data

The seminar ended at 1230.

Students came back at 1400 for a seminar by Menaga, Thanabalan and Uma. Prof Dr Narayan attended the seminar. The topic was on Epidemiology of Tuberculosis.. Learning objectives are:

a) Drug- doses, frequency, route of administration

b) Causes of default

c) Case detection rate

d) Explain the figure

e) Sputum examination

f) DOTS- Who implement it in Malaysia and How?

Seminar ends at 1500

At 1500, Dr Sawri came in to attend a seminar on Investigation of Outbreak which was presented by Dasar and Trishant. Objectives are:

a) Common outbreak

b) Format followed in Malaysia

c) Investigation of outbreak- how?

d) Surveillance program

Later Dr Sawri gave a lecture on the topic. The lecture was good and informative. It is a short comprehensive lecture which covers all the aspects of the seminar.

The class dismissed at 1645.

Food Quality Control

Seminar outline

The seminar was held on 4^th December 2008, presented by Teoh, Ooi and Yeoh from group C. Other group members joining the discussion are Sharvin, Tey, Parames and Nalini. It was a brief presentation about the Food Safety and Quality Division, which is a branch of Ministry of Health under the Public Health Unit. Besides that, we also discussed on the stages of food processing and various interventions on each stage in ensuring the food quality. The last part of the presentation mentioned few current issues which are challenging the nation on the aspect of food safety and quality.

The seminar was considered as an introduction to food quality control and all of us are expected to look for more practical information regarding the topic during the coming DHO posting.

We had spent a few days in finding information on the topic. With the help given by Dr Kay, we managed to gather much more useful information on the aspects of food processing and interventions in each food processing stage in order to maintain the food quality. However, we faced some difficulties in searching information regarding plans and interventions of Food Safety and Quality Division (FSQD) specifically for Kedah state. Therefore, topics that we left out would be the learning objectives that all of us have to look for during our DHO posting.

Additional learning objectives

- Food-borne diseases and statistics in Kedah state.

- Immunization program for food handlers.

- What are the aspects of medical examination for food handlers before obtaining license/renewing their licenses? How often the examination has to be carried out? Where can they have the examinations?

- How food sampling is carried out? How long it takes to get the result? How often food sampling is carried out? Who are responsible in carrying out the sampling?

- How often FSQD check on the hygiene/food quality of a food-processing factory/restaurant/hawker centre/school canteen?

- What are the actions taken by the authorities when food handlers do not achieve the food quality?

- What are the 'borang'(forms) used?

Child health

Seminar putline

GROUP E(Presenters are sonia, nilesh and thanalechumi)

Child health is a diverse topic covering many aspects of health and well-being related to children and their families. It is important, for :

1. Children constitute a large population in the country

2. To decrease the disease burden by avoiding preventable diseases

3. Children are vulnerable to physical and physiological stress, which will lead to poor health if not cared for

Malaysia's infant and child mortality rates at 10 and 12 respectively per 1,000 live births in 2006

There are various aspects of child health :

1. Growth and development

2. Immunization

3. Health promotion

4. Common communicable illnesses and their treatment

1. Growth and development

Growth is assessed by plotting measurements on growth charts while the Denver developmental screening test is commonly used to assess the development of children. In hospitals, children cards are used to keep track of their health

To overcome nutritional diseases and deficiencies, especially prevalent in rural areas, the Government initiated the multi-agency "Applied Food and Nutrition" programme and the "School Supplementary Feeding Programme (SSFP)" since the 1970s. The main objective of SSFP is to improve the health and nutritional status of children, especially those from the rural areas, through a provision of a wholesome and balanced meal.

As a result, acute malnutrition is no longer a problem in our country. On the other hand, Malaysia has begun to see the emergence of overweight and obesity in both children and adults

2. Immunization

Malaysia is now providing immunization against 10 major diseases, namely BCG, Hepatitis B, Diphtheria, Pertusis (Whooping Cough), Tetanus, Measles, Rubella, Mumps, Poliomyelitis, and Haemophilus influenza B

Since then, the incidence of vaccine-preventable diseases has dropped tremendously.

As at 2003, BCG coverage is 99%; hepatitis third dose is 95% and measles coverage is 92%.

Immunization is important, for it helps prevent diseases that are debilitating and my lead to morbidity

OTHER VACCINES AVAILABLE IN KKM - Meningococcal A , C, Y & W-135, Cholera, Japanese B encephalitis vaccine., Varicella zoster

3. Health promotion

a) How to care for a child

Education regarding infant and child feeding, including breastfeeding.

Convincing the mother about the need for immunization and family planning

Mother craft classes on various aspects of child care

b) Breastfeeding awareness

The National Breastfeeding Policy (2006) states "All mothers are encouraged to breastfeed their babies exclusively with breast milk from birth until 6 months of age and thereafter to continue until the child is 2 years old. Complementary foods should be introduced when the baby is 6 months old."

c) Dangers of passive smoking

d) Dangers of alcohol and drugs

e) Dental health

1. Pre-School Service

A dental programme specially for pre-school children was launched in 1984. This programme focuses mainly on oral health promotion and prevention of oral diseases.

2. School Dental Service

The aim is to render school children orally fit before they leave school.

3. Service for Children With Special Needs

In early 1993, a special programme was launched for these children. These children have been known to have a high prevalence of oral diseases

f) Hazard avoidance

Examples : Road traffic accidents, Burns and scalds, Choking, Falls, Suffocation, Poisoning, Cuts, Drowning

4. Common illnesses among children in malaysia and their treatment

Common cold

Sore throat

Diarrhea

Learning Objectives 1. The organization of the administration in charge of child health 2. How is the extent of coverage of immunization known? 3. What programme is in place for midwive training? 4. Programmes for avoiding and treating common communicable illnesses in children 5. Are child care centers operational?