UNICEF (UNITED NATIONS CHILDREN’S (FUND)

 UNICEF is one of the  specialized agencies of the united Nations. It was established in 1946. Formerly known as UNICEF (United Nations International Children’s Emergency Fund). It is now called “United Nations Children’s Fund”, but the title UNICEF is retained.

The Headquarters of the UNICEF is at United nations, New York. 

UNICEF

  A. Aims and objectives of UNICEF

     1. Reduction of infant and under five mortality

      2. Reduction of maternal mortality.

      3. Reduction of moderate and severe malnutrition

      4. Universal access to safe drinking water.

      5. Universal access to and completion of basic education for all children.

B. Organizational structure

   UNICEF is semiautonomous though it is an integral part of the UN. UNICEF has an Executive Board and

     1. An Executive Board and

     2. A Secretariat

C. Activities of UNICEF

  There are four areas of special emphasis by the UNICEF in its activity:

   1. Child health

   i. UNICEF provides substantial aid for the production of vaccines and sera in many countries, thus helps in universal immunization on children against six major diseases.

  ii. UNICEF activities cover programmes assisting in –

•         Environmental sanitation programmes

•         Oral rehydration

•         Primary health care to mothers and children.

•         Family planning aspects of family health

2. Child nutrition

3. Family and child welfare

4. Education

D. Role of UNICEF in promoting health services in Bangladesh.

   some of the important areas of activities in which UNICEF helps include :

     
1. Growth monitoring

     
2. Oral rehydration

  
3. Breast feeding

4. Family planning and MCH

  
5. TBAs (Traditional Birth attendants) training programme.

6. Food supplementational programme

  
7. Helps BRAC in the ORT extension activities

  
8. Also helps ICDDR,B in the ORS development

    
9. Supports the Public Health Engineering Departments

10. Supports Universal Childhood Immunization programme by supplying vaccines.

  

Concept of Primary Health Care

Definition of PHC (Alma – Ata declaration)

       
      The concept of ‘Primary health care’ was adopted at an International Conference in 1978 at alma Ata in the then USSR, which was jointly sponsored and organized by WHO  and UNICEF. In its declaration, popularly known as “The Alma Ata Declaration”, the International Conference defined primary health care as follows:

         
      “Essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self - determination”

Elements of primary health care (PHC)

  

    E = Education about health problems and their control.

    L = Local disease control

    E = EPI (Expanded programme on immunization)

    M = MCH based family planning

    E = Essential drugs provision.

    N = Nutrition

    T = Treatment of common diseases

    S = Sanitation

Health for All by the Year 2000 (HFA/2000)

  

   Definition: The member countries of WHO defined HFA/2000 as – “attainment by all the people of the world by the year 2000 AD of a level of health that will permit them to lead a socially and economically productive life.”

Global Indicator of HFA/2000

   The WHO has established 12 global indicators as the basic point of reference for assessing the progress towards HFA. These are:

1. Endorsement of HFA strategy as a policy at the highest political level.

2. Establishment of a mechanism for the involvement of people in implementing the strategies.

3. At least 5% of GNP is to be spent on health.

4. Allocation of reasonable percentage of national health expenditure to be devoted to local health care, i.e., at the level of first contact with health services, like health centre care and not secondary level hospital care.

5. Equitable distribution of health resources in terms of facilities and manpower as well as geographically (urban, rural) groups of population wise e.g. , women, children.

6. Formulation and updating of national strategies and explicit resources allocation in support of implementation through mobilization of internal and external resources.

7. Availability of primary health care to the entire population with at least the following:

     (i) Safe water at home or within 15 minutes walking distance and adequate sanitary facilities at home or in the immediate vicinity.

    (ii) Immunization against EPI target diseases e.g., diphtheria, whooping cough, measles poliomyelitis and tuberculosis.

   (iii) Local health care including availability of at least 20 essential drugs within an hour’s travel or walk.

   (iv) Antenatal care and child birth as well as caring of children up to at least 1 year of age by trained health personnel.

8. Nutritional status of children:

    (i) At least 90% of newborn have birth weight of at least 2500gm.

   (ii) At least of 90% of children have a weight for age that correspond to the standard prescribe by WHO.

9. Infant mortality rate of all identifiable subgroups is below 50 per 1000 live births

10. Life expectancy at birth is over 60 years.

11. Adult literacy rate for both sexes exceeds 70%.

12. The GNP per capita exceeds US $ 500.

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• Concept of health care 

• Determinants of Health

CONCEPT OF HEALTH CARE

Definition of health care:

   A multitude of services provided to individuals, families or communities by agents of the health services or professions, for the purpose of promoting, maintaining, monitoring, or restoring health.

Levels of Health Care

  1. Primary health care: Upazilla Health Complex, Union health sub centers and community clinics.

  2. Secondary health care: In Bangladesh, this kind of care is provided at districts hospitals.

  3. Tertiary health care: This level is a more specialized level, provided by the regional medical Hospitals.

4. Super – Specialized care: It is the highest level of health care available at the national level institutions which are highly specialized. i.e. BSMMU hospital, Institute of cardiovascular diseases, BIRDEM hospital.

Changing Concept of Health Care   

    1. Comprehensive health care

    2. Basic health services

    3. Primary health care



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• Determinants of Health

ORGANIZATION OF HEALTH SERVICES

 

1.National level – Ministry of health and Family Planning

·         The ministry of health and family planning is headed by a Minister. He is assisted by a deputy Minister, a Secretary, an Additional Secretary, Joint Secretaries, deputy Secretaries and Assistant Secretaries.

·         The Ministry is responsible for policy and planning formulations and decision making.

2. Central level – Health Directorates

·         Under the Ministry, there are two Director General, one for health and the other for family planning.

·         The Director General of Health Services is responsible for implementation of all health programs and projects and for providing technical guidance to the Ministry.

3. Divisional level

·         The functional unit at the divisional level is the Divisional Health Authority. It is headed by one Deputy Director who is assisted by 2 Assistant Directors – 1 for administration and other for communicable disease control (CDC).

·         Divisional Health Authority is responsible for supervision, monitoring and coordination of health activities in all the districts of the division.

4. District level

·         At this level, the Civil Surgeon is the team leader and health authority in the District. He is also the Ex – Officio Superintendent of the district hospital.

   The civil Surgeon is assisted by a Deputy Civil Surgeon and medical officers.

·         The Civil Surgeon is responsible for all health activities, domiciliary and institutional (except medical colleges and medical assistant training schools) in his district.

     

5. Upazilla level

·         The Upazilla Health and Family Planning Officer (UHFPO) are in charge of the health and family planning activities at the upazilla level.

6. Union level

·         At this level, there are Health and Family welfare centers / sub centers. One MBBS medical graduate is in charge of this union level facility. 

Sterilization and disinfection

Sterilization and disinfection

Sterilizationis the process by which all viable microorganism including viruses, bacteriaand their spores are killed or eliminated. This is important in many fieldsparticularly in surgery and in microbiological works. There are three mainmethods of sterilization:

• Physical
• Chemical and
• Filtration

Disinfectionis the killing of many but not all microorganisms. For adequate disinfection,pathogens must be killed but some organisms and bacterial spores may survive.

Differencebetween sterilization and disinfection:

Traits	Sterilization	Disinfection
Definition	Sterilization is the process by which all viable microorganism including viruses, bacteria and their spores are killed or eliminated.	Disinfection is the killing of many but not all microorganisms.
killed	Viruses, bacteria and their spores are killed or eliminated.	Pathogens must be killed but some organisms and bacterial spores may survive

Trustable Homoeopathic website

There is a list of medical website and also list of homoeopathic website

National Center for Homeopathy
http://nationalcenterforhomeopathy.org/

Homeointernational
http://www.homeoint.org/

Taubman Medical Library
http://quod.lib.umich.edu/h/homeop/

Homeopathy for Everyone
http://www.hpathy.com/

Homeopathy Home
http://www.homeopathyhome.com/

WholeHealthNow
http://www.wholehealthnow.com/

David Little
http://www.simillimum.com/

Minimum Price Leading Voices
http://www.minimum.com/bb/index.php

George Vithoulkas website
http://www.vithoulkas.com/

Luc DeSchepper
http://www.drluc.com/

Julian Winston
http://www.julianwinston.com/

How to make a remedy
http://www.youtube.com/watch?v=6EEOsiJF1X0

Free lectures on the Organon
http://hpathy.com/philosophy/

Whole Health Now Teleconference Recordings
http://www.wholehealthnow.com/teleconferences.html

Websites for Archaic Medical Terminology with Modern Definitions

Civil War Medial terms
http://ehistory.osu.edu/uscw/features/medicine/cwsurgeon/medicalterms.cfm

19th Century Disease
http://www.racetimeplace.com/diseasedefinitions.htm

Old Diseases and their modern definitions
http://www.homeoint.org/cazalet/oldnames.htm
a nd
http://www.pennyparker2.com/disease.html
and
http://freepages.genealogy.rootsweb.ancestry.com/~ilkane/OldMedTermsFrame1Source1.htm

Glossary of old medical terms
http://www.thornber.net/medicine/html/medgloss.html
and
http://www.amlwchhistory.co.uk/data/medicalterms.htm

Old/Archaic Medical Terms
http://www.genproxy.co.uk/old_medical_terms.htm
and
http://www.antiquusmorbus.com/English/Terminology.htm

Hanging and its types

It is the form of asphyxia in which the body issuspended wholly or partially with a ligature round the neck which causesconstriction of the air passage preventing exchange of air between theatmosphere and the alveoli of the lungs, the constriction force being theweight of the body.

Hanging

Types of hanging:

• Atypical hanging and
• Typical hanging

Difference suicidal and homicidal hanging are givenbellow-

Traits	Suicidal hanging	Homicidal hanging
1.      Age	More common adolescent and adults. Children bellow the age of ten or adults above 50 rarely commit suicide by hanging.	No age limitation
2.      Ligature mark	Oblique, non-continuous, circular, and high up in the neck.	Usually transversely continuous and low down in the neck.
3.      Knot	Usually one slip knot is found.	Usually more than one (farm knot).
4.      Design	History of previous unsuccessful attempts to commit suicide.	No previous history to commit suicide.
5.      Injuries	In the body contraindicate suicide	Presence of injuries is in favour of it.
6.      Poison	No evidence of poison	Might be evidence of poison associated with marks of violence or signs of struggle.
7.      State of hands or legs	If found tied contraindicates suicide	If found tied, it is always in favour of homicide.
8.      Access-liability	The point of hanging must be accessible to the victim or there must be means to reach the point.	The point of hanging is quite inaccessible of the means reaching the point would be missing or absent.
9.      Place of occurrence	The room is found closed from inside – indicate suicide.	If the room is open or locked from outside- indicate homicide.
10.  Sign of struggle	Absent.	Present, except when the victim was asleep, unconscious or mere a child.

Different types of inquest

Different types of inquest

An inquiry or investigation into the cause of un-natural death or sudden or suspicious deaths. 

Example-

• suicide, homicide and infanticide
• sudden death, the cause of whose unknown

Different types of inquest:

    3-types.-

• The police inquest
• The magistrates inquest and
• The coroner’s inquest

Signs of death

Signs of death

A.    IMMEDIATE 1.      Insensibility and loss of EEG rhythms 2.      Cessation of circulation(i.e., ECG rhythms) 3.      Cessation of respiration 4.      Cadaveric spasm	Somatic death
B.     EARLY 1.      Cooling 2.      Skin changes 3.      Eye changes 4.      Blood changes a)      Hypostasis b)      Fibrinolysis c)      Post mortem bleeding 5.      Chemical changes in body fluids 6.      Muscular changes- Rigor mortis	Cellular death Early reliable signs
C.     LATE(reliable signs) 1.      Putrefaction a)      In air b)      In water c)      In earth 2.      Adipocere formation 3.      Mummification 4.      Larval infestation	Decomposition and decay

Different types of death

Death is a permanent and irreversible cessation of functions of the three interlinked vital systems of the body (the tripod of life), namely the nervous circulatory and respiratory systems.

Different types of death

Deference between somatic and molecular death are given bellow-

Somatic death	Molecular death
Complete and continuous cessation of the vital functions of the three important organs, i.e. brain, head and lungs.	Individual cell death takes place.
It procedes molecular death.	It procedes somatic death.
It may be confused with suspended animation.	No chance to confuse.
Muscles respond to electric stimuli.	Muscles do not respond to electric stimuli.
At this stage, organs can be removed for transplantation.	At this stage, organs can not be removed for transplantation.

Exhumation and its procedure

Exhumation means lawful digging out of an already buried body from the grave for such medico-legal purpose as identification of autopsy in case of suspicious death for foul play.

Exhumation and its procedure

Procedure of exhumation:

Written order from first class magistrate or any other empowered magistrate is required to undertake exhumation.

• The body is exhumed under the supervision of a medical officer in the presence of a police officer.
• It is to be carried out in the day light, preferably in the morning.
• The exact situation of the grave should be found out
• A suitable screen should be erected around the grave.
• The coffin should be identified by the name plate or by the undertaker who made it.
• The medical officer should stand on the wind ward side of the grave to avoid inhaling offensive gases. He should wear rubber gloves and a gas mask.
• Collection of samples o earth from just above the coffin and also from each side of the coffin, then placing them in separate dry glass jars which are properly sealed and labeled. And fluid in the coffin should also be collected. Of the body is uncoffined several samples of earth actually in contact with the body should be collected.
• The body should then be raised from inside the coffin after waiting for sometime so that the offensive gases may escape.
• Identification of the body by the relatives and friends.
• The post mortem examination should be conducted in mortuary if possible, or by the side of the grave, screened off from public view.
• P.M. examination is conduction as usual.

All the viscera should be preserved for chemical analysis.

Forensic medicine and its branches

Forensic medicine and its branches

Forensic medicine may be defined as ‘the science which deals with the application of each and every branch of medicine, wherever and whenever it is required or necessary for taking decision in legal affairs both in civil and criminal cases.’

Branches of forensic medicine:

    Branches of forensic medicine are given bellow-

• Forensic pathology
• Forensic toxicology
• Forensic ballistic
• Forensic serology
• Forensic radiology
• Forensic dactylographic
• Forensic thanalogy
• Forensic psycharity
• Forensic obstetrics
• Forensic odontology
• Forensic criminology
• Forensic osteology
• Forensic nursing