48 5.9 Medicine Is a science and art of healing it encompasses variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness.
5.10 Diagnosis Is an art of identifying a disease from its signs and symptoms.
5.11 Impairment Impairment is any loss or abnormality of psychological or anatomical structure or function.
5.12 Disability It is any restriction or lack (resulting from impairment) of ability to perform an activity in the manner or within the range considered normal for a human being. It is a limitation in regard to the kind or number of activities a person can do due to long-term physical condition, mental condition or health problem.
5.12.1 People with Disabilities:
Can be defined as Persons with physical, intellectual, sensory or mental impairment
and whose functional capacity is limited by encountering attitudinal, environmental and
institutional barriers.
5.12.2 Washington Group questions set for disabilities
The WG questions sets are designed to provide comparable data for person with d
cross-nationally for populations living in a variety of cultures with varying economic
resources.
Covers six functional domains: seeing, hearing, walking, cognition, self-care, and
communication. Each question has four response categories: (1) No, no difficulty, (2)
Yes, some difficulty, (3) Yes, a lot of difficulty and (4) Cannot do it at all. Scaled
responses begin to describe the continuum of functioning from mild to severe.
5.12.3 Technical Devices:
Assistive Devices are those assistance be a person or equipment that supports a person
with disability to work in same pace as a non-disabled person e.g Sign Language
interpreter; Wheel Chairs, Visual Aids (Glasses, Braille and White Cane).
5.13 Handicap Handicap is the condition of being unable to perform as a consequence of physical and mental unfitness (depending on age, sex, social and cultural factors) for that individual e.g. reading disability or hearing disability.
49 5.14 Rehabilitation Means combined efforts in the domain of health, education, vocational training, psychology, public awareness and work including community-based rehabilitation intended to raise functional level of a person with disability so as to enable him, take part in the normal life of the community.
5.15 Settlements
A public building established for the purpose of providing welfare requirements of the needy
persons with disabilities.
5.16 Social Protection Means family or community support structures, and interventions by state or non state actors that support individuals, households and communities to prevent manage, overcome the risks threatening their security and well-being.
5.17 Social Support Means a support or assistance given to a person with disability in order to help that person to cope with his situation in a given environment.
5.18 Psychosocial Support Is an approach to victims of disaster, catastrophe or violence to foster resilience of communities and individuals. It aims at easing resumption of normal life; facilitate effected people participation to their convalescence and preventing pathological consequences or potentially traumatic situations.
5.19 Orphan It is a child under 18 years who has lost one or both parents.
5.19.1 Maternal Orphan It is a child under age 18 years who has lost his/her mother
5.19.2 Paternal Orphan It is a child under 18 years who has lost his/her father
5.20 Doctor Patient Ratio The doctor-patient ratio refers to the number of doctors available to serve a given population. It's an important metric in assessing healthcare accessibility and quality.
50
5.21 Nurse Patient Ratio
The nurse-patient ratio is a critical factor in determining the quality of patient care in healthcare
settings. It refers to the number of patients assigned to each nurse during a particular shift or
time period.
5.22 Outpatient Attendance Ratio.
Refers to total number of OPD attendance in a year divided by total population in a year.
5.23 Pharmacist Patient Ratio
Refers to number of people served by one pharmacist
5.24 Nurse Midwife Patient Ratio
Refers to number of people (pregnant women) served by one nurse midwife.
5.25 Hospital Bed
Refers to bed specially designed for hospitalized patient or others in need or some form of
health care.
• Licensed Beds: The maximum number of beds for which a hospital holds a
license to operate. Many hospitals do not operate all of the beds for which they
are licensed.
• Physically Available Beds: Beds that are licensed physically set up, and
available for use. These are beds regularly maintained in the hospital for the use
of patients, which furnish accommodations with supporting services (such as
food, laundry, and housekeeping). These beds may or may not be staffed but are
physically available.
• Staffed Beds: Beds that are licensed and physically available for which staff is
on hand to attend to the patient who occupies the bed. Staffed beds include those
that are occupied and those that are vacant.
• Un-staffed Beds: Beds that are licensed and physically available and have no
current staff on hand to attend to a patient who would occupy the bed.
• Occupied Beds: Beds that are licensed, physically available, staffed, and
occupied by a patient.
• Vacant/Available Beds: Beds that are vacant and to which patients can be
transported immediately. These must include supporting space, equipment,
medical material, ancillary and support services, and staff to operate under
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51 normal circumstances. These beds are licensed, physically available, and have staff on hand to attend to the patient who occupies the bed.
5.25.1 General Ward Bed This is a standard bed used in general wards for patients who do not require specialized care, usually come with basic features like adjustable height and sometimes have side rails for patient safety.
5.25.2 Intensive Care Unit (ICU) Bed ICU bed is designed for critically ill patients who require close monitoring and intensive medical care. Often has advanced features such as cardiac monitoring, respiratory support, and may be equipped with attachments for medical devices like ventilators.
5.25.3 Pediatric Beds These beds are specifically designed for infants and children, taking into account their smaller size and unique needs. They may come with features like side rails and colourful designs to create a child-friendly environment.
5.25.4 Maternity Beds Maternity beds are designed for pregnant women during labor, delivery, and postpartum recovery. They often have adjustable positions to accommodate different stages of childbirth and may include features for comfort and support.
5.25.5 Orthopedic Beds
These beds are designed for patients with orthopaedic conditions or those recovering
from orthopaedic surgeries. They may feature specialized mattresses and positioning
options to support proper alignment and healing.
5.25.6 Psychiatric Beds
Psychiatric beds are designed to meet the specific needs of patients with mental health
conditions. They often have features to prevent self-harm, such as padded surfaces and
tamper-resistant components.
5.25.7 Rehabilitation Beds Rehabilitation beds are used for patients undergoing physical therapy or rehabilitation. They may have features like adjustable height and positioning to support mobility and therapy exercises.
52 5.25.8 Hospital Bed Density Hospital bed density refers to the number of hospital beds available per 10,000 population within a specific geographical area.
5.26 Anthropometric Measurements Anthropometric Measurements are used to assess the nutritional status of children by collecting anthropometrics data which includes age, height and weight measurement. The nutrition status indicators are categorized in three standard indices which are:
5.26.1 Height - for- Age (Stunting) Stunting is the outcome of failure to receive adequate nutrition over an extended period and is also affected by recurrent or chronic illness. Children whose height- for- age is below minus two standard deviations from the median of reference population are stunted or short for their age.
5.26.2 Weight - for- Height (Wasting) Wasting represents the failure to receive adequate nutrition in the period immediately before the survey, and typically is the result of recent illness episodes especially diarrhoea, or a rapid deterioration in food supplies. Children whose weight- for- height is below minus two standard deviations from the median of reference population are considered wasted or thin.
5.26.3 Weight - for- Age (Underweight) Underweight reflects the effects of both acute and chronic under nutrition. Children whose weight -for -age is below minus two standard deviations from the median of the reference population are considered underweight.
5.27 Body Mass Index (BMI) Body Mass Index (BMI) is a number calculated from a person's weight and height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems. Body mass index (BMI) is a measure of body fat based on height and weight that applies to both adult men and women (except for pregnant women).
BMI Categories:
•
Underweight = <18.5
•
Normal weight = 18.5-24.9
•
Overweight = 25-29.9
•
Obesity = BMI of 30 or greater
53
5.28 Anemia
A condition in which the blood is deficient in red blood cells or oxygen-carrying proteins.
Hemoglobin is the oxygen-carrying pigment in the blood, the predominant protein in the red
blood cells. In the routine laboratory test for hemoglobin (Hb), it is usually measured as total
hemoglobin and the result is expressed as the amount of hemoglobin in grams (gm) per deciliter
(dl) of whole blood a deciliter being milliliters.
The normal ranges for hemoglobin depend on the age and beginning in adolescence and the
sex of the person. The normal ranges are:
Newborns: 17-22 gm/dl
One (1) week of age: 15-20 gm/dl
One (1) month of age: 11-15gm/dl
Children: 11-13 gm/dl
Adult males: 14-18 gm/dl
Adult women: 12-16 gm/dl
Men after middle age: 12.4-14.9 gm/dl
Women after middle age: 11.7-13.8 gm/dl.
5.28.1 Anemia Prevalence in Women of Reproductive Age Percentage of women aged 15−49 years with a hemoglobin concentration less than 120 g/L for non-pregnant women and lactating women, and less than 110 g/L for pregnant women, adjusted for altitude and smoking.
5.29 Low Birth Weight Low Birth Weight refers to infants who weigh less than 2.5 kg at birth.
5.30 Arm Circumference Refers as a Public Health Index of Protein-Calories Malnutrition of early childhood. Arm circumference indicators of nutritional status are such as simple arm circumference, arm circumference-for-age and arm circumference-for- height.
5.31 Surveillance
Surveillance is the monitoring of the behavior, activities, or other changing information,
usually of people for the purpose of influencing, managing, directing, or protecting them.
5.32 Curative Services Curative care refers to treatment and therapies provided to a patient with an intent to improve symptoms and cure the patient's medical problem. Examples of curative care are like antibiotics, chemotherapy and a cast for a broken limb.
54 5.33 Preventive Services Routine health care that includes check-ups, patient counselling and screenings to prevent illness, disease and other health-related problems
5.34 Adoption Is a process whereby a person assumes the parenting of another, usually a child, from that person's biological or legal parent or parents, and, in so doing, permanently transfers all rights and responsibilities, along with affiliation, from the biological parent or parents.
5.35 Most Vulnerable Children
Are children under the age of 18 years falling under extreme condition characterized by severe
deprivation as to endanger their health; well-being and long term development like those who
live in a house with chronically ill parent; Maternal Orphan, Paternal Orphan; Stigmatized;
marginalized or discriminated; child without both parents; abandoned child; child forced to
work; child in harassment situation; children living institutional care; children born in prison,
children with Disabilities; early childhood bearing; street children and those living in child
headed households.
5.36 Male Circumcision Procedure that removes the foreskin from the human penis. In the most common form of the operation, the foreskin is extended with forceps, then a circumcision device may be placed, after which the foreskin is excised.
5.37 Perinatal Deaths
Perinatal deaths refer to the loss of a baby either through stillbirth (occurring after 20 weeks of
pregnancy but before birth) or within the first week after birth (neonatal death). They can occur
due to various factors including congenital anomalies, complications during pregnancy or
childbirth, infections, and other medical conditions affecting the mother or baby.
5.37.1 Rate of Perinatal Deaths The rate of perinatal deaths (stillbirths, deaths within the first seven days of life) per 1000 live births. It is a crucial indicator that can be calculated and reported within short time.