PHS 211 Communicable Diseases

BPH, Second Year, Third Semester

Course Description
This course provides comprehensive overview of the communicable diseases which mainly
includes introduction, prevalence/magnitude of the disease in the Nepalese context, cause and
factors, signs and symptoms, mode of transmission, medicine used for treatment based on
national protocol/guidelines of Nepal/WHO, preventive and controlling measures with public
health approaches of bacterial, viral, parasitic, mycolic and emerging communicable diseases.

Learning Objectives
Upon the successful completion of the course, students will be able to:
 Describe common communicable diseases prevalent in Nepal,
 Explain emerging communicable diseases in context of Nepal and world,
 Identify cause and factors, mode of transmission of communicable diseases, and
 Apply prevention and controlling measures of the communicable disease.

Course Contents

Unit I: Bacterial Diseases 16 hours

Introduction, Prevalence/Magnitude of the disease in the Nepalese context, Cause and Factors,
Signs and Symptoms, Mode of Transmission, Medicine used for treatment based on National
protocol/Guidelines of Nepal/WHO, prevention and controlling measures of following
bacterial diseases.
 Cholera, Enteric Fever, Diarrhea and Dysentery
 Acute Respiratory Infections, Tuberculosis, Diphtheria, Pertussis, Leprosy, Tetanus
Trachoma, Plague, Brucellosis, Anthrax
 Syphilis, Gonorrhea, Chlamydia
 Conjunctivitis

Unit II: Viral Diseases 14 hours

Introduction, prevalence/magnitude of the disease in the Nepalese context, cause and factors,
signs and symptoms, mode of transmission, medicine used for treatment based on national
protocol/guidelines of Nepal/WHO, prevention and controlling measures of following viral
diseases.
 HIV and AIDS, Hepatitis, Poliomyelitis, Diarrhea, Rabies,
 Influenza (Swine Flu, Bird Flu), SARS ((SARS-CoV), Chickenpox, Measles/Rubella,
Mumps,
 Dengue, Japanese Encephalitis, Hemophyllus influenza type B

Unit III: Parasitic Diseases 14 hours

Introduction, Prevalence/Magnitude of the disease in the Nepalese context, Cause and Factors,
Signs and Symptoms, Mode of Transmission, Medicine used for treatment based on National
protocol/Guidelines of Nepal/WHO, prevention and controlling measures of following
parasitic diseases.
 Protozoal: Amoebiasis, Giardiasis
 Malaria
 Leishmaniasis, Filariasis

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 Ancylostomiasis, Ascariasis, Enterobiasis, Taeniasis, Trichuriasis
 Scrub Typhus, Scabies, Pediculosis

Unit IV: Mycolic and Emerging Diseases 4 hours

Introduction, Prevalence/Magnitude of the disease in the Nepalese context, Cause and Factors,
Signs and Symptoms, Mode of Transmission, Medicine used for treatment based on National
protocol/Guidelines of Nepal/WHO, prevention and controlling measures of following mycolic
and emerging diseases.
 Candidiasis
 Emerging communicable diseases in Nepal/World
 List the national prioritized disease control programs of Nepal

Reading Materials
1. Park K. Park's Textbook of Preventive and Social Medicine. 23 ed. Jabalpur (India): M/s
Banarasidas Bhanot; 2015.
2. Troeger C, Forouzanfar M, Rao P, Khalil I, Reiner ABRJ, Fullman N, et al. Estimates of
global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases:
a systematic analysis for the Global Burden of Disease Study 2015. 2017.
3. Kandel N. Situation Update on Communicable Diseases. WHO Nepal. December 2010.
Available on: http://un.org.np/attachments/who-situation-update-communicable-diseases
4. David H. Control of Communicable Diseases Manual, 19th Edition. Washington DC:
American Public Health Association, 2008.
5. Available on: http://www.apha.org/publications/bookstore/ccdmmobile.htm.
6. Control of Communicable Disease Manual, DOHS, Epidemiology and Disease Control
Division. 2003.
7. World Health Organization. Communicable Diseases prevention and Control (CPC) for
Nepal. Available on: http://www.searo.who.int/nepal/areas/CommDiseasePrevControl/en/
8. Annual Report. Department of Health Services, MOH, Government of Nepal, 2017 (or
latest).
9. Websites of World Health Organizations and Centers for Disease Control and Prevention.

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PHS 212 Environmental Health
BPH, Second Year, Third Semester

Course Description
This course offers an opportunity to understand and internalize emerging environmental health
issues and problems locally and globally. The course is also expected to comprehend the major
environmental health concerns and the implication of environmental health programs in the
areas of public health. The course will also describe the conceptual knowledge on
environmental health policy for understanding different human activities in deteriorating and
exploiting the environment and find a sustainable way for improving human health.

Learning Objectives
The purpose of course is to acquire essential knowledge on environment, environmental
problems, environmental hazards and their impact on health, and ways of prevention and
control of environmental related problems. Upon the completion of the course, students will be
able to:

 Explore the different types of environmental pollution and its public health impact
 Role of sanitation in public health
 Existing policy measures for the sustainable development.
 Principles and stages of environmental health prevention

Course Contents

Unit I: Concept of Environmental Health 8 hours

 Definition and scope of environmental health: Biological, chemical, physical, socio-
cultural
 Terminologies used in environmental health: Ambient air, contamination, effluent
hazardous waste, parts per million, parts per billion, pesticide, pollution and sediment
 Historical development of environmental health and emergence of modern public
health functions on environment protection
 Application of the DPSEEA framework
 Driving forces in environmental health: population, technology, economic growth,
poverty and inequity

Unit II: Water Pollution and Health 8 hours

 Functions and importance of water in human body
 Sources and availability of water in Nepal
 Sources and health effects of water pollution
 River and ground water pollution
 Water and water related diseases
 Water purification
 WHO guidelines for drinking water quality
 Acts and policies for water resource management in Nepal

Unit III: Air pollution, Noise and Health 8 hours

 Functions and importance of air in human body
 Criteria air pollutants
 Sources of indoor air pollution (rural and urban)

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 Sources of ambient air pollution
 Air pollution and health risks
 Management of air pollution: measurement, monitoring and control
 Definition of noise
 Sources of noise
 Noise levels and health effects
 Management of Noise

Unit IV: Human Excreta and Health 6 hours

 Present situation and practices
 Health hazard from human excreta
 Types/Methods of human excreta disposal
 Promotional activities of excreta disposal: at family and community
 National Sanitation Policy in Nepal

Unit V: Solid and Health Care Waste 8 hours

 Solid and liquid waste generation, treatment, and disposal
 Integrated management of solid waste
 Nature and types of healthcare waste
 Generation, management, treatment, and disposal of health care waste
 Health hazard of health care waste
 Waste and health risks
 Management of healthcare waste
 Waste water treatment technique

Unit VI: Environmental Health Management 4 hours

 Shelter and Human Health: Detrimental effect of poor housing; Principles of housing
and health; Standards of housing
 Environmental monitoring and evaluation
 Environmental management in disaster

Unit VII: Prevention and Regulation in Environmental Health 8 hours

 Stages of Environmental health prevention
 Principles of environmental health prevention: sustainable development;
precautionary principle; intergenerational equity; access to information and the
decision-making process; integrated decision making; polluter pays principle
 Sustainable Development Agenda for Nepal in respect of environmental health
 Environment health related legislation, policies, plan, and programs in Nepal.

Reading Materials
1. Allen. T.F.H. and T.W. Hoekstra, 1992. Towards a unified ecology. Columbia
University.
2. Baldwin. John. 1985 Environmental planning and management, Westview press,
Boulder and London.
3. Capra. Frijof. 1982. The turning point: Science, society and the rising culture. Published
by Fontana Paperbacks.
4. Corson, W.H. 1990. The Global ecology handbook, beacon press, Boston. USA.
5. DOHS. 2016. Annual report of department of health services, Nepal
6. Odum. 1971. Fundamentals of ecology. Saunders College Publishing.

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7. Wilson, E.O. 1988. Biodiversity, National Academy Press. Washington. D.C.
8. Carson, Walter (1990), The Global Ecology Handbook, Boston, USA.
9. FAO/WHO (1997), Health and Environment in Sustainable Development
WHO/EHG/97.8.
10. WHO (1996), Biodiversity, Biotechnology and Sustainable Development in Health and
Agriculture: Emerging Connection. WHO
11. WHO (1999), HACCP (Hazard Analysis and Critical Control Point) Principle and
Practice.
12. Frumkim, H. 2010, Environmental Health from Global to Local, John Wiley & Sons,
Inc.
13. Miller, G.T.; Spoolman, S. (2009), Living in the Environment-Principles, Connections,
and Solutions, Brooks/Cole, sixteenth edition
14. Miller, G.T.; Spoolman, S. (2010), Environmental Science, thirteenth edition
15. WHO (2017) Guidelines for drinking water quality. The fourth edition.
16. Government of Nepal. Central bureau of statistics (2015) Compendium of environment
statistics
17. ADB (2013) Solid waste management in Nepal. Current status and policy
recommendations

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PHS 213 Non-Communicable Diseases
BPH, Second Year, Third Semester

Course Description
Non-communicable diseases (NCDs) are the current leading cause of morbidity and mortality
worldwide. This course focuses on current situation of NCDs, types, environmental, behavioral
and life style related risk factors/determinants of NCDs signs and symptoms, public health
approach to prevention and controlling of NCDs.

Learning Objectives
The purpose of the course is to describe and analyze non-communicable diseases (NCDs) and
different factors influencing NCDs and preventive measures. Upon the completion of this
course, students will be able to:
 Describe common non-communicable diseases.
 Explain the risk and associated factors of the NCDs.
 Analyze the situation of NCDs in context of Nepal, SEAR and World.
 Describe the impact of personal behaviors on the burden of non-communicable disease.
 Apply public health approach including prevention, promotion, protection, control and
empowerment (PPPCE) for managing the NCDs.
 Describe the NCDs screening including WHO’s STEP survey and its application in
Public Health.

Course Contents

Part I

Unit I: Concept of Non-Communicable Diseases 5 hours

 Meaning, definition and types of chronic diseases and non-communicable diseases
(NCD)
 Difference between communicable and non-communicable diseases
 Common characteristics of NCDs
 Leading causes of Attributable Global Morbidity and Mortality
 Overview of Global Burden of NCDs
 Risk factors of NCDs (Modifiable and Non-Modifiable risk factors)
 Intersectoral actions on NCDs

Unit II: Major Non-Communicable Diseases 15 hours

Introduction, current situation and burden, types, risk factors, determinants, signs and
symptoms, public health approach to prevention and control-
 Hypertension
 Cerebral vascular accident
 Diabetes
 Chronic respiratory diseases-COPD, Asthma, Occupational lung diseases
(According to WHO)
 Cancer: Lungs cancer, cervical cancer, breast cancer, stomach cancer, oral cancer
 Nephrotic syndrome
 Joint disorder- Arthritis
 Neurological disorder- Autism spectrum disorder, Parkinson’s disease

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 Genetic Hemoglobin disorder- Sickle cell anemia, Thalassemia
 Eye disorder- Glaucoma, Cataract

Part II

Unit III: Accident and Violence 4 hours

Introduction, current situation and burden, types, risk factors, determinants, public health
approach to prevention and control-
 Road Traffic Accident
 Domestic injuries and violence
 Industrial accident and injuries

Unit IV: Nutrition related Diseases 6 hours

Introduction, current situation and burden, types, risk factors, determinants, signs and
symptoms, public health approach to prevention and control-
 Malnutrition
- Underweight
- Overweight and Obesity and
- Micronutrient deficiency disorders (Vitamin A deficiency, Iron deficiency,
Iodine deficiency disorders, Vitamin D deficiency, Calcium deficiency)
- Macronutrient disorders: Protein Energy Malnutrition

Unit V: Mental Health Problems 6 hours

Introduction, current situation and burden, types, risk factors, determinants, signs and
symptoms, public health approach to prevention and control-
 Stress, depression, anxiety, neurosis
 Schizophrenia,
 Alzheimer’s
 Dementia
 Suicidal tendency

Unit VI: Substance Abuse 4 hours

Introduction, current situation and burden, types, determinants, signs and symptoms, public
health approach to prevention and control-
 Alcohol
 Tobacco
 Drug abuse

Unit VII: Screening of Risk Factors 4 hours

 STEP Survey
 Dip-stick test for kidney diseases
 Pap smear, breast self-examination
 Diabetic retinopathy test
 Screening of uterine prolapse

Unit VIII: Approaches for Prevention and Control of NCDs in Nepal 4 hours
 NCD and Sustainable Development Goal for Nepal
 Multi-sectoral Action Plan for the Prevention and Control of NCDs in Nepal
 WHO’s Package of Essential NCDs (PEN)

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Reading Materials
1. CDC Global Noncommunicable Diseases (NCDs): Centers for Disease Control and
Prevention 2017. Available from:https://www.cdc.gov/globalhealth/healthprotection/ncd.
2. Global Action Plan for the Prevention and Control of Non Communicable Diseases 2013-
2020. Geneva, Switzerland: World Health Organization; 2013.
3. Government, of, Nepal. Multisectoral Action Plan for the Prevention and Control of Non
Communicable Diseases (2014-2020). Nepal: Government of Nepal.
4. Gregg MB. Field Epidemiology 3rd ed. New York: Oxford University Press; 2008.
5. Implementation and Facilitator Guide for the Healthy Lifestyle: Non communicable
Diseases (NCDs) Prevention and Control Module. Geneva International Federation of
Red cross and Red Crescent Societies 2014.
6. Ministry of Health K. Facilitator's Manual of Non Communicable Diseases. Kenya2015.
7. Annual Report. Department of Health Services, MOH, Government of Nepal, 2017.
8. MOHP, GON, Non Communicable Disease Risk Factors: Steps Survey Nepal 2013.
9. Non Communicable Diseases and Mental Health World Health Organization Available
from: http://www.who.int/nmh/en/.
10. Package of Essential Non Communicable (PEN) Disease Interventions for Primary Health
Carein Low-Resource Settings. World Health Organization; 2010.
11. Park K. Park's Textbook of Preventive and Social Medicine. 23 ed. Jabalpur (India): M/s
Banarasidas Bhanot; 2015.
12. Prevention and Control of Non Communicable Diseases in the European Region: A
Progress Report. Denmark: World Health Organization, 2014.
13. World Health Organization and MOHP, GON. Report on Mental Health System in Nepal,
2006.

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PHS 214 Public Health Nutrition
BPH, Second Year, Third Semester

Course Description
The course, under Public Health Science strand, covers the different areas of public health
nutrition including healthy diets consumption, dietary requirements of normal population,
nutritional problems, different types of nutrition programs, food security status and food quality
control mechanism. The course provides the scientific background for control of different
nutritional problems; understand the national nutritional program, food security strategies and
food quality control system.

Learning Objectives
The purpose of the course is to acquire essential knowledge on role of nutrition in promotion
of better health, prevention and control of nutritional related diseases and disorders,
effectiveness of national nutritional programs, and situation of national food security and
functioning of national food control system.
Upon the completion of this course, students will be able to:
 Classify foods as healthy or less healthy through nutrient profiling
 Describe the role of nutrition in prevention and control of nutritional related diseases
 Comprehend the role of national nutrition program and strategies for controlling the
nutritional problems
 Enumerate the different types of food security strategies
 Describe the different measures for food quality control

Course Contents

Unit I: Diet and Nutrition 16 hours

 Overview of public health nutrition
 Healthy diets
 Classifying foods as healthy or less healthy through nutrient profiling
 Role of nutrition in good health,
 Dietary guidelines for general population
 Nutrient profile model for WHO South-East Asia Region
 Nutrition related health problems in Nepal
 Diet, nutrition and chronic diseases
 Population nutrient intake goals for preventing diet-related chronic diseases
 Over-nutrition and obesity and role of diet in prevention of obesity
 Fiscal policies for diet and prevention of non-communicable diseases
 Positive Deviance Inquiry/Hearth Nutrition Model, Relationship between PDI and
Hearth and Evolution of Hearths
 Nutrition in emergencies
 Nutritional anthropometry assessment in emergencies
 Emergency Food Needs Assessments
 Calculating Food Requirements Based on Access to Food
 Meeting the Special Nutritional Needs of the Most Vulnerable Persons: Infants and
Young Children, Pregnant and Lactating Women, Older Persons

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Unit II: Nutrition Education and Nutrition Programs 12 hours
 Nutrition education
 Need & Scope of nutrition education
 Purpose of nutrition education
 Advantages of nutrition education
 National nutritional strategies
 National malnutrition prevention and control programs: iron deficiency anemia,
vitamin A deficiency disorders, iodine deficiency disorders, control of parasitic
infestation by deworming, flour fortification via large roller mills, maternal, infant,
and young children nutrition program, integrated management of acute malnutrition,
micronutrient powder distribution, school health and nutrition program,
 Nutrition situation in SAARC member states
 Status of nutrition-specific interventions in SAARC member states
 Evidence-based nutrition actions to tackle malnutrition and build a healthy food
environment: Nutrition-specific actions and Nutrition-sensitive actions

Unit III: Poverty, Food Security and Nutrition 10 hours

 Concepts of poverty and food poverty
 Relation between poverty and nutrition
 Food security
 Food Security and Nutrition security
 Food security information systems (FSIS)
 Four dimensions of food security
 Indicators for assessing the food security status
 Factor determining food security
 Policy and strategies measures for the promotion of food security
 Food sovereignty
 Food security status in Nepal

Unit IV: Food Quality Control 10 hours

 Food quality
 Scope of food quality control
 Responsibility for food quality control
 Quality attributes of food items
 Measurement of quality attributes
 Food standards
 International (codex) standards
 Systems and programs for food safety
 Fundamentals of quality management systems
 Good manufacturing practice
 Standard operating procedures
 Types of food hazards
 Hazard analysis and critical control point system (HACCP)
 Food quality control system and act in Nepal
 Food inspection techniques for common foods (Meat, fish, fruits and vegetables)
 Role of civil society in monitoring and controlling of food quality

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Reading Materials
1. Annual Report. Department of Health Services. Ministry of health and population,
Current
2. Anon. A HACCP Principles Guide for Operators of Food Establishments at the Retail
Level Managing Food Safety; 1998. http://vm.cfsan.fda.gov/~dms/hret-4.html
3. Bamji MS, Prahlad Rao N, and Reddy V. Textbook of Human Nutrition. Oxford and
IBH Publishing. 2004
4. Diet, nutrition and the prevention of chronic diseases. WHO Technical Report Series.
5. Gibney MJ, Kearney JM, and Arab L. Public Health Nutrition. Blackwell Publishing.
2008
6. FAO. Food Quality and Safety Systems, Rome;1998.
7. MoH/New ERA/ORC Macro: Nepal Demographic Health Survey, Kathmandu;2016
8. Park K. Park's Textbook of Preventive and Social Medicine. Banarasidas Bhanot
Publisher, Jabalpur, (Current)
9. World Health Organization. A practice guide to effective population-based food policy
actions to promote healthy diets.2017
10. WHO, Fiscal policies for diet and prevention of non-communicable diseases, 2015
11. World Health Organization. Nutrient profile model for south-east asia region, 2017

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PHS 215 Reproductive Health and Demography
BPH, Second Year, Third Semester

Course Description
This course develops a basic concept of reproductive health and demography issues among
students by acquiring introductory knowledge on reproductive health and demography. It is
anticipated that students completing this course will be able to discuss on reproductive health
and demography in their professional career.

Learning Objectives
This course provides introductory knowledge of the reproductive health and demography. In
particular, this course focuses on the concept, scopes, problems and issues of reproductive
health and demography. Upon the completion of the course, students will be able to:
 Define reproductive health and demography.
 Describe the concept, scopes and basic content of reproductive health and demography.
 Describe problems, challenges and issues of reproductive health and demography.

Course Contents

Unit I: Reproductive Health 9 hours

1. Concept and definition
2. Development of human sexuality and Sexual orientation: Gay (MSM-Male sex with
male), Lesbian (FSF-female sex with female) and bisexual including transsexual
and intersex (LGBTI)
3. Scopes and components of reproductive health
4. Forms of sexual behaviour and their effects on health: normal and abnormal-
- Solitary sexual behaviours
- Heterosexuality
- Premarital and extramarital sexual behaviour and their issues
- The varieties of abnormal sexual behaviours
- Paraphilia
- Hyper sexuality
5. High risk sexual behaviour
6. Responsible and safer sex behaviours
7. Reproductive process: Menstruation, fertilisation, pregnancy, birth
8. Overview of priority aspects (WHO) of reproductive health and public health
concern:
- Improving antenatal, delivery, postpartum, and newborn care;
- Quality family planning services;
- Eliminating unsafe abortion;
- Combating STI/HIV/AIDS and gynaecological problems; and
- Promoting sexual health

Unit II: Family Planning 9 hours

1. History, concept, definition and scope
2. Family Planning as Basic Human Rights
3. Role of FP in MDGs
4. Benefits of Family Planning
5. Health aspects of family planning

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- Women’s health
- Foetal health
- Neonatal, infant and child health

6. Contraceptive methods
- Spacing methods
o Barrier methods
o Intra-uterine devices
o Hormonal methods
o Post-conceptual methods
o Miscellaneous

- Terminal Methods
o Male sterilization
o Female sterilization

7. Fertility care services- Rcanalization, Invitro-Fertilization (IVF), Assisted Insemination

Donor/husband (AID), surrogacy
8. Contraceptive prevalence rate (CPR) and couple year of protection(CYP)
9. Elements of family planning program
10. Evaluation of contraceptive methods (Pearl Index, Life-table analysis)
11. Unmet need for family planning
12. Adolescence and contraception
13. Emergency contraceptives
14. Quality assurance in family planning service delivery
15. Counseling for Family Planning

Unit III: Abortion 4 hours

1. Overview of concept, definition and various forms of abortion and their causes
2. Health effects of unsafe abortion and its prevention
3. Overview of safe abortion law, policy and strategies in Nepal
4. Challenges of liberal abortion strategies to public health functions
5. Sex selective abortion and its impact on demography

Unit IV: Adolescent Reproductive Health in Nepal 2 hours

- Introduction
- Importance of focussing on adolescent reproductive health
- Status of ASRH in Nepal
- National adolescent health and development strategy
- Adolescent friendly services
-
Unit V: Gender Based Violence 2 hours
- Introduction
- Factors contributing to GBV
- RH and GBV
- Importance of gender equality
- Ways to improve gender equality

Unit VI: Infertility 2 hours

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- Introduction
- Causes of infertility
- Social consequences of infertility

Unit VII: Reproductive Health Issues and Conventions 4 hours

- Common reproductive health issues: Harmful practices, unwanted pregnancy,
unsafe abortion, reproductive tract infections including sexually transmitted
diseases and HIV/AIDS, gender-based violence, infertility, malnutrition and
anemia, and reproductive tract cancers.
- International Conference on Population and Development (ICPD)
o Goals of ICPD
o Guiding principles of ICPD

Unit VII: Demography 16 hours

1. Concept and definition
2. Theories (Demographic transition, Malthusian, Optimum)
3. Population dynamics (fertility, mortality and migration)
4. Basic measurements of population dynamics
o Fertility related statistics
o Mortality related statistics
o Migration related statistics
5. Concept measures and importance of population projection
o Arithmetic growth method
o Geometric growth method
o Exponential growth method
o Component projection method
6. Sources of demographic information/data
o Census
o Vital events registers
o Surveys
o Sample registration system
7. Population growth, distribution and trend of Nepal
o Age and sex composition
o Population pyramid, construction and interpretation
o Sex ratio
o Population density
o Rural and urban population
o Family size
o Life expectancy
8. World population growth and trend
9. Fertility, mortality and migration trend: Nepal and world
10. Population policy and programs of Nepal
11. National demographic health surveys, Nepal (Introduction, method, findings)
12. Application of demography in public health interventions/programs

Reading Materials
1. Reproductive Health Epidemiology Modules | Publications and Products | Reproductive
Health | CDC. [cited 2017 Jul 31]. Available from:
https://www.cdc.gov/reproductivehealth/productspubs/modules.htm

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2. Textbook of Public Health and Community Medicine, 2009 Published in Collaboration
with WHO. Editor: Rajvir Bhalwar. [cited 2017 Jul 31]. Available from:
https://www.researchgate.net/publication/282132865
3. Divya A. Patel, MPH, Nancy M. Burnett, BS, Kathryn M. Curtis, PhD. Maternal Health
Epidemiology. [cited 2017 Jul 31]. Available from:
https://www.cdc.gov/reproductivehealth/productspubs/pdfs/epi_module_2_04__tag508.p
df
4. Park K. Park’s textbook of preventive and social medicine. India, Jayapyr 1167,
Publisher M/S BanaesidasBhanot. 2015.
5. Principles of Population Studies: Asha A. Bhende, Tara Kanitkar [Latest edition].

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PHA 211 Integrated Concurrent Field Practice I (Practical)
BPH, Second Year, Third Semester

Course Description
This course, under Public Health Application strand, helps to acquire basic and practical skills
of various theoretical disciplines of third semester as mentioned in course objectives. The
course objectives will be met with group and individual assignments, collection and analysis
of primary and secondary data in close collaboration with faculties and the program
coordinator. The guideline will cover about 50 progressive working days as followings:
1. 7-10 days: Preparation workshop including development of data collection/evaluation
tool;
2. 7-10 days: Data collection in the field;
3. 10-15 days: Data analysis, development of tool and Intervention Plan of Action (POA)
for implementation; This part will cover two presentations:
a. Presentation at school/college
b. Community Presentation (Community Assembly-I)
4. 6-8 days: Public Health intervention and program evaluation;
5. 6-8 days: Data analysis and Dissemination in the community (Community Assembly-
II)
6. 3-5 days: Report Writing and Submission to the Dept./Program
7. 2-3 days: Final Presentation at school/college for Final Evaluation

Learning Objectives
The purpose of this course is to acquire not only practical and applied skills for theory subjects
and knowledge delivered during this semester but also to interlink these disciplines in Public
Health Practice in an integrated way. Theory subjects delivered during this semester includes
Communicable Diseases, Non-communicable Diseases, Environmental Health, Public Health
Nutrition, and Reproductive Health and Demography. Upon the completion of the course,
students will be able to:
 Apply evidence-based principles and the scientific knowledge base to critical
evaluation and decision-making in public health.
a. Calculate burden of communicable and non-communicable disease of nearby
community with number and frequency of disease
b. Develop case studies of communicable and non-communicable diseases
c. Assess nutritional status of children and other high-risk population segments of
nearby community using anthropometric measurements and carry out health
promotion activities
d. Develop a food pyramid and recommend a balanced/healthy diet based on it to
the local community.
e. Assess water quality of drinking water, assess waste water with selected
parameters of nearby community and carry out preventive and health promotion
measures
f. Assess air quality of a nearby community and carry out preventive and
promotive measures
g. Develop demographic and reproductive health profile of a nearby community
h. Carry out various analysis related to risk behavior and disease burden;
nutritional status; water and air quality; and demographic and reproductive
health based on selected indicators

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i. Develop plan of action along with prototype of health promotion program
focusing disease prevention, environment, reproductive and public health
nutrition promotion
j. Prioritize the program
 Promote high standards of personal and organizational integrity, compassion, honesty
and respect for all people.
 Work collaboratively with diverse communities and constituencies (e.g. practitioners,
agencies and organizations) to advance public health goals
a. Implement and monitor the program
b. Evaluate the program
 Demonstrate effective written and oral skills for communicating with different
audiences in the context of professional public health activities.
a. Present in the community
b. Write the report in a given format and submission to the Program, School, and
related organizations

Course Contents

1. Collection of various foods from students’ home and develop

a. Nutrition profile of locally available and traditional foods.
b. Preparation of food pyramid in local context.
c. Dietary chart preparation
2. Assessment of food consumption practices by 24-hour dietary recall method
3. Assessment of anthropometric measurements (head, chest, arm, height, weight, skin-
fold thickness, BMI, WHR, MUAC) and their interpretation and report writing
4. Calculation of disease burden by count and frequency using secondary data obtained
from nearby health facilities- major morbidity and mortality indicators of various major
communicable and non-communicable diseases
5. Calculation of high risk behavior indicators from primary data, using count and
frequency
a. Current smoker/tobacco user
b. Second-hand smoking
c. Current alcohol user
d. Binge drinking
e. Low fruits and vegetables consumption
f. Inadequate physical activity
g. Regular/in last 30 days breast-self examination
6. Calculation of major demographic and reproductive health indicators from primary data
a. Crude birth rate
b. Crude death rate
c. Standardized death rate
d. Standardized birth rate
e. TFR
f. Age-specific fertility rate
g. Nuptiality rate (Marriage, divorce)
h. Migration related indicators: Immigration, Emigration, Total Migration rates
i. ANC, PNC average visits
7. Assessment of water quality
A. Drinking water quality tests (primary or secondary data from drinking water office)
a. Residual Chlorine test

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b. Turbidity test
c. Coliform test
B. Waste Water tests and its reuse
a. BOD
b. Chemicals
c. Development of low cost water re-use methods
8. Secondary data (air pollution) from Ministry of Environment
9. Prioritization of program activities
10. Development of community health promotion and education program for disease
control and prevention, nutritional, environmental, and reproductive health program
11. Implementation of prioritized program
12. Evaluation of program
13. Presentation in the community
14. Report Writing and Submission

Evaluation
Internal (10*5 Subjects=50) = 50%
External (10*5 Subjects=50) = 50%

Reading Materials
1. MoHP, GoN. NDHS (2016). Nepal Demographic and Health Survey
2. GoN, Ministry of Environment, Website:
3. Periodic reports of different relevant ministries, local line agencies and organizations

18
PHT 251 Basic Epidemiology
BPH, Second Year, Fourth Semester

Course Description
This course has been designed to understand the basic concepts of epidemiology for the health
promotion, disease prevention and control.

Learning Objectives
The course is aimed to deliver basic knowledge on epidemiological concepts, principles and
procedure that can be used for the planning, control, management and evaluation of health
problems and systems for the improvement of health of community people. Upon the
successful completion of the course, the students will be able to:
 Describe the concepts of epidemiology
 Establish the relationship between health, disease and epidemiology
 Define the terminologies applicable in epidemiology and disease prevention
 Identify the concept and procedure of Epidemiological investigation and
management

Course Contents

Unit I: Concept of Epidemiology 12 hours

 Definition of Epidemiology
 Historical development and achievements of Epidemiology
 Aims, principles, scope and application of Epidemiology
 Modern Epidemiology and its ramifications
 Social Epidemiology, Environmental Epidemiology, Nutritional Epidemiology,
Reproductive Epidemiology, Perinatal and Early Life Epidemiology.
 Epidemiology and its relationship with other disciplines,
 Epidemiologic functions in public health
 Practice of epidemiology in public health

Unit II: Health, disease and Epidemiology 8 hours

 Spectrum of health and its epidemiological importance
 Natural history of disease and its implication in disease prevention
 Epidemiological classification of diseases: idea and need for classification of diseases,
principles of classification of disease, international Classification of Disease (ICD)-10
and updates.
 Data sources in epidemiology

Unit III: Terminologies and Principles of Epidemiology 20 hours

 Terminology used in communicable disease epidemiology
o Infection, infestation, inflammation, communicable disease, disease agent,
reservoir, source of infection, contamination, pollution, case, carrier, vector,
susceptible host, immunity, herd immunity, portal of entry, incubation period,
period of communicability, endemic, epidemic, sporadic, pandemic, enzootic,
exotic, zoonosis, epiornithic, contamination, contagious disease, nosocomial
infection, opportunistic infection, iatrogenic infection, surveillance,
elimination, eradication, certification of eradication

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 Terminology used in non- communicable disease epidemiology
o Cause, association, interaction, latent period, precursor, risk factor, risk group,
synergism, antagonism, intervention, effect modification,
 Principles related to communicable and non-communicable disease prevention and
control
o Single cause idea including Henle Koch’s postulates
o Epidemiological triad
o Chain of infection
o Multifactorial causation
o Web of causation
o Rothman’s causal model of disease causation (necessary and sufficient,
necessary but not sufficient, sufficient but not necessary, neither necessary nor
sufficient)
o Methods of disease prevention and control in reference to epidemiological triad,
chain of infection, multifactorial causation, web of causation and Rothman’s
causal model of disease causation
 Epidemiological method of causal reasoning: method of agreement, difference, joint
method of agreement and difference, method of residue, method of concomitant
variation
 Establishing causal relationship: concept of association and causation, Hill’s criteria
of causation

Unit IV: Epidemiological Approaches and Investigation 8 hours

 Epidemiological Approach to investigating health problems
 Concept of count, rate, ratio and proportion
 Epidemiological/outbreak investigation and management
 Review of case studies on outbreak investigation and management of the disease
prevalent in Nepal

Evaluation
This course carries full marks: 100; evaluated by two approaches
A. Internal Assessments: 50 marks (first internal: 15 marks, second: 25 marks, 5 marks
teacher’s evaluation and 5 marks class attendance)
B. Final examination 50 marks; semester exam conducted by Controller of Examination,
Pokhara University.

Reading Materials
1. Beaglehole R, Bonita R, Kjellstrom T. Basic Epidemiology. World Health
Organization, Geneva, 2002
2. AB Joshi, Banjara MR. Fundamentals of epidemiology vol I and II. 2.
3. Gordis L. Epidemiology, Second Edition, WB Saunders Company, Aharcourt Health
Sciences Company, Philadelphia, 2000.
4. Park K. A text book of preventive and social medicine; Latestedition, Jabalpur:
Banarasidas Bhanot Publishers.
5. Abraham M Lilianfield, David E Lilienfield "Foundation of Epidemiology", Oxford
University Press. 8. Heninkens CH, Buring JE.
6. Epidemiology in Medicine, Lippincott Williams and wilkins, a Wolters Kluwer
Company: 1987. 9.

20
7. MacMahon B, Trichopoulos D. Epidemiology: Principles and Methods, Second
Edition. Boston: Little, Brown, 1996. 10.
8. Mahajan BK. A Text Book of Preventive and Social Medicine
9. Principles of Epidemiology, 2nd Edition, and An Introduction to applied Epidemiology
and Biostatistics. US Department of Health and Human Service, CDC, Atlanta Georgia.
12.
10. Rothman KJ, Greenland S. Modern Epidemiology, 2ndEdition, Lippincott- Raven
publishers: 1998. 13. Rothman KJ. Epidemiology: An Introduction. Oxford University
Press, 2002
11. Robert H Fris, Thomas A Sellers. Epidemiology for Public Health Practices
12. Adhikari S. Foundations of Epidemiology. Makalu Publication House Dillibazar,
Kathmandu 2008
13. Introduction to Epidemiology and Biostatistics, CDC, Atlanta
14. Karki R, Paudel R, Shah SK, Jha W, Basel P. A text Book of Epidemiology. Makalu
Publication House 2014

21
PHS 251 Introduction to Public Health II
BPH, Second Year, Fourth Semester

Course Description
The course aims to provide integrated knowledge and stimulate interactions among students
around emerging and remerging health issues facing the health of the nation and the world.
This course helps to develop conceptual foundations of current Public Health Laws in Nepal.
Learning ethics can help them to apply ethics in their profession. By learning this course,
students will be able to learn about PHC concepts and their role in primary health care. This
course will prepare the students to gain basic understanding of public health system of SAARC
countries and role of various voluntary health agencies in Public health.

Learning Objectives
The course is aimed to develop the competencies in public health so that the graduates can
develop their career as a public health professional in either a service or an academic setting.
Upon the successful completion of the course students will be able to:

• Explore the public health approaches

• Explore the emerging and remerging diseases at national and international level.
• Describe the main legal and ethical principles relevant to public health work
• Explain the national health related plan and policy
• Describe the concept of Primary Health care and review the components of PHC in
Nepal
• Describe the concept of international health and role of various health agencies

Course Contents

Unit I: Public Health 5 hours

 Review of Concept of Public Health
 Public Health approaches
 Domains of Public Health
o Thematic Domain, such as nutrition, environmental health, life-style,
reproductive health, MCH, communicable and non-communicable diseases
o Public Health core action domain, such as health promoting action, health
risk factors, injuries and disease prevention actions, health protecting actions,
epidemic control actions, and actions leading to early detection, treatment and
compliance to treatment resume
o Public Health Intervention domain, such as health education, health
promotion strategies, policy and legal intervention, community organization
and participation
 New Emerging & re-emerging diseases & their burden: at national and international
level
o Communicable diseases: HIV/AIDS, Malaria, Dengue, JE, Diarrhoeal diseases,
Typhoid, Poliomyelitis, Tuberculosis, Leprosy, Pneumonia, Measles, Influenza,
Hepatitis
o Non-communicable diseases: Cardiovascular diseases, Diabetes, Cancer, Road
Traffic Accident, Malnutrition, Mental Health Problems
 Public health status of Nepal (in relevance with social determinants- 10 criteria)
 Public health achievements and future challenges in Nepal

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Unit II: Preventive Health 3 hours
• Concept and Scope of Preventive Health
• Practices of levels of prevention in Nepalese context (Public and Private)
• Concept and examples of Preventive health behavior (PHB)
• Preventive care versus preventive services
 Public Health versus preventive medicine, community medicine, Clinical medicine,
social medicine and community health

Unit III: Laws, Legal and Policy in Public Health 24 hours

• Overview of Public health laws, policies, plans, strategies with revision
• Concept, definition of Public health laws; sources of public health laws
• Laws related to public health:
- Environmental health laws of Nepal: Definition, aims, environmental
protection act including Kathmandu Declaration 2015
- Occupational health laws of Nepal
- Consumer Rights, Consumer Act
- Patient Rights
• Plan & policies related to health
- Health Policies: National health policies 2071(focused on Public health
aspects)
- Health plans: National health sector plans: NHSP I, NHSPII, NHSS 2015-20
- Second long-term health plan
- Health strategy: National health sector strategy
- Social health insurance scheme: Concept, objectives, coverage
• International declarations:
- Alma Ata declaration of PHC (1978) including HFA
- Universal declaration of human rights 1948
- Women: 1979-(CEDAW) of described as an international right for women.
- Convention on the right of child
- Ageing: Elderly health problems, International plan of action on ageing
(Madrid Declaration)
- Disable: Declaration on the rights of disabled person
• International Conferences/Assemblies in Public health
- Ottawa Charter, Jakarta Declaration, Bangkok Charter, Nairobi Declaration
- ICPD Cairo declaration: introduction, preamble, principles and action
- Beijing conference: Introduction, objectives and actions including 12 critical
areas.
- Habitat 2nd Istanbul 1996: Introduction, goals, objectives, global plan of
action
- MDG, SDGs: introduction, goals, target and indicators
- Peoples Health Assembly(PHA)
• Public Health Politics and Controversies
- Primary health care: The root for health politics
- Selective versus comprehensive PHC
- Executive, Legislative, and judiciary aspects of Health in Nepal

Unit IV: Public Health Ethics 4 hours

• Ethics and medical ethics concept
• Public health ethics: Definition, Concepts and Contribution of public health ethics
• Public health professional ethics

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Unit V: Introduction to Primary Health Care 4 hours
• Definition, Philosophy and elements
• Principles and strategies of PHC
• Principles and strategies to the components of primary health care
• Role of community people and health personnel in PHC

Unit VI: International and Global Health 8 hours

• Concept of International Health and Global Health
• Activities of Bilateral and Multilateral agencies in Nepal
• Bilateral Partners (USAID, GIZ, DFID, SDC)
• Multi-lateral agencies (WHO, UNICEF, UNFPA, UNDP, World Bank, ADB, IOM,
UNAIDS, UNHABITAT, WFP, SAARC)
• Other health-related agencies –INGOs (mention in DoHS Annual report)
• Health related contributions of SAARC secretariat

Reading Materials
1. Freudenberg N, Eng E, Flay B, Parcel G, Rogers T, Wallerstein N. Strengthening
individual and community capacity to prevent disease and promote health: in search of
relevant theories and principles. Health Education Quarterly 1995; 22 (3): 290-306.
2. Friis RH, Sellers TA. Epidemiology for public health practice. 2nd edition Gaithersburg,
MD; Aspen Publication, 1999.
3. Institute of Medicine. The Future of the Public’s Health in the 21st Century. Washington
DC: National Academy Press, 2003.
4. Lasker RD. Medicine and Public Health: the power of collaboration. New York NY: The
New York Academy of Medicine, 1997.
5. Park JE and Park K. Text book of social and preventive medicine, 23rd edition, 2015.
6. Schwab M, Syme SL. On Paradigms, Community Participation, and the Future of Public
Health. American Journal of Public Health.1997; 87 (12). 2049-2051.
7. Bernard J. Turncock. Public Health: What It Is and. How It Works. Published by Jones
and Bartlett.
8. Public Health Ethics Training Materials: Good decision making in real time: Public health
ethics training for local health department: Department of health & human services, CDC,
1 August 2012.
9. Annual Report. Department of Health Services, MOH, Government of Nepal, 2072/73.
Available from
dohs.gov.np/wpcontent/uploads/2016/06/Annual_Report_FY_2071_72.pdf
10. Ministry of Health and Population, National Health Policy, 2071. Available from
2014_Nepali:http://nnfsp.gov.np/PortalContent.aspx?Doctype=Resources&ID=69
11. Nepal Public health association: www.nepha.org.np/public-health-incicator
12. PubMed(Medline):http://www.ncbi.nlhm.nih.gov/entrez/query.fcgi?=PubMed
13. World health Organization(WHO): www.who.int
14. World Bank: www.worldbank.org
15. The Politics of Primary Health Care. IDS Bulletin Volume 14, Issue 4 October
1983 Pages 27–37

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PHS 252 Maternal, Child and Elderly Health
BPH, Second Year, Fourth Semester

Course Description
This course develops a basic concept of maternal, child and elderly health and health issues
among students by acquiring introductory knowledge on maternal, child and elderly health. It
is anticipated that students completing this course will be able to discuss on maternal, child and
elderly in their professional career.

Learning Objectives
This course provides introductory knowledge of the maternal, child and elderly health. In
particular, this course focuses on the concept, scopes, problems and issues of the maternal,
child and elderly health. Upon the completion of the course, students will be able to:
 Define the maternal, child and elderly health.
 Describe the concept, history, scopes and basic content of maternal, child and elderly
health.
 Enumerate the safe motherhood services prevalent in Nepal
 Describe the problems, challenges and issues of maternal, child and elderly health.

Course Contents

Unit I: Maternal Health 24 hours

1. Definition of Maternal health
2. Components of maternal health
o Antenatal care(ANC)
o Natal care (NC)
o Postnatal care(PNC)
3. Sources of maternal morbidity and mortality information
o Vital records
o Hospital records
o Community identification of deaths
o Formal surveillance systems
o Maternal perinatal deaths review
4. Measurement of maternal mortality
o Maternal mortality ratio
o Maternal mortality rate
o Lifetime risk of maternal death
o Concept of near miss cases
5. Definition of maternal death
o Maternal deaths
o Direct obstetric deaths
o Indirect obstetric deaths
o Late maternal deaths
o Pregnancy-related death
6. Preconception care
7. Six pillars of safe motherhood
8. Indication for preconception care
9. Antenatal care (ANC)
o Concept and definition of ANC

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o Objectives of ANC
o Time and frequency of ANC
o Essential ANC
o Identification of high risk pregnancies
 Maternal factors
 Bad obstetric history
 Medical disorders
 Warning signs
o Planning for birth
o Health education
o Public health concerns of ANC
10. Intra-natal/natal care (NC)
o Concept and definition
o Objectives
o Common childbirth practices
 Home delivery and its consequences
 Institutional delivery
o Delays for institutional delivery care
o Conditions for institutional delivery
o Skilled Birth Attendants (SBA)
o Essential obstetric care (EOC) and emergency obstetric care (EmOC)
o Public health concerns of NC
11. Postnatal care (PNC)
o Concept and definition
o Time and frequency
o Complication and danger signs in puerperium
o Public health concerns of PNC
12. Causes of maternal mortality
o Hemorrhage
o Infection (sepsis)
o Eclampsia
o Obstructed labor
13. Measures to reduce maternal mortality
14. Developmental milestones of Safe motherhood services in Nepal
15. Safe motherhood policies, plans, programs and services existing in Nepal
16. Challenges of maternal health care in Nepal

Unit II: Neo-natal and Child Health 12 hours

1. Concept and definition neo-natal health and child
2. Neonatal health problems
o Status of neonatal health in Nepal
o Causes of neonatal death
o Essential care for newborn health
o National neonatal health strategy
3. Components of child health
o IMNCI (CB-IMNCI and health facility based)
o Nutrition
o EPI
4. Child health problems
o Malnutrition

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o CDD/ARI
o Vaccine preventable disease
o Child abuse and trafficking
o Health concern of street children
5. World Declaration on the Survival, Protection and Development of Children
6. Child rights and international declarations on child rights: Convention on the Rights
of the Child (1989)
7. Burden of child health diseases in Nepal
o Direct measurement
 Growth monitoring
 Neo-natal and pre-natal mortality rate
 Infant mortality rate
 1-4 year mortality rate
 Child mortality/under five morality
 Child survival index
o Indirect measurement
 Proportion of low birth weight child
 Proportion of protein energy malnutrition(PEM) children
 Proportion of vitamin A deficiency(VAD) children
 Proportion of nutritional anemiachildren
 Immunization coverage

Unit III: Child Health Policies, Plans Strategies and Programs in Nepal 6 hours
1. Concept of child health promotions
2. Child health problems and intervention plans
3. Child health promotion strategies
4. Review of existing child health policies, plans and programs of Nepal (Immunization,
nutrition, and CB-IMCI and newborn care/CB-IMNCI, early childhood development
center (ECDC), mid-day meal for school children)

Unit V: Elderly Health 6 hours

1. Concept, meaning, scopes and components of elderly health
2. Strategies of elderly health in global and national context
3. Health problems of elder people
4. Lifestyle and healthy aging
5. Geriatric health services
6. Policy, strategy and programs for elder population
7. Public health concerns of elderly health

Reading Materials
1. Say L, Chou D, Gemmill A, Tunçalp Ö, Moller A-B, Daniels J, et al. Global causes of
maternal death: a WHO systematic analysis. The Lancet Global Health. 2014;2(6):e323–
33.
2. You D, Hug L, Ejdemyr S, Idele P, Hogan D, Mathers C, et al. Global, regional, and
national levels and trends in under-5 mortality between 1990 and 2015, with scenario-
based projections to 2030: a systematic analysis by the UN Inter-agency Group for Child
Mortality Estimation. The Lancet. 2015;386(10010):2275–86.
3. Reproductive Health Epidemiology Modules | Publications and Products | Reproductive

27
Health | CDC [Internet]. [cited 2017 Jul 31]. Available from:
https://www.cdc.gov/reproductivehealth/productspubs/modules.htm
4. Textbook of Public Health and Community Medicine, 2009 Published in Collaboration
with WHO. Editor: RajvirBhalwar. [cited 2017 Jul 31]. Available from:
https://www.researchgate.net/publication/282132865_Textbook_of_Public_Health_and_
Community_Medicine_2009_Published_in_Collaboration_with_WHO_Editor_Rajvir_B
halwar
5. Divya A. Patel, MPH, Nancy M. Burnett, BS, Kathryn M. Curtis, PhD. Maternal Health
Epidemiology. [cited 2017 Jul 31]. Available from:
https://www.cdc.gov/reproductivehealth/productspubs/pdfs/epi_module_2_04__tag508.p
df
6. Park K. Park’s textbook of preventive and social medicine. India, Jayapyr 1167,
Publisher M/S BanaesidasBhanot. 2015.
7. Department of Health Services. Annual Report 2015/16 (Updated). DoHS, Government of
Nepal.

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PHS 253 Occupational Health and Safety
BPH, Second Year, Fourth Semester

Course Description
The adverse effect of man-made environment and work-related hazards on human health is
ever increasing. Such environment challenges promotion of health and act as agent for
emergence of several diseases and accidents. The OHS concern of unfavorable environment is
surmounting and concern of public health workforce, workplace workers and stakeholders.
Therefore, the course intends to provide students with the concept of various aspects of
occupational health and safety hazards together with their sound management for the cause of
establishing healthy environments for healthy living.

Learning Objectives
The course is interdisciplinary in nature and aims at giving the undergraduate students a broad
scientific understanding of occupational health and safety aspects making them competent and
aware through analytical interdisciplinary approach. Upon the completion of the course,
students will be able:
 To describe occupational hazards and measures to be taken to protect health of the workers.
 To describe workplace pollution/emissions like air, noise, thermal and control principles to
safeguard health of the workers.
 To describe principles of occupational hygiene and its application in workplace
improvements.
 To describe principles and application of occupational health and safety management
system.
 To take leadership in implementing occupational health, safety and environmental
strategies and practices with organizing and mobilizing public health workforce and
workplace workers and stakeholders.
 To familiarize with applicable legal national and international provisions related to OHS.
To familiarize the co-relation of OHS with different disciplines like Environmental
Management System; Climate Change; Cleaner Production; Good Manufacturing
Practices;

Course Contents

Unit I: Concept of Occupational Health and Safety 8 hours

 State the Historical development of Occupational Health and Safety.
 State the meaning and definition of Occupation and OHS
 Definition, types and source of occupational hazards: Physical, chemical, biological etc
 Concept and principle of OHS including its impact on human health, organization and
society.
 Concept and feature of occupational and environmental health.
 Normal/Standards of occupation and industry
 Concept of risk and hazard
 Concept, principle and classification of workplace/work related accident.
 Definition and types/ classification of Occupational/ work related diseases and non-
communicable disease (ILO, WHO and MOH notification).
 Status and facts on OHS in occupational setting (National and International including
ILO).

29
 Critical review of Acts, policies, strategies, programmes provision, implementation and
results of policies, strategies, programs, projects, support (National, international and
local) for maintaining healthy work environment and prevention and control of
occupational hazards and diseases in Nepal.

Unit II: OHS Hazard: Assessment and Management 7 hours

 Workplace Assessment and Occupational Hygiene: Tools, Techniques and
Measurement;
 Hazard Identification and Risk Assessment: Principle and Application of qualitative
and quantitative analysis and Management;
 Accident investigation and Root Cause analysis: Concept and Principle,
 Job Safety Analysis: Principle and Application
 Workplace Hazard control: Principle and Techniques.

Unit III: Workplace Hazard/Pollution: Assessment and Management 8 hours

 Noise pollution and its effects: Introduction, Assessment and control
technologies/measures (source control, path control & receiver control) including noise
related diseases.
 Air pollution and its effects: Introduction, Assessment and control
technologies/measures (source control, path control & receiver control) including air
borne diseases.
 Thermal pollution and its effects: Introduction, Assessment and control
technologies/measures (source control, path control & receiver control) including
thermal related diseases.
 Chemical hazard and Bio-chemical effects: Introduction, Assessment and chemical
hygiene plan including pesticide and industrial chemicals and chemical related
diseases.
 Introduction to Ergonomics.

Unit IV: Emergency Preparedness and response (safety) 5 hours

 Concept of risk and hazards
 Emergency preparedness and response: Introduction, Principle and Application,
focusing on Fire and Chemical.
 Occupational Health surveillance at workplace: Concept and Functioning, including
First Aid.
 Personal Safety Gears/ Personal Protective Equipment: Principle, Classification and
Application.

Unit V: OHS System and Culture 5 hours

 Occupational health and safety management system: Principle and Requirement and
Certification process, including OHSAS 18001 and ISO 45001.
 Improving Safety Performance with Behavior-Based Safety: Concept and
Application.
 Workplace Violence and Organizational function: Concept and Application in OHS
performance.
 Permit to work: Introduction, Requirement and Application, focusing on confined
space work, hazardous work/chemical, working at height.

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Unit VI: OHS and Municipal Waste (Safety) 5 hours
 Overview of classification of Municipal Waste and waste related hazards and possible
diseases at workplace.
 Source wise (individual, households, institutional/business houses, industry, hospital,
community) analysis of Municipal Waste and possible exposure to concern workers
and mitigation measures.
 Measures, including strategies (of prevention and control of solid waste related
diseases, nuisances and other ailments.
 Critical review of provision, implementation and results of solid waste disposal
policies, strategies, programs, projects, support (National, international and local) in
Nepal in the context of prevention and control of solid waste related diseases, nuisances
and other aliments

Unit VII: OHS and Climate Change 5 hours

 Introduction to Climate Change and its possible risk and diseases including control of
Climate Change related diseases.
 Current policies and practices to reduce occupational health impacts
 Potential links between work, health, and climate change.
 Critical review of provision, implementation and results of solid waste disposal
policies, strategies, programs, projects, support (National, international and local) in
Nepal in the context of prevention and control of Climate Change related diseases,
nuisances and other aliments

Unit VIII: OHS Integration and Application 5 hours

 OHS tools and its’ application: Environmental Management System (EMS); Cleaners
Production (CP), Energy Efficiency (EE), Industrial Relation (IR) in occupational
setting.
 Research Based Practical Project on OHS (Case study)

Reading Materials
1. Fundamental principles of occupational health and safety, Benjamin O. ALLI, ILO
Geneva.
2. Fundamentals of Occupational Safety and Health Fourth Edition Mark A. Friend and
James P. Kohn, Government Institutes An imprint of The Scarecrow Press, Inc.
Lanham, Maryland, Toronto, Plymouth, UK 2007. Downloaded from
(http://ohshub.com/wp)
3. On the Practice of Safety: By Fred A. Manuele
4. Occupational Health and Safety Management Systems: A Review of their Effectiveness
in Securing Healthy and Safe Workplaces Clare Gallagher Elsa Underhill Malcolm
Rimmer A report prepared for the National Occupational Health and Safety
Commission
http://www.safeworkaustralia.gov.au/sites/SWA/about/Publications/Documents/127/
OHSManagementSystems_ReviewOfEffectiveness_NOHSC_2001_ArchivePDF.pdf
5. Guidelines on occupational safety and health management systems, ILO-OSH 2001
(http://www.ilo.org/wcmsp5/groups/public/@ed_protect/@protrav/@safework/docum
ents/normativeinstrument/wcms_107727.pdf)
6. Occupational Health and Safety, September 2015 ISBN: 1-55146-581-7,
http://www.ed.gov.nl.ca/edu/k12/curriculum/guides/skilledtrades/OHS_3203_2015.pd

31
7. A Guide to Human Factors and Ergonomics. Second Edition Martin Helander Nanyang
Technological University Singapore. Taylor & Francis Group Boca Raton London New
York A CRC title, part of the Taylor & Francis imprint, a member of the Taylor &
Francis Group, the academic division of T&F Informa plc.
8. International Encyclopedia of Ergonomics and Human Factors, Second Edition, edited
by Informa Healthcare, Waldemar Karwowski, University of Louisville, Kentuki, USA,
https://books.google.com.np/books
9. A TEXTBOOK OF MODERN TOXICOLOGY FOURTH EDITION Edited by Ernest
Hodgson North Carolina State University Raleigh, North Carolina
http://samples.sainsburysebooks.co.uk/9780470617656_sample_417891.pdf
10. Canadian Centre for Occupational Health and Safety,
http://www.ccohs.ca/oshanswers/hsprograms/basic.html
11. A manual for primary health care worker,
http://www.who.int/occupational_health/regions/en/oehemhealthcareworkers.pdf
12. Understanding ergonomics at work, Health and Safety Executive, UK,
https://www.westmidspolfed.com/media/downloads/ergonomics-at-work-
1360326696.pdf
13. http://www.iloencyclopaedia.org/part-iv-66769/occupational-hygiene-47504
14. https://www.amazon.com/Fundamentals-Industrial-Hygiene-
6tHygene/dp/0879123125
15. www/worldbank.org: Occupational and Environmental Health Issues of Solid Waste
Management Special Emphasis on Middle- and Lower-Income Countries, Sandra
Cointreau, 2006
16. Abbasi, SA, Environmental Pollution and its Control, Cogent International, 1998.
17. Human Health: Impacts, Adaptation, and Co-Benefits, Coordinating Lead Authors:
Kirk R. Smith (USA), Alistair Woodward (New Zealand)
18. Gautam R P et. al Current situation of occupational health and safety in Nepal.

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PHT 252 Public Health Behavior and Anthropology
BPH, Second Year, Fourth Semester

Course Description
Public health practice is being influenced by the ways people behave on health matters backed
by traditional and modern cultures prevalent in the society. Therefore, planning and
implementation of an effective public health program should consider the health-related
behavior patterns and their anthropological back up. This course under Public Health
Tools/Methods (PHT) strand develops a basic concept of public health behavior and public
health anthropology. It is anticipated that students completing this course will be able to discuss
public health behavior and related anthropological components and apply them adequately and
appropriately during their public health professional practice.

Learning Objectives
The objective of the course is to provide introductory knowledge on theories and processes of
human behavior regarding public health themes and actions. The aim is to develop skills of
utilizing the knowledge to plan and implement public health intervention programs. Upon the
completion of the course, students will be able to:
 Define human behavior, process, importance, domains in relation to concept of public
health,
 Describe various models/theories of behavior change,
 Define public health anthropology and its various components/traits,
 Differentiate public health anthropology from medical anthropology,
 Identify and describe various public health themes related to anthropological
components/traits, such as taboos, traditions, rituals prevalent in Nepalese societies, and
 Relate various public health anthropological traits with public health core actions such
as promoting health, prevention of health risk factors and diseases.

Course Contents

Unit I: Introduction to Public Health Behavior 6 hours

 Meaning and definitions of human behavior
 Process of behavior (biological and social)
- Stimulus – sensation -reaction (reflex behavior)
- Stimulus – Sensation – perception – reaction (conscious behavior)
- Stimulus – Sensation – perception – thinking – reaction (rational behavior)
 Importance of rational behavior
 Domains of behavior (cognitive, affective, psycho-motor)
 Review of concept of public health including its three domains
- Thematic Domain, such as nutrition, environmental health, life-style,
reproductive health, MCH, communicable and non-communicable diseases
- Public Health core action domain, such as health promoting action, health
risk factors, injuries and disease prevention actions, health protecting actions,
epidemic control actions, and actions leading to early detection, treatment and
compliance to treatment resume
- Public Health Intervention domain, such as health education, health
promotion strategies, policy and legal intervention, community organization
and participation

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 Need for understanding target people’s behaviors regarding public health thematic
domain, core action domain and intervention domain

Unit II: Process of and Models/Theories Related to Public Health Behavior and their
Application 5 hours
 Some models and theories and application in understanding motivation to public
health behavior:
- Health Belief Model ((Rosenstock)
- Hierarchy of Needs Theory (Maslow and Herzberg)
- Protection Motivation Theory (Rogers)
- The Social Learning Model (Bandura)
- Trans-theoretical model (Prochaska et al.)
- Theory of Planned Behaviour (Fishbein & Ajen)
 Process of behavior change in planning and implementation of public health
intervention programs
- Individual, Group, and Community/Societal Level:
 Compliance or Force or Coercion (Exhortation/Motivation, Gentle
Pressure, and Compulsion) ; Threat or Risk
 Mutual Understanding: Persuasion/Verbal Reasoning
 Internalization/Counseling: Awareness, Interest, Evaluation, Trial, and
Adoption)/GATHER
- Policy Level:
 Behaviour Change Matrix
 Matrix of Awareness and Willingness
 Application and Lessons from A Study of Littering in
Switzerland
- Concept and Process of Social and Planned Public Health Behaviour Change
 Planned Change: Diffusion of Innovation (DOI) theory of behavior
change
 Social change: Empowerment Process

Unit III Introduction to Public Health Anthropology 5 hours

 Definition of cultural anthropology and public health anthropology
 Cultural anthropology as one of the behavioral sciences
 Distinction between public health anthropology and medical anthropology
 Importance of public health anthropology in planning and implementation of public
health intervention programs

Unit IV: Components/Traits of Public Health Anthropology 5 hours

 Various components/traits of cultural anthropology and their meanings
- Taboos, rituals, artifacts (ritualistic, aesthetic, common use, modern
technological gadgets), customs, beliefs, folkways, religious performances,
traditions, superstitions

Unit IV: Brief study of Anthropological Components/Traits Regarding Selected Public

Health Thematic Domain (as and where pertinent) in Nepalese Societies 14 hours
 Production, preparation and consumption of foods (nutrition)
 Bodily movement
 Air, water, living space, waste handling including disposal of human excreta

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 Life styles including alcohol, tobacco, and substance abuse
 Communicable diseases (Tuberculosis, leprosy, HIVand AIDS)
 Non-communicable diseases (epilepsy, mental diseases)
 Menstruation, marriage, sexuality
 Conception, pregnancy, abortion, child birth, newborn and maternal care
 Immunization
 Use of contraceptives (family planning)

Unit VI: Some Aspects of Medical Anthropology Applicable to Public Health Core
Actions and Interventions 3 hours
 Cultural perspective of sickness, illness and disease
 Beliefs and taboos related to treatment
 Treatment seeking behaviors
 Self-medication

Unit VII: Anthropological Components/Traits and Public Health Core Actions

5 hours
 Overview of anthropological components/traits regarding selected public health
thematic domain in taking pertinent public health core actions
- health promoting actions,
- health risk factors, injuries and disease prevention actions,
- health protecting actions,
- epidemic control actions, and
- actions leading to encouraging early detection, treatment and compliance to
treatment resume

Unit VIII: Anthropological Components/traits and Public Health Interventions 5 hours

 Overview of anthropological components/traits regarding selected public health
thematic domain in planning and implementing public health interventions:
- health education intervention
- health promotion intervention
- public health policy and legal intervention
- public health infrastructure development
- community organization and participation

Reading Materials
1. Mehata, Manju Behavioral Science in Medical Practice (Part 2 Basis of Behavior),
New Delhi: Jyapee Brothers Medical Publishers (P) Lt.
2. Egger, Garry, Spark R., & Lauson, J., Health Promotion Strategies and Methods.
Sydney: McGRAW HILL BOOK COMPANY. (For various models of behavior)
3. Foster, G.M. & Anderson, B.G. Medical Anthropology New York: John Wiley &
Sons.
4. Anthropology for Nurses: Jaypee Brothers, New Delhi.
5. Gerhard Fehr, Alain Kamm and Moritz Jäger, Fehr Advice & Partners AG (2017).
The Behavioral Change Matrix: A Tool for Evidence-Based Policy Making. In A.
Samson (Ed.), The Behavioral Economics Guide 2017(with an introduction by Cass
Sunstein). pp. 47-53. Retrieved from: http://www.behavioraleconomics.com.

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PHA 251 Integrated Concurrent Field Practice II (Practical)
BPH, Second Year, Fourth Semester

Course Description
This course, under Public Health Application strand, helps to acquire basic and practical skills
of various theoretical disciplines of fourth semester as mentioned in course objectives. The
course objectives will be met with group and individual assignments, collection and analysis
of primary and secondary data in close collaboration with faculties and the program
coordinator. In total, the practicum will cover about 50 progressive working days as followings:
1. 7-10 days: Preparation workshop including development of data
collection/evaluation tool;
2. 7-10 days: Data collection in the field including observation
3. 10-15 days: Data analysis, development of tool and Intervention Plan of Action
(POA) for implementation; This part will cover two presentations:
a. Presentation at school/college
b. Community Presentation (Community Assembly-I)
4. 6-8 days: Public Health intervention and program evaluation;
5. 6-8 days: Data analysis and Dissemination in the community (Community
Assembly-II)
6. 3-5 days: Report Writing and Submission to the Dept./Program
7. 2-3 days: Final Presentation at school/college for Final Evaluation

Learning Objectives
The purpose of this course is to acquire not only practical and applied skills for theory subjects
and knowledge delivered during this semester but also to interlink these disciplines in Public
Health Practice in an integrated way. Theory subjects delivered during this semester includes
Basic Epidemiology, Introduction to Public Health-II, Maternal, Child and Elderly Health,
Occupational Health and Safety, and Public Health Behavior and Anthropology. Community
including organizational/institutional visit will be carried out to meet the objectives.
Community visit will be conducted for Public Health behavior and anthropology, disease
burden, outbreak investigation, and elderly health whereas Health Facility for Maternal and
Child Health and Occupational Setting will be visited for occupational observation. Upon the
completion of the course, students will be able to:
 Apply evidence-based principles and the scientific knowledge base to critical
evaluation and decision-making in public health.
a. Calculate burden of communicable and non-communicable disease of nearby
community
b. Assess nutritional status of children and other high-risk population segments of
nearby community using anthropometric measurements and carry out health
promotion activities
c. Assess nutritional values of various locally available foods; develop a food
pyramid and recommend a balanced diet based on it to the local community.
d. Assess water quality of drinking water, assess waste water with selected
parameters of nearby community and carry out preventive and health promotion
measures
e. Assess air quality of a nearby community and carry out preventive and
promotive measures
f. Observe Occupational setting and apply Occupational Health and Safety (OHS)
tools for health promotion

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g. Develop demographic and reproductive health profile of a nearby community
h. Carry out various analysis related to risk behavior and disease burden;
nutritional status; water, soil and air quality; and demographic and reproductive
health based on selected indicators
i. Develop plan of action along with prototype of health promotion program
j. Prioritize the program
 Promote high standards of personal and organizational integrity, compassion, honesty
and respect for all people.
 Work collaboratively with diverse communities and constituencies (e.g. practitioners,
agencies and organizations) to advance public health goals
a. Implement and monitor the program
b. Evaluate the program
 Demonstrate effective written and oral skills for communicating with different
audiences in the context of professional public health activities.
a. Present in the community
b. Write the report in a given format and submission to the Program, School, and
related organizations

Course Contents

1. Collection of various foods from students’ home and develop

2. Nutrition profile of locally available and traditional foods.
3. Preparation of food pyramid in local context.
4. Dietary chart preparation
5. Assessment of food consumption practices by 24-hour dietary recall method
6. Assessment of anthropometric measurements (head, chest, arm, height, weight, skin-
fold thickness, BMI, WHR, MUAC) and their interpretation and report writing
7. Calculation of disease burden using secondary data obtained from nearby health
facilities- major morbidity and mortality indicators of various major communicable and
non-communicable diseases
a. Crude death rate
b. Disease specific mortality rate
c. Disease specific morbidity rate
d. Age specific mortality rate
e. Disease prevalence
f. Disease incidences
8. Calculation of high risk behavior indicators from primary data
a. Proportion of Current smoker/tobacco user
b. Proportion of second-hand smoking
c. Proportion of Current alcohol user
d. Proportion of binge drink
e. Proportion of low fruits and vegetables consumption
f. Proportion of inadequate physical activity
g. Proportion of regular/in last 30 days breast-self examination
9. Calculation of major demographic and reproductive health indicators from primary data
10. Crude birth rate
11. Crude death rate
12. Standardized death rate
13. Standardized birth rate
14. TFR

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15. Age-specific fertility rate
16. Nuptiality rate (Marriage, divorce)
17. ANC, PNC average visits
18. Assessment of water quality
19. Drinking water quality tests (primary or secondary data from drinking water office)
20. Residual Chlorine test
21. Turbidity test
22. Coliform test
23. Waste Water tests and its reuse
a. BOD
b. Chemicals
c. Development of low cost water re-use methods
24. Secondary data (air pollution) from Ministry of Environment
25. Prioritization of program activities
26. Development of community health promotion and education program for disease
control and prevention, nutritional, environmental, and reproductive health program
27. Implementation of prioritized program
28. Evaluation of program
29. Presentation in the community
30. Report Writing and Submission

Evaluation
Internal 50%
External 50%

Reading Materials
4. MoHP, GoN. NDHS (2016). Nepal Demographic and Health Survey
5. GoN, Ministry of Environment, Website:
6. Periodic reports of different relevant ministries, local line agencies and organizations

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