Community & Family Medicine

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Introduction

Highlights

The discipline of Community and Family Medicine has witnessed rapid evolution from the community oriented health care point of view to the clinic aspect of the subject for appropriate patient care. In addition to bridging the gap between public health and clinical medicine, the department is committed to improve the quality of research in the field of medical sciences and thus, assuring an impactful medical background.

The Department of Community & Family Medicine within AIIMS Patna has facilitated an enthusiastic and dynamic environment where faculty, staff, and students are engaged in learning, scholarship, research, collaboration and committed to improving the health of Bihar. The Centre aims to produce high quality public health professionals and community physicians.

It has the specialty which deals with populations, and provide comprehensive, culturally sensitive, community-oriented health care to community, as a part of its outreach services. Along with it, the department is contributing immensely towards educational innovation through accelerated research and training.

The broad goal of the Department is to provide exceptional care to individuals and families by addressing physical, psychological and social problems; and coordinate comprehensive health care services with other specialists as needed and apply knowledge of behavioral and social sciences in the patient management plan, respecting the autonomy, dignity and rights of the patient/family.

In addition, it also offers educational and research opportunities for individuals pursuing careers in the patient-care professions, public health and the biomedical sciences, advancing knowledge through epidemiological, bio-statistical, behavioural and socio-clinical, ethical, legal, research.

The Centre is consistently working towards discovery of new knowledge in the domain of public health, advocacy for application of new ideas in health care of populations. The department is actively involved in providing its expertise both at the national as well as at the state health programs and policy through its participation.

Community Medicine OPD at AIIMS provides range of services like Yellow Fever/Oral Polio Vaccination is provided for international travellers six days in week Integrated Counselling and Testing Centre for HIV and Sexually Transmitted Disease (STD) clinic six days a week.

COVID vaccination centre: Covaxin vaccination against COVID- 19 disease is provided on all the days of the week.

Rural Health Training Centre (RHTC) at Naubatpur, is an integral part of the Department of Community and Family Medicine (C&FM), AIIMS Patna offers an array of health interventions including preventive, promotive diagnostic curative services with counselling to the needy clients. It caters to a variety of patients who self-report to the centre for utilization of these facilities. It is situated in Naubatpur, within the premises of Community Health Centre (CHC) Naubatpur.

The spectrum of activities done here are Clinical (General OPD, Ante-Natal Clinic (ANC Clinic), Non-Communicable Diseases Clinic (NCD Clinic) and Immunization Clinic which runs on all the working days of the week), National campaigns like Hepatitis-B Screening and also, MBBS student teaching is done. The centre also celebrated World TB Day and Swachhata Karyakram in the previous year.

Urban Health Training Centre (UHTC) at Khagaul is about 3.6 km from AIIMS Patna. The PHC is under the administrative control of the Health Department, Government of Bihar. Department has letter of communication with civil surgeon Patna, Bihar for working arrangement for student’s teaching and training. The PHC is situated in ward 27 having a population of 44,364 of which 23.492 are males while 20,872 are females as per report released by Census India 2011. The population of children with age of 0-6 is 5198. Child Sex Ratio in Khagaul is around 843 compared to Bihar state average of 935. Total no. of households is 7951.

The spectrum of activities done here are Clinical (General OPD, Non- Communicable Diseases Clinic (NCD Clinic) and Immunization Clinic which runs on all the working days of the week). NCD clinic in the centre mainly caters the cases of hypertension and diabetes. The cases are screened from general OPD. A registered case in NCD clinic of the centre receives following services: regular monitoring and recording of blood pressure and blood sugar; screening of family members for hypertension and diabetes, counselling of patients and promotion of behavioural changes for lifestyle modification. In immunisation centre, immunization services as per national immunization schedule are provided free of cost to all the pregnant mothers and children.

The future plans of the department include: setting up a well-baby clinic, get involved in immunization activities as per National Immunization Schedule, establish a cohort of at least 500 cases of hypertension and/or diabetes in 1 years, start post-partum counselling and clinical examination, implement standard treatment guidelines in local language to strengthen general OPD services, establish dental services, establish a dynamic digital reporting dashboard for all activities and to obtain a memorandum of understanding with Govt, of Bihar; to attach PHC Khagaul.

The Department have diverse area of activity like innovative educational activity of undergraduate and post graduate teaching, research activity and patient care and community services.

Apart from the conventional classroom teaching, the students visited PHC, CHC, Sub-Center, ICDS Centre, Patna Dairy Project, Sewage treatment plant at Beur; Incineration plant at IGIMS, Rehabilitation Center at Kankarbagh, Leprosy home, and Public Health Institute, Patna Medical College & Hospital, Patna during their Urban Health posting.

Although the field training of MBBS students was compromised in the year 2020, because of covid pandemic and lockdown, still the institute kept providing the orientation through virtual mode. And as the lock down was lifted, field visits commenced in small batches. Training of MBBS students was planned at Start of 4th Semester and was implemented as follows:

Urban Health Posting (UHP): The posting was conducted at Urban Health Training Centre (UHTC) Khagaul, Patna as per curriculum developed by the Faculty of department.

Family Health Advisory Service (FHAS): About 250 Households are surveyed by Field Staff (Medical Social Workers and the Residents) under the supervision of Faculty members. On the basis of this survey every student was allotted one Household for conducting FHAS activity.

Tutorials for OSCE (Objective Structured Clinical Examination) of undergraduates was started to impart skills and competencies that are fundamental to the practice of Family medicine.

Clinico-Psycho-Social Case Review (CPSCR): Students were given some cases, residing in the different locations near by UHTC Khagaul, RHTC Naubatpur for CPSCR under guidance of residents and social workers of department. CPSCR activity has been conducted at the family level on real location of the allotted cases.

The theory classes were conducted by different faculties on different topics of community and family medicine like epidemiology, biostatics, environment, nutrition, medical sociology, occupational health, communicable and non-communicable diseases, health management etc., The clinical demonstration was done by senior resident on supervision of concerned faculty.

Research Methodology: MBBS students in their third semester are imparted vigorous training on research methodology for developing research proposals through lectures and hand-on training. Each student participates in development of a research proposal in group and implement the proposal at field level. They are trained to collect data from field, data entry on computer and use of statistical software SPSS version 10 for data analysis.

The Post graduate course in the Department of Community & Family Medicine started in the year January 2019 and post graduate trainees are enrolled every six monthly. Total number of Post Graduate seats are 8 per year. The post graduate students have been posted in different departments for two weeks like general medicine, paediatrics, obstetrics and gynaecology, ophthalmology, otorhinolaryngology, casualty, skin VD and one week in PMR and psychiatry for clinical teaching.

A journal club is organized on every alternate Thursday in which the post graduate student critically reviews an article and Seminar presentation on important public health topics is done every alternate Thursday and Saturday under the guidance of faculty members.

The department conducts Research Methodology classes for Post Graduate Trainee belonging to several departments for their orientation in the field of research and betterment of quality thesis and an individual assessment is held after each session.

The community medicine OPD at AIIMS Patna offers an array of health intervention including preventive, promotive, diagnostic and counselling service foe all clients. It caters variety of patients not only from AIIMS hospital but also those who self-report for utilization of these facilities.

This is the only centre for Yellow Fever & Oral Polio Vaccination Centre in Bihar for International travellers approved by Ministry of Health & Family Welfare, Govt. of India. It started its journey on 21st July 2016. Since then, vaccination was provided three days of week till the year 2020. Since 2021, yellow fever vaccination is being provided daily and during 2020-2021, 3068 beneficiaries received vaccinated against yellow fever.

The Integrated Counselling and Testing Centre (ICTC) for HIV testing and counselling was inaugurated on 28th June 2018 at CFM OPD, and the services began from 1st July 2018 at a rapid pace. People are counselled and tested for HIV either of their own free will (client-initiated) or as advised by a medical provider (provider-initiated). All the information by expert counsellors followed by the HIV testing. Depending on the HIV test results, these clients also receive post-test counselling, and the positive cases also receive post-test counselling, and the positive cases are referred to the designated ART centre for proper management and follow up. For the prevention of parent to child transmission of HIV (PPTCT), all pregnant women visiting the obstetrics Dept. of AIIMS are offered HIV testing as well as the pre-test and post-test counselling in similar manner. A total of 241 antenatal women were tested during period 2020- 21.

With the year 2020 witnessing the emergence of the novel corona virus, Flu corner was set up in April 2020 for initial assessment, stabilisation and admission of COVID 19 patients. Since then, the flu corner is successfully running 24/7 to tackle the ongoing COVID pandemic. Department of Community & Family Medicine successfully conducted different MULTICENTRIC COVID-19 VACCINE TRIALS like Phase I/II/III of Bharat Biotech (COVAXINE, Adult), Phase I/II of Biological E, Phase I of Intranasal COVID-19 vaccine (Bharat Biotech).

Further, the department of Community & Family Medicine contributed to the COVID vaccination drive by starting up a COVID vaccination centre. The COVAXINE for COVID vaccination is being provided on daily basis and till date, 17518 first doses and 13936 second doses have been provided to the beneficiaries.

Community Services / Outreach Programme:
  1. CELEBRATION OF World TB Day 2021 (March 24)
    World TB Day was celebrated on 24th March 2021 at the field practice areas of Dept. of CFM, AIIMS Patna [RHTC, Naubatpur & UHTC, Khagaul]. The residents from Dept. of CFM, interns posted at the respective health centers and the undergraduate medical students of AIIMS Patna under the supervision of Faculty form AIIMS Patna were involved in different awareness activities. The teams spread awareness on signs and symptoms of TB, importance of testing and medication adherence, and service availability by carrying out health rallies and performing Nukkad Natak at both the centers.
  2. Celebration of Swachhata Karyakram at RHTC, Naubatpur, (April 3)
    Swachhata Karyakram, as a part of Swachhata pakhwada, was conducted on 03/04/2021 at Rural Health and Training Center (RHTC), Naubatpur, the rural field practice area of AIIMS, Patna under Department of Community and Family Medicine. The Faculty, Residents, Social workers and interns from Department of CFM carried out the health talks with demonstration and health education activities so as to create awareness and instilled the importance of swachhata and personal protection against the needle stick injury among the staff and safai karmachari of RHTC, Naubatpur.
  3. Celebration of World Health Day 2021 (April 7)
    Due to increase in number of corona positive case in the region, and several residents and faculty from the dept. of CFM testing positive for SARS CoV-2, the scheduled programme for World Health Day 2021 (except the poster competition) was called off. The poster competition for the occasion of world health day was held on 31st March 2021.
  4. Supportive Supervision of Maternal, Infant and Young Child Nutrition Services in Muzaffarpur, Bihar
    MIYCN National Working Group, to provide supportive supervision of the National Nutrition Mission through the involvement of the IAPSM members in various medical colleges (AIIMS PATNA) all over the country. AIIMS Patna was selected to start the pilot phase in Muzaffarpur. A total of 4 blocks (2 high performing and 2 low performing) were selected from Muzaffarpur based on HMIS data / maternal and Child health indicators. Community based events and health facility are being assessed by regular visits of faculties and Senior Residents regarding MIYCN activities that include service delivery and counselling. To assess quality of priority MIYCN service provision including counselling at various service delivery points (home, community/outreach and facility based) through Health and ICDS platforms in first 1000 days of life and also to identify relevant gaps in the functioning of the health and nutrition delivery platforms to deliver the specified under POSHAN Abhiyaan strategy. The study is ongoing and other districts are also being involved (Darbhanga, Gorakhpur and Gaya). Gaps in the services related to MIYCN are being identified along with solutions for the same and the reports are being submitted on monthly basis to IAPSM and further by IAPSM officials to NITI.
  5. Training of DCO supervisors in eliciting Covid-19 related information during VA for deaths enumerated in 2020.
    One-day online training was provided to DCO supervisors of Bihar, in eliciting Covid-19 related information during VA for deaths enumerated in 2020. The training was conducted by the department in collaboration with Technical Support Unit, AIIMS New Delhi & Directorate of Census Operation Bihar. Training comprised of interactive sessions, and hands on practice, with minimal use of didactic methods.
  6. AEFI Collaboration Unit
    The department has State AEFI causality assessment unit with collaboration of state health society of Bihar. Every 3 months an AEFI meeting is held in which cases are discussed with senior residents /junior residents with the AEFI team member of faculties of AIIMS Patna. During 2020- 2021 also, the AEFI meetings were conducted successfully through offline or virtual mode in accordance with the prevailing COVID situation.
  7. Common Review Mission (CRM) analysis and report writing: The department was involved in CRM analysis and report writing for 2020 under the NHSRC for various different Health and infrastructure domain of state of Bihar during October 2020.

SL No.Name of FacultyDesignation
1.Dr. C.M. SinghProfessor & Head
2.Dr. Sanjay PandeyProfessor
3.Dr. Pragya KumarAdditional Professor
4.Dr. Alok RanjanAssistant Professor
5.Dr. Shamshad AhmadAssistant Professor
6.Dr. Santosh Kumar NiralaAssistant Professor
7.Dr. Bijaya Nanda NaikAssistant Professor

  • Yellow Fever/Oral Polio Vaccination for international travellers six days in week
  • Integrated Counselling and Testing Centre for HIV and Sexually Transmitted Disease (STD) clinic six days a week
  • Covaxin vaccination against COVID- 19 disease on all the days of the week.

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