CURRICULUM

Master of Public Health

(MPH)
(TwoYearsProgramme)

The University of Health Sciences, Lahore

2013
 Table of Contents
PREFACE…………………………………………………………………………….1
1. INTRODUCTION ........................................................................................................... 2
1.1 MISSION STATEMENT ................................................................................................... 2
1.2 VISION STATEMENT ..................................................................................................... 2
1.3 INSTITUTIONAL GOAL .................................................................................................. 2
1.4 INSTITUTIONAL OBJECTIVES......................................................................................... 2
2. GOALS AND OBJECTIVES OF THE MPH PROGRAMME ..................................... 3
2.1 GOAL OF THE MPH PROGRAMME ................................................................................. 3
2.2 OBJECTIVES OF THE MPH PROGRAMME ....................................................................... 3
3. PROGRAMME ORGANIZATION AND STRUCTURE.............................................. 3
3.1 PROGRAMME DURATION, CREDITS AND MEDIUM OF INSTRUCTION .............................. 4
3.2 SESSION-WISE DISTRIBUTION: ...................................................................................... 4
4. METHOD OF ASSESSMENT/EXAMINATION .......................................................... 6
ANNEX 1: SEQUENCING OF THE MPH PROGRAMME............................................. 9
ANNEX 2:.......................................................................................................................... 14
COURSES FOR SESSION I............................................................................................. 14
01: FOUNDATIONS OF PUBLIC HEALTH............................................................................. 14
02: BASIC EPIDEMIOLOGY................................................................................................ 17
03: BASIC BIOSTATISTICS ................................................................................................ 21
04: POPULATION DYNAMICS ............................................................................................ 27
05: COMPUTER APPLICATIONS IN PUBLIC HEALTH ........................................................... 30
06: QUALITATIVE RESEARCH METHODS........................................................................... 33
07: ENVIRONMENTAL HEALTH ......................................................................................... 38
08:OCCUPATIONAL HEALTH ............................................................................................ 42
09. SOCIAL AND BEHAVIOURAL SCIENCES IN PUBLIC HEALTH ......................................... 43
10: HEALTH SYSTEMS ANALYSIS ..................................................................................... 47
ANNEX 3: COURSES FOR SESSION II......................................................................... 50
11: RESEARCH PROCESS I AND II...................................................................................... 50
12: INTRODUCTION TO REPRODUCTIVE HEALTH............................................................... 54
13: CHILD HEALTH PROGRAMMES AND INTERVENTIONS .................................................. 61
14: APPLIED EPIDEMIOLOGY AND BIOSTATISTICS ............................................................ 64
15: COMMUNICABLE AND NON-COMMUNICABLE DISEASE CONTROL ............................... 68
16: HEALTH EDUCATION AND HEALTH PROMOTION......................................................... 72
17: HEALTH SYSTEMS MANAGEMENT .............................................................................. 76
18: HEALTH PLANNING .................................................................................................... 79
ANNEX 4: COURSES FOR SESSION III ....................................................................... 81
19: HEALTH CARE FINANCING ......................................................................................... 81
20: APPLIED NUTRITION .................................................................................................. 85
21: HOSPITAL MANAGEMENT........................................................................................... 92
22: ADVANCED EPIDEMIOLOGY AND BIOSTATISTICS........................................................ 96
23. HEALTH POLICY ....................................................................................................... 100
24: COMMUNITY-BASED REPRODUCTIVE HEALTH INTERVENTIONS ................................ 104
ANNEX 5: DISSERTATION GUIDELINES (SESSION III) ........................................ 108
25: DISSERTATION ......................................................................................................... 108
PROPOSAL CRITIQUE AND EVALUATION GUIDELINES..................................................... 115
DISSERTATION CRITIQUE AND EVALUATION GUIDELINES .............................................. 118
ANNEX 6: PRACTICUM FOR SESSION IV................................................................ 122
26: PRACTICUM (ON-THE-JOB ASSIGNMENT).................................................................. 122
ANNEX 7: CORE COMPETENCY MODEL................................................................ 132
ANNEX 8: ADMISSION CRITERIA AND PROCEDURES ........................................ 133
INTRODUCTION .............................................................................................................. 133
ELIGIBILITY CRITERIA ................................................................................................... 133
APPLICATION PROCEDURES ........................................................................................... 135
ADMISSIONS PROCEDURES............................................................................................. 136
PREFACE

Needless to say that the importance of Public Health is many times more in the 21st century
compared to the previous years. The threats of new diseases, the ease of their transmission
to populations around the world, bioterrorism, epidemic of obesity, maternal and child
health, environmental and occupational impacts on health of the populations and the socio-
political impact of policy making in countries are imminent. The responsibility of providing
protection, both health-wise and financially, to the less advantaged has rapidly become an
immense challenge at the national and international levels.

Therefore, we need an effective public health system. This will require well-educated public
health professionals. Public health professionals are required to receive education and
training in a wide range of disciplines fulfilling competencies needed with focus on
populations. Therefore, we need to develop this area of education and training in line of
improving health of the populations through scientific evidence for changes in policies and
their implementation.

The Public Health education in Pakistan is outmoded as the curricula do not address the
changing needs of the population being taught at the undergraduate level (Community
Medicine) or at the post graduate levels (Public Health). It does not coach the professionals
with necessary competencies to function as a part of the Health Systems according to the
changing needs of the populations.

According to a careful estimate, Pakistan needs at least 5000 Public Health professionals
every year to make the health systems work and progress in terms of health of the
populations. There are a few Public Health Institutes in Punjab. Private sector is now trying
to fill in the gap. The numbers produced by the few existing Institutes are too few and far
from the required standards.

In light of this, the University of Health Sciences needs to take up Public Health education
and training regulation in the province It will require to improve on the existing facilities
and encourage even private institutes to offer a high quality education and training for
ensuring the delivery of recognizable change in the health of the people.

1
1. Introduction
The Master of Public Health (MPH) offered by the University of Health Sciences,
Lahore is planned as a twenty four months post-graduate degree program.

The mission and vision statements are described below.

1.1 Mission Statement

To bring a qualitative and quantitative revolution in medical education by providing
an environment geared towards promoting research and academic culture in order
to improve the existing healthcare system.

This will be brought about through education and research for the scientific
development of health policies, translation of policies into feasible action plans and
executing such plans.

1.2 Vision Statement

To train health professionals through Bio-Psycho-Social Model and develop human
resources required for meaningful, multidisciplinary health care.

1.3 Institutional Goal

The Institutional goal is to improve the health of the population through enhancing
human resource development and improving the health related policy through
research and practices.

1.4 Institutional Objectives

The objectives of the institution are to:

1. Produce competent, committed and skilled public health professionals.

2. Assist in the translation of the knowledge into sound evidence-based policies and
practices.

3. Prepare leadership in public health.

4. Develop, administer and evaluate health policies and programmes.

5. Participate directly in efforts to improve the health of the community using

community-based and health systems’ assessment of preventive/curative
services.

6. Conduct basic and applied research relevant to the description, risk factors and
interventions for the resolution of health problems in the human populations.

2
 These objectives will be appreciated through developing institutional values, such as
a merit-based system, transparency, assuring quality through a team network and
providing sustainable institutional infrastructure.

2. Goals and Objectives of the MPH Programme

2.1 Goal of the MPH Programme
The MPH programme aims to improve the health status of the population, which is
to be achieved by providing public health and health care professionals with a high
quality postgraduate training programme in public health sciences.

2.2 Objectives of the MPH Programme

The graduates of the MPH programme are prepared to:

1. Solve health-related problems within the financial, socio-cultural, environmental

and political framework of Pakistan and its surrounding region.
2. Design, conduct, analyze and interpret the results of relevant studies, projects
and programmes.
3. Plan, manage, monitor and evaluate interventions in the field of public health.
4. Communicate public health messages to diverse audience effectively.
5. Advocate sound public health policies and practices.

The Master of Public Health programme will provide experienced professionals

with a thorough grounding in population-based approaches to health sector problem
identification, investigation, and analysis and response management.

3. Programme Organization and Structure

The intensive curriculum emphasizes on basic public health sciences, essential
managerial and analytical skills including project planning and evaluation,
epidemiological investigations, health systems analysis and research, reproductive
and child health, environmental and occupational health, disease control, and
effective communication and leadership. It adopts a discipline-based methodology
based on core competencies.

The 24-month curriculum is organized around a guiding framework, which first

provides students with a conceptual overview of the diverse profession of public
health and team-oriented approach to professional practice as well as a 3-month
practicum (hands-on-training).

3
 The courses are taught in a concurrent manner to build upon and integrate with each
other. The first session curriculum provides exposure to the basics of public health
disciplines. The second session curriculum provides advanced applied training in
key methodological and programmatic disciplines which continues into the third
session, along with electives and a supervised dissertation. The dissertation
integrates public health knowledge, skills, and methods in a professionally and
individually relevant practice context. Elective courses are offered only during the
third session if minimally six participants enroll for a course. New credited courses
will be subsequently introduced on a need-and-demand basis in the coming years.

Students are encouraged to become involved in the institutional research wherein a

Field Area will provide an opportunity for supervised, mentored practical
experiences while addressing the health needs of Pakistan and its surrounding
region.

In the fourth session the students proceed to their respective

workplaces/attachments and apply the skills that they learnt in the first three
sessions. The immediate supervisor’s/mentor’s appraisal at the end of the session is
submitted to the Registrar.

3.1 Programme Duration, Credits and Medium of Instruction

The total programme consists of 67 credits. One credit is equivalent to 16 hours of
formal teaching/contact hours or 45 hours of practical fieldwork. Practical fieldwork
is defined as consisting of individual fieldwork, group fieldwork, field visits,
individual assignments and class exercises and is indicated after a + sign.

English is the medium of instruction and examination for the MPH programme.

3.2 Session-wise Distribution:

The distribution of the core and elective courses in the three sessions is given in the
following tables.

Year I Session I: Core Courses (Credits 21)

Foundations of Public Health 1

Basic Epidemiology 3
Basic Biostatistics 3

Population Dynamics 1
Computer Applications in Public Health 1+2

4
Qualitative Research Methods 1+1

Environmental and Occupational Health 3+1

Social and Behavioural Sciences in Public Health 1
Health Systems Analysis 3

Session II: All Core/Applied Courses (Credits 24)

Introduction to Reproductive Health 1.5+0.5

Child Health programs and Interventions 1.5+0.5
Applied Epidemiology and Biostatistics 2+1

Communicable and Non-communicable Disease Control 3+1

Health Education and Health Promotion 2.5+0.5
Health Systems Management 3
Research Process I and II 2+2
Health Planning 2.5+0.5

Session III: Tracks/ Elective* Courses (Credits 20)

Health Care Financing

Applied Nutrition 3

Hospital Management
3
Advanced Epidemiology & Biostatistics

Community-based Reproductive Health Interventions

3
Health Policy
Research Process III 0+1
Proposal and Dissertation writing 2+8

* Three out of six elective courses need to be taken.

Session IV: Practicum (Credits 2)

Courses Credits
Practicum and Report writing 2

Each session is of 22 weeks duration with an additional 2 weeks’ break. The

teaching hours per session differ as the division of time for lectures and practical
work for different courses varies.

5
4. Method of Assessment/Examination
The students are evaluated during each course on the basis of:

1. Formative assessment: which is a mix of tests, end of course examinations, class

and home assignments, class participation, interactive discussions, practical
exercises and/or group works depending on the course outline (ongoing
assessment); and
2. Summative assessment based on the end of the 2 year examination papers.
Summative assessments are held at the end of first three sessions. The general
viva voce examination will be carried out at the end of the written papers.
Dissertation work is assessed through a viva voce examination on the basis of a
structured format covering the quality of the project, work performed in the field,
data generation and analysis and presentation of results, discussion and
conclusions presented as a written report.

In the fourth session, the students either go back to their workplaces or take an
attachment with a national programme, agency etc. and apply the skills learnt in the
first three sessions. At the end of the session an on-job written report will be
submitted by the students in addition to the written appraisal by the designated
supervisor/mentor. A joint agreement has to be made with the supervisor/mentor
and the faculty advisors at prior to the beginning for the fourth session. This will be
finally assessed by the senior faculty of .

Twenty percent marks shall be reserved for the ongoing (formative) assessment and
eighty percent for the final examination paper and dissertation (summative
assessment).

Candidates obtaining less than 60% in any of the examinations will be deemed to
have failed in that paper/session of the MPH. A student failing in a paper (when
scores of session examination and ongoing assessment are less than 50%), will be
allowed to clear that paper in the supplementary examination to be held within 3
months of the declaration of the result of the session. However, a student
accumulating more than two failures at any stage shall cease to be a student of the
University.

The distribution of marks for each examination is as follows:

6
Paper 2. All Applied courses Credit Assessment marks
tool
Introduction to Reproductive Health 2 MCQ,SEQ 50
Child Health programs and Interventions 2 MCQ,SEQ 50

Applied Epidemiology and Biostatistics 3 MCQ,SEQ 75

Communicable and Non-communicable 4 MCQ,SEQ 100
Disease Control
Health Education and Health Promotion 3 MCQ,SEQ 75

Health Systems Management 3 MCQ,SEQ 75

Research Process I and II 4 MCQ,SEQ 100
Health Planning 3 MCQ,SEQ 75
Total credit hours 24 600

Session III. All Elective courses + credit Assessment marks

Dissertation tool
Health Care Financing

Applied Nutrition 3 75
Hospital Management
3
Advanced Epidemiology & Biostatistics 75

Community-based Reproductive Health

Interventions 3
Health Policy 75
Research Process III 1 Research 25
Proposal and Dissertation writing 10 Thesis & 250
defense
Total 20 500

Courses Practical Assessment marks

Credits tool
Practicum and Report writing 2 Report 100

7
 Year Year II Ongoing Ongoing Research Pract Total Passing
I Papers Assessment Assessment Project/ icum Mark Marks
Pape Year I Year II Dissertatio s
rs n/
Viva Voce
Total 500 600+200 200 300 300 100 2200 1320
Marks

Candidates passing all the session examinations shall be declared to have passed the
MPH programme and shall be awarded the degree.

The final evaluation of the students will be as per the existing university regulations.
The minimum passing marks in each of the subjects will be 60%; however the overall
cumulative minimum marks required for passing the MPH programme will be 60%.

Grading of course work is as under:

 Grade “A” 90% or higher

 Grade “B” 70% to 89%
 Grade “C” 60% to 69%
 Fail Less than 60%

8
 MPH PROGRAMME

Annex 1: Sequencing of the MPH Programme

First Year

No. Courses (credits) Weeks

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Session I

1 Non-credit Orientation 1 day

2 Foundations of Public Health (1)

3 Basic Epidemiology (3)*

4 Basic Biostatistics (3)

Session Break
5 Introduction to Population Dynamics (1)

Prep Leave

Exam
6 Computer Applications in Public Health (1+2)

7 Qualitative Research Methods (1+1)

8 Environmental and Occupational Health (3+1)

9 Social & Behavioural Sciences in PH (1)

10 Health Systems Analysis(3)

* The credits distribution per course is shown below as didactic + practical, e.g. 1+1 is calculated as one credit of didactic classroom teaching and one credit for interactive work
such as exercises, field assignments, etc.

9
 Session II

No. Courses (credits) Weeks

27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52

11 Research Process I, II (2+2)

12 Introduction to Reproductive Health (1.5+0.5)

13 Child Health Programmes(1.5+0.5)

Session Break
14 Applied Epidemiology and Biostatistics (2+1)

Prep Leave

Exam
15 Communicable & Non-communicable Diseases(3+1)

16 Health Education and Health Promotion (2.5+0.5)

17 Health Systems Management (3)

18 Health Planning (2.5+0.5)

Second Year Session III

No. Courses (credits) Weeks

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

1 Research Process Part III (1)

Prep leave/Exam/Synopsis

2 Elective 1 (2.5+0.5)

Examination
Prep Leave
3 Elective 2 (2.5+0.5)

4 Elective 3 (2.5+0.5)

5 Dissertation (2+8)

10
 Session IV

27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52

End of MPH Programme

Submission of Report
26. Practicum (On-the-job
Assignment) Viva Voce Reporting to Workplace
(0+2)

11
 MPH PROGRAMME

Annex 2:

Courses for Session I

01: Foundations of Public Health
Course Title: Foundations of Public Health
Course Credits: 1

Introduction:
Public Health Science is a multidisciplinary field that has changed over the years. However,
an effective public health system is as urgent as it has ever been. A public health
professional receives education and training in a wide range of disciplines but aim at
improving health through a population focus. Public Health education and training not only
includes the five long-recognized core components of public health (i.e., epidemiology,
biostatistics, environmental health, health services administration and social and
behavioural sciences) but new areas are also considered these days as essentials of public
health: disease-control, reproductive and child health, informatics, genomics,
communication, cultural and social diversity, community-based participatory research,
policy and law, global health and ethics. Public health professionals’ education and
preparedness should be of concern to everyone for this will improve the health of the
populations

Learning Goal:
The goal of this course is to introduce the MPH students to the various facets of public
health concepts, the problem solving paradigm and prepare them for the multi-disciplinary
approach of public health.

Learning Objectives:
By the end of the course participants should be able to:

1. Examine public health through its historical context and use this information in the
evaluation of current public health issues
2. Analyze a public health problem and evaluate interventions and policy alternatives
using the problem-solving methodology

14
 MPH PROGRAMME

Contents:
The following areas will be covered during the course:

1. Definition of public health in a historical perspective

2. Recent developments in public health and future directions of public health
3. Problem-solving methodology applied to public health

 Defining the problem

 Measuring the magnitude of the problem
 Developing a conceptual framework for understanding the key determinants
 Identifying and developing strategies (policies and interventions)
 Setting priorities and recommending intervention or policies
 Implementing interventions or policies and evaluation plan
 Developing a communication strategy

4. Research in public health and importance of evidence-based decision making

5. Overview of public health programs in Pakistan

Teaching Methodology:
The methodology used ranges from didactic and participative lectures, discussions to
practical problem solving exercises.

Recommended Readings:
1. Basch PF. Textbook of international health, 2ndEd. New York, NY:OxfordUniversity
Press.
2. Brownson RC, Baker BA, Leet TL, Gillespie KN. Evidence-based public health. New
York, NY: OxfordUniversity Press; 2003.
3. Detels R, McEwen J, Beaglehole R, Tanaka H, (eds.). Oxford textbook of public health:
the practice of public health, 4th ed. Oxford: Oxford University Press; 2002.
4. Malin N, Wilmot S, Manthorpe J. Key concepts and debates in health and social policy.
Philadelphia, PA: Open University Press; 2002.
5. Porter D. Health, civilization and the state, 1st ed. New York, NY: Chapman and Hall
Routledge; 1999.

15
 MPH PROGRAMME

6. Rohde J, Wyon J. Community-based health care lessons from Bangladesh to Boston, 1st
ed. Cambridge, MA: Management Sciences for Health in collaboration with the Harvard
; 2002.
7. Schneiderman N, Speers MA, Silva JM, Tomes H, Gentry JH (eds.). Integrating
behavioral and social sciences with public health, 1st ed. WashingtonDC: American
Psychological Association; 2001.
8. Tulchinsky TH, Varavikova EA. The new public health: an introduction for the 21st
century. San Diego, CA: Academic Press; 2000.

Students’ Evaluation:
Formative (20%)
Class participation
Group work (group performance and group report)
Summative Assessment (80%)
Based on the end of the course examination

16
 MPH PROGRAMME

02: Basic Epidemiology

Course Title: Basic Epidemiology

Course Credits: 3

Introduction:
Epidemiology is an essential discipline for public health practice. The importance of this
science is demonstrated by the inclusion of epidemiology courses in most medical, nursing
and public health curricula. Basic Epidemiology lays stress on the basic epidemiological
principles and their application to research methodology developing on the understanding
of the fundamental principles and on the development of the practical skills and concepts
rather than on mathematical calculations.

This core course is offered in the first session of the MPH programme. This is particularly
linked with the courses on Health Informatics and Computer Applications in Public Health.

Learning Goal:
The goal of this course is to enable health professionals to understand the concepts and
apply the epidemiological and statistical methods to design, conduct, analyze and apply
interventions for evaluation, making use of computer statistical software and information
technology.

Learning Objectives:
By the end of the course, the participants must be able to:

1. Define Epidemiology and its uses in Public Health and Research

 Importance of epidemiological investigations
 Developments in modern Epidemiology
 Uses of Epidemiology in health and disease
2. Apply and design strategies commonly used for epidemiological studies
 Describe Descriptive and Analytical studies, the principals of various study designs
with their merits and main outcome measures highlighted for each study design:
case report and case series (description), cross-sectional studies(prevalence), cohort
studies (incidence, relative risks), case control studies (Odds Ratio), experimental
studies/clinical trials, intervention studies
 Describe each study design with its uses, strengths and limitations
17
 MPH PROGRAMME

3. Assess the burden of disease using the measures of disease frequency e.g.:
 Define rates, ratios, proportions in relation to vital statistics. Calculate incidence,
prevalence, morbidity and mortality rates in human populations.
 Apply these measures in defining population dynamics
4. Describe the validity and reliability of a study design:internal and external validity and
its measure,Hawthorne effect etc.Reliability and its measures.
5. Investigate association in terms of strength of association and causality. Make 2x2 tables.
Calculate Relative risk, Attributable risk, population attributable risk percent and
population attributable risk fraction. Interpret these measures.
6. Identify Risk and risk factors: definition and characteristics. Define Causality and judge
cause-effect relationship:
 Examine the epidemiological evidence
 Examine the statistical evidence
 Examine biological plausibility
7. Drawing Inference from study results (alternative explanations):
 Define confounding, its characteristics and effects on the results and how to control
for it.
 Define Bias, its characteristics and effects on results and how to control for it.
 Define Chance, its characteristics and effects on results and how to control for it.
8. Apply screening in disease control:
 Define Screening, uses, screening tests, their validity and yield discussing the bias
associated with Screening.

Contents:
The following are the contents of the course:

1. Definition of Epidemiology
2. Importance of Epidemiology
3. Types of study designs: their importance, uses and limitations.
4. Outcome measures for each study design e.g. Relative risk, Odds ratio etc.
5. Causality and association
6. Inferential Epidemiology
7. Validity and Reliability
18
 MPH PROGRAMME

8. Measuring the Disease burden: Rates, Ratios, Incidence, Prevalence

9. Role of Chance, Confounding and Bias in interpretations.
10. Screening in disease control.

Recommended Readings in Epidemiology:

1. Beaglehole R, Bonita R, Kjellstrom T. Basic epidemiology. Geneva: World Health
Organization; 1993.
2. Gordis L. Epidemiology. Philadelphia, PA: WB Saunders Company; 2008.
3. Greenberg RS, Daniels SR, Flanders WD, Eley JW, Boring JR. Medical Epidemiology, 2nd
ed. New York, NY: McGraw Hill; 1996.
4. Hennekens CH, Buring JE. Epidemiology in medicine. Boston, MA: Little Brown and
Company; 1987.
5. Holford TR. Multivariate methods in epidemiology. New York, NY: OxfordUniversity
Press; 2002.
6. Last JM. A dictionary of epidemiology, 2nd ed. New York, NY: OxfordUniversity Press;
1988.
7. Lilienfeld AM, LilienfeldDE. Foundations of epidemiology,3rd edition. New York, NY:
OxfordUniversity Press; 1994.
8. MacMahon B, Thomas FP. Epidemiology: principles and methods, 1st ed. Boston, MA:
Little, Brown and Company; 1970.
9. Mausner JK, BahnAK. Epidemiology: an introductory text, 2nd ed. Philadelphia, Pa: WB
Saunders Company; 1985.
10. Olsen J, Saracci R, Trichopoulos D, (eds.). Teaching epidemiology: a guide for teachers in
epidemiology, public health and clinical medicine, 2nd ed. Oxford: Oxford University
Press.
11. Fletcher RH, Fletcher SW, Wagner EH. Clinical epidemiology: the essentials, 3rded.
Philadelphia, PA: Williams & Wilkins Publishers; 1996.
12. Szklo M, Neito FJ. Epidemiology: beyond the basics. Boston, MA: Jones and Bartlett
Publishers; 2000.
13. Vetter N, Matthews I. Epidemiology and public health medicine, 1sted. Edinburgh:
Churchill Livingstone; 1999.

19
 MPH PROGRAMME

14. Dupont WD. Statistical Modelling for Biomedical Researchers. A simple introduction to
the analysis of a complex data. 2nd edition. CambridgeUniversity Press; 2008.

Teaching Methodology:
Interactive (scenario-based learning) and other teaching tools, discussions and practical
examples (exercises), lectures.

20
 MPH PROGRAMME

03: Basic Biostatistics

Course Title: Basic Biostatistics

Course Credits: 3

This discipline plays a fundamental role to prepare the students to apply basic statistical
methods in designing the scientific studies, data collection, data analysis and draw
inferences. This will introduce essential statistical tools to the students of Public Health to
conduct and interpret quality research.

Learning Goals:
The following are the learning goals of this course:

1. Introduce important statistical concepts to thestudents of Public Health to solve

everyday problems
2. To prepare the students to design studies/trials including the sample size, sampling
techniques, data analysis, tests of significance etc.
3. To prepare the student to interpret collected data and draw inferences.

Learning Objectives:
The following are the objectives of the course:

1. Define and give the rationale for statistics in medicine

2. Define variables and their types:
 What are variables, different type of variables, classify variables into qualitative,
quantitative, discrete and continuous variables
 Define dependent and independent variables
 Breakdown the range of a series of quantitative measurements into intervals and
specify which measurement belongs to which intervals.
3. Define the data types and the scales of measurements
 Continuous and discrete data sets
 Ordinal and nominal data sets
 Interval scales
 Composite scales

21
 MPH PROGRAMME

4. Interpret a given data: Apply descriptive statistics for continuous variables in terms
of:
 Measures of central tendency: Calculate the mean, median and mode and interpret
them.
 Measures of dispersion: variance, standard deviation, coefficient of variation
 Measures of shapes: regarding the distribution of the data sets
5. Apply frequency distribution to a given data and its interpretation. What are
percentiles, their uses and limitations in a dataset
6. Apply the concepts of probability. Recognize the algebraic notations used in statistics
to differentiate between parameters and statistics.
7. Define Probability, types of probability with examples.
8. Describe the common probability distributions especially Normal and Binomial
distributions.
 List the descriptive properties of a normal distribution with mean μ and standard
deviation σ
 Use tables of normal distribution function to estimate the area under a normal curve
with mean μ and σ for one and between 2 values of the variable.
 Define Binomial distribution: use the normal approximation to the binomial
probabilities and use of continuity correction to improve the estimates.
9. Describe Population and its relation to sample:
10. Define Sampling and its techniques:
 Distinguish between probability and non-probability sampling
 Define various types of probability and non-probability sampling
 Why sampling errors arise in a sample estimate of a parameter.
 Describe the sampling distributions of a mean and a proportion.
 Interpret and explain quantitatively the effect of the standard deviation and sample
size on the sampling distributions
11. Calculate the sampling errors; Calculate the standard error of a mean and a
proportion and its interpretation.
12. Calculate and interpret confidence intervals for a parameter. Explain why it is
necessary to calculate confidence interval in a data
13. Apply concepts of comparing data (Inferential statistics):
22
 MPH PROGRAMME

 Learn about the basics of hypothesis development

 What is a Null hypothesis and Alternate Hypothesis
 Describe the rationale of a significance test
 Define Alpha and Beta errors
 Calculate the Power of a study
14. Apply various tests of significance: their rationale and use.
15. Calculate Confidence Intervals
16. Explain the meaning of ‘p’ in statistical terms and its interpretation.
17. Apply the steps of Hypothesis testing
 Choosing an appropriate test of significance
 Use the tests of significance for parametric data: for a single mean, for two means of
unpaired observations, two means of paired observations, three or more
independent means (ANOVA).
 Use the tests of significance for categorical data: for one proportion, two independent
proportions, two paired proportions, several proportions, analyzing frequency tables
(2x2, 2xk tables), large tables with ordered categories.
18. Investigate the association between two continuous variables: using a scattergram to:
 Identify dependent and independent variables
 Apply correlation–calculate correlation coefficients,
 interpretation and presentation of correlation.
19. Investigate the relationship of two continuous variables using regression, calculating
linear regression of y on x and draw line of regression, interpreting and presenting
regression.
 When to choose –regression or correlation?

Contents:
The following are the contents of the course:

1. Introduction to Biostatistics
2. Types of statistical applications
3. Variables
4. Scales of measurements
5. Descriptive Statistics
23
 MPH PROGRAMME

6. Measures of central tendencies

7. Measures of variability
8. Measures of shapes
9. Probability
10. Probability Distributions: Normal, Poisson, Binomial
11. Sampling techniques, sampling errors/ Confidence Intervals
12. Concepts of analytical statistics: Hypothesis testing:
13. Alpha and Beta errors
14. Tests of Significance: Normal test, t test, Chi square test etc.
15. Correlation
16. Regression
17. Sampling and various sampling techniques
18. Data presentation: Figures, graphs, tables

Teaching Methodology:
Interactive (scenario-based learning) and other teaching tools, discussions and practical
examples (exercises), lectures

Recommended Readings:
1. Altman DG. Practical statistics for medical research, 3rd ed. London, UK: Chapman &
Hall; 1991.
2. Colton T. Statistics in medicine, 1st ed. Boston, MA: Little Brown and Company ; 1994.
3. Daniel WW. Biostatistics: a foundation for analysis in the health sciences, fifth edition.
New York, NY: John Wiley & Sons; 1991.
4. Kirkwood BR. Essentials of medical statistics, 2nd ed. Oxford, UK: Blackwell Scientific
Publications; 1988.
5. Selvin S (ed.). Statistical analysis of epidemiologic data, 3rd edition. New York, NY:
OxfordUniversity Press; 1991.

6. Dupont WD. Statistical Modelling for Biomedical Researchers. A simple introduction to

the analysis of a complex data. 2nd edition. CambridgeUniversity Press; 2008.

24
 MPH PROGRAMME

Articles:
1. Bashir A, Yaqoob M, et. al. Prevalence and associated impairments of mental retardation
in six to ten year old children in Pakistan: a prospective study. Acta Paediatr 2002:91;
833-37.
2. Beasley RP. Hepatitis B virus as the etiologic agent in hepatocellular carcinoma –
epidemiologic considerations. Hepatology 1982:2; 21S-26S.
3. Bentley ME. Household behaviors in the management of diarrhea and their relevance for
persistent diarrhea. Acta Paediatr 1992: 381(suppl.); 49-54.
4. Bhutta ZA. Beyond informed consent. Bull World Health Organ2004:82; 771-778.
5. Brahmbhatt H, Gray RH.Child mortality associated with reasons for non-breastfeeding
and weaning: is breastfeeding best for HIV-positive mothers?AIDS 2003:17; 879-85.
6. ButteNF, Villalpando S, et. al. Higher total energy expenditure contributes to growth
faltering in breast-fed infants living in rural Mexico. J Nutr 1993;123:1028-35.
7. Cravioto A, Reyes RE, et. al. Prospective study of diarrhoeal disease in a cohort of rural
Mexican children: incidence and isolated pathogens during the first two years of life.
Epidemiol Inf 1988:101;123-34.
8. DeWitt TG, Humphrey KF, et. al. Clinical predictors of acute bacterial diarrhea in young
children. Pediatrics 1985: 76; 551-56.
9. Farr W, Humphreys NA. Vital statistics:a memorial volume of selections from the
reports and writings of William Farr. Bull World Health Organ 2000;78:88-95.
10. Gordis L. Challenges to epidemiology in the next decade. Am J Epidemiol 1988:128;1-9.
11. Grunberg SM, Cefalu WT. The integral role of clinical research in clinical care. N Engl J
Med2003: 348; 1386-8.
12. Keusch GT, Thea DM, Kamenga M, Kakanda K, et al. Persistent diarrhoea associated
with AIDS. Acta Paediatr Suppl 1992:381; 45-8.
13. Khalil K, Lindblom GB, Mazhar K, Sjogren E, Kaijser B. Frequency and
enterotoxigenicity of campylobacter jejuni and C. coli in domestic animals in Pakistan as
compared to Sweden. J Trop Med Hyg 1993 Feb;96(1):35-40.
14. Rose G. Sick individuals and sick populations. Int J Epidemiol 1985:14; 32-38.
15. Saleemi MA, Zaman S, et. al. Feeding patterns, diarrheal illness and linear growth in 0-24
months old children. J Trop Pediatr 2004:50; 164-9 .

25
 MPH PROGRAMME

16. Schulz KF, Grimes DA. Blinding in randomized trials: hiding who got what. Lancet
2002:359; 696-700.
17. Scrimshaw N. The new paradigm of public health. Amer J Public Health 1995:85; 622-24.
18. Wagstaff A. Socioeconomic inequalities in child mortality: comparisons across nine
developing countries. Bull World Health Organ 2000;78:19-29.
19. Watkins PJ. Cardiovascular disease, hypertension and lipids. Br Med J 2003:326; 874-6.
20. Williams IT, Milton JD, et. al. Interaction of socioeconomic status and provider practices
as predictors of immunization coverage in Virginian children. Pediatrics 1995;96: 439-
446.
21. Wylie I, Griffiths S, Hunter DJ. Everywhere and nowhere: aSocratic dialogue on the new
public health. Br Med J 1999:319; 839-40.

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and class exercises
Summative Assessment (80%)
Summative assessment consists of: MCQs and short essay questions

26
 MPH PROGRAMME

04: Population Dynamics

Course Title: Population Dynamics
Course Credits:2

Introduction:
Pakistan is currently going through demographic transition. This transition and the ultimate
effects of the same are needed to be understood and appreciated in terms of policy,
management and research. Not all health managers, policy makers and researchers know
various static and dynamic measures of populations. The country’s annual growth rate
implies effect on its economy and resources. Poverty, population growth and disease is the
vicious cycle that has to be addressed from a local perspective. Changing population
pyramids of the developed world also emphasize to look into a twenty year time for our
interventions in future for health.

Learning Goal:
The overall goal of this course is to impart basic knowledge and bring a change in attitude of
the participants towards major issues in population dynamics to enable them to do research
on some of these issues.

Learning Objectives:
By the end of the course, the participants must be able to:

1. Define demography, its tools and vital statistics.

2. Describe demographic transition and historical forces leading to the current situation
3. Explain population pyramid and different profiles of population pyramids
4. Interpret and compute different mortality and morbidity related measures
5. Compute and interpret different fertility related measures such as Crude Birth
Rate, Total Fertility Rate, Age Specific Fertility Rate, Net Reproduction Rate and
Doubling Time
6. Discuss the impact of population growth on development and health issues
7. Demonstrate knowledge and understanding of scientific, evidence based approaches to
the study of population issues.
8. Identify causes and consequences of population change and relate these to underlying
population dynamics.

27
 MPH PROGRAMME

9. Demonstrate knowledge and understanding of demographic behavior in social and

policy context

Contents:
The contents of the course are:

1. Introduction to Population dynamics: Various static and dynamic measures of

populations
2. Population and Health: An introduction to Epidemiology
3. Visit to Federal Bureau of Statistics
4. Demographic perspective and basic demographic equations
5. Sources of data including census
6. Salient features of population pyramids
7. Concepts and theories of demographic transition
8. World population growth patterns and population momentum
9. Mortality & measures of mortality
10. Global burden of diseases
11. Fertility, natural increase and reproduction rates
12. Characteristics of Pakistani population and other countries
13. Migration and urbanization
14. Population, Poverty and Politics
15. Islam and family planning
16. Population growth and aging
17. Population Policy

Teaching Methodology:
1. Didactic class room instruction on multimedia and white board
2. Interactive discussions and experience exchange
3. Panel discussion
4. Assignment: Library/Internet
5. Role plays

28
 MPH PROGRAMME

Recommended Readings:
1. Haupt A, Kane TT. Population handbook. Washington, DC: Population Reference
Bureau; 1997. Available from: URL:http://www.prb.org/pdf/PopHand book_ Eng .pdf
2. Palmore JA, Gardner RW. Measuring mortality, fertility and natural increase: a self-
teaching guide to elementary measures. Honolulu: East-West Population Institute, East-
WestCenter; 1983.
3. Population Reference Bureau. World population: more than just numbers.
WashingtonDC: Population Reference Bureau; 1999.

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and class exercises
Summative Assessment (80%)
Summative assessment consist of: MCQs and Short essay questions

29
 MPH PROGRAMME

05: Computer Applications in Public Health

Course Title: Computer Applications in Public Health
Course Credits:1+2

Introduction:
Computer skills in public health schools are a prime necessity. Not only the applications and
skills are needed for the word processing for proposal writing and creating a
questionnaire/proforma, but also for using statistical analysis and report writing. Currently,
the available computer software are user friendly and can be easily operated by the
professionals. Public health professionals are expected to have a thorough insight into the
available software and be capable of producing the required results. The successful use of
internet can make the communications easy and efficient. Moreover the efficient utilization
of online resources for literature review and research depends on the respective skill
attainment by the concerned researcher.

Learning Goal:
The learning goal of the course is to provide the public health professionals with skills to
operate the computers and utilize the software and related resources efficiently.

Learning Objectives:
By the end of the course, the students will be able to:

1. Use internet efficiently for research purposes.

2. Use a word processor like Microsoft Word for writing their research proposal and
dissertation.
3. Develop presentations using Microsoft Power point.
4. Enter and handle the data using statistical software, like Excel, Access, Epi Data, Epi
Info, SPSS and Stata.
5. Analyze data and generate results by using these statistical software.
6. Present data in graphical and tabulated forms using appropriate software.
7. Use citation software like End Note

Contents:
The following are the contents of the course:

30
 MPH PROGRAMME

1. Introduction to Computers.
2. Types of Computers
3. Computer Operating System
4. Use of Input out Devices
5. Accessing to PDF Files
6. Basics in word processing
7. Advanced functions in Word, Power point and Excel
8. Literature search using internet
9. Advance Search Tools (Google, Bing)
10. Ability to use citation software like End Note
11. Introduction to Epi Data & Epi Info:
 Data entry and cleaning procedures
 Data processing procedures
 Data analysis procedures
 Graphics in Epi Info
12. Introduction to SPSS:
 Data entry procedures
 Data processing procedures
 Data analysis procedures
 Graphics in SPSS
13. Introduction to STATA:
 Data entry procedures
 Data processing procedures
 Data analysis procedures

Recommended Readings:
1. Stata Corporation. STATA release 8: user’s guide. College Station, Texas: Stata Press;
2003.
2. SPSS for Dummies 2007
3. Other manuals for statistical software
4. Help options in the software programs

31
 MPH PROGRAMME

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and individual computer-based
exercises

Summative Assessment (80%)

Summative assessment consists ofshort essay questions, computer-based exercises
testing the ability to utilize various software

32
 MPH PROGRAMME

06: Qualitative Research Methods

Course Title: Qualitative Research Methods
Course Credits:3

Introduction:
In this course the participants are introduced to basic concepts of social and medical
anthropology. In this course the participants are introduced to basic concepts of social and
medical anthropology. The students of Public Health generally lack training in designing
and conducting research studies. This basic course will prove helpful to anyone working as
a health worker or researcher, interested in learning the qualitative research methods. This
course will equip students to better understand published research and gain an insight into
different ways of designing the research trials, data collection, and data analysis. Theory
behind qualitative research and a number of qualitative research methods will be discussed.
On completion of the course, students should be able to understand and appreciate
qualitative research and undertake this as a tool in research.

The socio-cultural dimensions and lay perceptions of health and medicine including the
concepts and definitions of disease, illness and sickness from the public health’s point of
view are taught. The course teaches qualitative research methods, i.e. interview, observation
and participative techniques, and their application to public health. Students discuss and
practice methods for collecting and analyzing qualitative data.

Learning Goal:
The goal of this course is to sensitize the participants to the social and cultural factors that
influence health and disease including the people’s perception including experiences of
health and illness and to equip them with qualitative research knowledge and skills to
address public health problems. This will enable participants to develop the skills to use
qualitative methodology in undertaking public health and primary care research.

Learning Objectives:
By the end of the course participants should be able to

1. Understand the background principles of undertaking qualitative research applied to

health care sector.

33
 MPH PROGRAMME

2. Explain and critically discuss the principal qualitative methods that can be used to
undertake research as a means of exploring a range of important public health and
primary care issues.
3. Compare and contrast the ways in which qualitative data may be collected and used in
primary care and public health research.
4. Identify, synthesize and conduct secondary analysis of qualitative data on topics
relevant to primary care, public health or health services research.
Course Contents:
1.Concepts and Qualitative Research Methods Applied to Health Care Sector
2. Difference between Qualitative and Quantitative Research Methods
3. Approaches to Qualitative Research
4. Qualitative Data Collection Methods
Interviews
Focus Groups
Observations
Collection of documented Material
Questionnaires
5. Qualitative Sampling and Selection
6. Sampling Strategy
7. Sample structure
8. Adequacy of sample
9. Samples for focus group studies
10. Introduction to alternative data collection methodologies i.e. video, photographs, diaries
11. Sampling while interpreting data and preparing findings
12. Qualitative Analysis
13. Keeping records in organized manner
14. Transcribing qualitative data
15. Using Qualitative software
16. Conducting qualitative analysis
17. Narrative analysis and thematic analysis
18. Secondary data analysis of existing data sets

34
 MPH PROGRAMME

19. Ethics, politics and policy: reflecting on the use of qualitative research methods in health
care settings

Contents:
The following areas will be covered during the course:

1. Overview of basic concepts of anthropology and medical anthropology.

2. Definition of anthropology and medical anthropology
3. Historical perspective
4. Importance and uses in public health
5. Basic concepts and terms:
 Emic and etic perspective
 Ethnocentrism and cultural relativism
 Culture bound syndromes
 Concepts and models of body, disease, illness and sickness
 Health
 Disease
 Illness
 Sickness
 Explanatory models
 Illness Explanations, Compliance and Social Context
 Medical and Non-Medical Conceptions of Health and Illness
 Patient explanations of illness
6. Medical pluralism, i.e. co-existence of different types of allopathic and non-allopathic
medical systems / formal and informal sectors.
 Pattern of resort
 Choices of therapy and health-seeking strategies
 Factors influencing the selection of particular forms of treatment.
 Traditional/Alternative Medicine and Health Care Provision
7. Patients and healers in the context of culture
8. The patients’ perspective
9. Application of anthropology in public health and Health Promotion.
10. Importance of study of people’s concepts and behavior in health care
35
 MPH PROGRAMME

11. Behavioral change and changing people’s beliefs.

12. Role of anthropological information in planning and implementation.
13. Qualitative research methods
 Observational methods (participant, direct, indirect)
 Interviews (in-depth, key informant, Focus Group Discussions)
 Participatory methods (Free listing and pile sorting, ranking, rating, RAP and RRA)
 Sampling methods in qualitative research
 Validity and triangulation in qualitative research
 Qualitative data analysis

Teaching Methodology:
Teaching is carried out in form of lectures, role plays, and practical exercises of different
qualitative methods as part of a mini group research project.

Recommended Reading:
1. Annett H, Rifkin SB. Guidelines for rapid participatory appraisals to assess community
health needs: a focus on health improvements for low-income urban and rural areas.
Geneva: World Health Organization; 1995. Document no. WHO/SHS/DHS/95.8; Distr:
General.
2. Arole M, Arole R. Jamkhed: a comprehensive rural health project. London and
Basingstoke: Macmillan Education Ltd; 1994.
3. Bernard HR. Research methods in anthropology: qualitative and quantitative
approaches, 2nd ed. Walnut Creek, CA: AltaMira Press; 1995.
4. Bryman A, Burgress RG (eds.). Analyzing qualitative data. London: Routledge, 1994.
5. Emerson RM, FretzRI, Shaw LL. Writing ethnographic fieldnotes. Chicago: University of
Chicago Press, 1995.
6. Hahn RA, Harris KW (ed.). Anthropology in public health: bridging differences in
culture and society. Oxford: OxfordUniversity Press; 1999.
7. Hardon A, et. al. Applied health research manual: anthropology of health and health
care. Amsterdam: Aksant Academic Publications; 2001.
8. Helman CG. Culture, health and illness, 4th ed. New York, NY: Arnold Publishers; 2001.
9. Johnson TM, Sargent CF (eds.). Medical anthropology: contemporary theory and
method. New York, NY: Praeger, 1990.

36
 MPH PROGRAMME

10. Kleinman, A. Patients and healers in the context of culture: an exploration of the
borderland between anthropology, medicine and psychiatry. Berkeley, CA: University of
California Press; 1984.
11. Maier B, Görgen R, Kielmann AA, Diesfeld HJ, Korte R. Assessment of the district health
system: using qualitative methods. London, UK: Macmillan Press Ltd; 1994.
12. Scrimshaw NS, Gleason GR (eds.). Rapid assessment procedures: qualitative
methodologies for planning and evaluation of health-related programs. Boston, MA:
International Foundation for Developing Countries; 1992.
13. Spradley JP. Participant observation. Fort Worth: HarcourtBraceJovanovichCollege
Publishers; 1980.
14. Spradley, JP. The ethnographic interview. Fort Worth, TX: HarcourtBrace Jovanovich
College Publishers; 1979.

Students’ Evaluation:
Formative (50%)
Ongoing assessment through class participation and class exercises
Summative Assessment (50%)
Summative assessment consists of: MCQs and short essay questions

37
 MPH PROGRAMME

07: Environmental Health

Course Title: Environmental Health
Course Credits: 1.5+0.5

Introduction:
The MPH programme is targeted at enabling the participants to use applied research tools
and techniques applying to the study of the environment in relation to health. The course
presents concepts, principles, and applications of the main natural and social science
disciplines that form the basis of environmental health and describes how these disciplines
and their practitioners interact in the environmental health paradigm. The course examines
health issues, scientific understanding of causes, and possible future approaches to control
of the major emerging environmental health problems in industrialized and developing
countries.

Learning Goal:
The overall goal of the course is to enable the participants to identify and describe the
important current and emerging environmental problems that pose risk to public health and
apply the multidisciplinary environmental health approach to their solution.

Learning Objectives:
By the end of the course the participants should be able to:

1. Describe the core issues in Environmental Health

2. Define the major sources and types of environmental agents
3. Identify the carriers or vectors that promote the transfer of these agents from the
environment to the human
4. Describe how these agents interact with biological systems, and the mechanisms by
which they exert adverse health effects
5. Describe the existing situations and remedies in developing countries
6. Identify and define the steps in the risk-assessment and risk-management processes
7. Describe the sources, pathways of exposure and methods of control of the principal
physical, chemical, biologic and psychosocial hazards that impact human health in
ambient, indoor and occupational environments.
8. Explain the processes associated with the translation of scientific and health data into
public health policy and environmental law.
38
 MPH PROGRAMME

9. Identify and describe important current and emerging environmental problems that
pose a risk to public health

Contents:
The following areas will be covered during the course:

Course Contents

During this course, the following course contents will be covered in the specific environmental
health areas;

A. General Contents
1. Introduction to Environmental Health Issues
2. Environmental Health Issues of Pakistan
3. Human Impacts on Environment
4. Environmental Impacts on Human Health
5. Sanitation Status and Options in Pakistan
B. Water Pollution
1. Surface and Groundwater Resources of Pakistan
2. Drinking Water Supply Sources
3. Drinking Water Quality Situation in Pakistan
4. Pesticides and Fertilizers
5. Arsenic, Fluoride and Nitrate contamination in Drinking Waters
6. Water Born Diseases in Pakistan
7. Water Supply Agencies, their Capacity and Performance
8. Present Drinking Water Treatment Practices
9. Waste Water Availability and its Treatment
C. Air Pollution
1. Air Pollution Sources
2. Air Quality Monitoring Network in Pakistan
3. Present Status of Air Pollution in Pakistan
4. Health Effects of Air Pollution
5. Air Pollution Control Devices
6. Legal Regulations
D. Noise Pollution
1. Sources of Noise Pollution
2. Effect of Noise Pollution on Health and Behavior
3. Noise Mitigation
4. Legal Requirements
E. Solid and Hazardous Waste Management
1. Solid Waste Sources and Quantitative Estimates
2. Methods of Disposal

39
 MPH PROGRAMME

3. Waste Handling and Transport

4. Waste Management Concepts
5. Technologies
6. Hazardous Waste Generation
7. Hazardous Waste Management
8. Hazardous Waste Storage
9. Common Hazardous Waste incineration Facilities
F. Environmental Impact Assessment (EIA)
1. Objectives of EIA
2. Types of EIA
3. Basic EIA Principals
4. Types of Environmental Impacts
5. Risk Assessment
6. Environmental Management Plan
7. Stakeholders Roles and Responsibilities
G. Climate Change and Its Effect on Health
1. Pakistan’s Vulnerability to Climate Change
2. Effect on Floods and Droughts
3. Human Health
H. Environment Policy and Law
1. Air Quality and Noise
2. Waste Management
3. Water Supply and Management
4. Forestry
5. Poverty and Environment
6. Health and Environment
7. Natural Disaster Management
8. Legislation and Regulatory Framework

I. Healthy Cities and Villages

Teaching Methodology:
1. Didactic inactive class room instruction primarily through multimedia presentations
2. Practical field work with demonstration on class room-based instructions
3. Group exercises and roleplays

Recommended Reading:
1. Aron JL, Patz JA (eds.). Ecosystem change and public health: a global perspective.
Baltimore, MD: JohnsHopkinsUniversity Press; 2001.
2. LaDou J. Current occupational and environmental medicine, 3rd ed. New York, NY:
Lange Medical Books/McGraw-Hill; 2004.
40
 MPH PROGRAMME

3. Lippmann M, Cohen BS, Schlesinger RB. Environmental health science, 2nd ed. New
York, NY: OxfordUniversity Press; 2003.
4. Moeller WD. Environmental health, 2nd ed. Cambridge, MA: Harvard University Press;
1997.
5. Moore GS. Living with the earth: concepts in environmental health science, 2nd ed. Boca
Raton, FL: Lewis Publishers; 2002.
6. Nadakavukaren A. Man and environment: a health perspective, 3rd ed. Prospect
Heights, IL: Waveland Press;1990.
7. Sellers CC. Hazards of the job: from industrial disease to environmental health science.
Chapel Hill: University of North Carolina Press; 1997.
8. Steiner GA, Miner JR, Gray ER. Management policy and strategy. New York, NY:
Macmillan Education Ltd; 1986.
9. Vesilind PA, Peirce JJ. Environmental pollution and control, 4th ed. Boston, MA:
Butterworths Publishers; 1983.
10. Yassi A, Kjellström T, de Kok T, Guidotti T. Basic environmental health. New York, NY:
OxfordUniversity Press; 2001.

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and class exercises
Summative Assessment (80%)
Summative assessment consists of: MCQs and short essay questions

41
 MPH PROGRAMME

08: Occupational Health

Course Title: Occupational Health
Course Credit: 1.5+0.5

Introduction:
Pakistan is basically an agricultural country with a population of 150 million, 65% of which
lives in rural areas. Our National workforce is distributed both in formal and informal
sectors. Globally, it is evident that about 45% of the world’s population and 58% of the
population over 10 years of age, belong to the global workforce. Recent occupational health
data indicates that 40-50% of the world’s population is exposed to hazardous condition in
the workplace. Over 120 million occupational accidents occur worldwide each year, with
200,000 fatalities. The magnitude of the occupational diseases and injuries is not less than the
reportable diseases. In Pakistan, there is a dire need to address the occupational health and
safety issues as we are rapidly progressing to a middle income country and the
industrialization and increase in working force demands more emphasis and concrete
actions taken for the health and safety of the occupational group of both formal and informal
sectors.

Learning Goal:
The overall goal of the course is to improve the capacity of health managers in occupational
health in terms of their knowledge, attitude and skills.

Learning Objectives:
By the end of the course, the participants will be able to:

1. Define occupational health that encompasses the main aspects of problem-solving

typically faced by health managers;
2. Define and describe essential concepts, principles, methods and terms in occupational
health;
3. Apply certain techniques in the resolution of selected occupational health issues and
4. Describe basic methods of quantitative and qualitative analysis being used by health
managers in occupational health.

Contents:
The following areas will be covered during the course:

42
 MPH PROGRAMME

1. Workplace and Health

2. Scope of Occupational Health and Safety
3. Occupational Health Issues in Low-income Countries
4. Industrial Hygiene
5. Anticipation
6. Recognition
7. Evaluation
8. Control
9. Clinical Occupational and Environmental Medicine
10. Legal and Regulatory Issues
11. Labour Laws

Teaching Methodology:
Lectures, discussions, walk through examination of the industries, panel discussion and role
plays and assignments.

Recommended Readings:
1. Jeyaratnam J, Koh D (eds.). Textbook of occupational medicine practice. Singapore:
World Scientific Publishing Co; 1996.
2. Sellers CC. Hazards of the job: from industrial disease to environmental health science.
Chapel Hill: University of North Carolina Press; 1997.
3. Reich MR, Okubo T (eds.). Protecting workers' health in the third world: national and
international strategies. New York, NY: Auburn House.
4. Merchant JA, Boehlecke BA, Taylor G, Pickett-Harner M (eds.). Occupational respiratory
diseases. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health
Service, Centers for Disease Control, National Institute for Occupational Safety and
Health, DHHS (NIOSH); 1986. Publication No. 86-102.

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and class exercises
Summative Assessment (80%)
Summative assessment consist of: MCQs and Short essay question09. Social and
Behavioural Sciences in Public Health

43
 MPH PROGRAMME

09: Social and Behavioural Sciences in Public Health

Course Title: Social and Behavioural Sciences in Public Health
Course Credit: 1

Introduction:
Psycho-social-cultural and political structures of society affect different spheres of public
health, including the type and distribution of illness and disease. They also determine
modes of intervention used in the prevention of illness, disease, and injury as well as the
organization of health services at the national, international, and community levels.

Learning Goal:
The goal of this course is to introduce the MPH participants to the various facets of the
public health in light of the social determinants of health. The main emphasis is on a holistic
view keeping under consideration the social, cultural, ecological, political and economic
factors and their mutual interaction that influences the occurrence of disease and its
management at individual and community level.

Learning Objectives:
By end of the course the participants should be able to:

1. Explain key concepts in the social and behavioural aspects of public health: culture,
race/ethnicity, gender, poverty/disparities,
2. Describe the factors related to behavior change, community, organizational climate and
family structure
3. Demonstrate understanding of the social determinants of health
4. Describe how social determinants influence population health
5. Critically assess the relevance of ethics in public health

Contents:
The following areas will be covered during the course:

1. Role of Social Sciences in Public Health

2. Equity in health care
3. Politics of Health
4. Gender and Health
5. Socio-cultural factors and their impact on health
44
 MPH PROGRAMME

6. Economics and Health

7. Health impact of rapid economic change
8. Role of Civil Society in Health Care
9. Community participation in Health Care
10. Ethics in Public Health
11. Public Health and Law
12. Social Policy and Health of Population

Teaching Methodology:
Teaching will be carried out in the form of didactic and interactive lectures and discussions
as well as individual assignments.

Recommended Readings:
1. Anand S, Fabienne P, Sen A. Public health, ethics, and equity, 1st ed. London, UK:
Oxford University Press; 2004.
2. Baldock J, Manning N, Miller S, Vickerstaff S (eds.). Social policy, 3rd ed. Oxford: Oxford
University Press; 1999.
3. Bury M, Gabe J (eds.). The sociology of health and illness: a reader. London, UK:
Routledge; 2004.
4. Danis M, Clancy CM, Churchill LR. Ethical dimensions of health policy. London, UK:
OxfordUniversity Press; 2002.
5. Detels R, McEwen J, Beaglehole R, Tanaka H, (eds.). Oxford textbook of public health:
the practice of public health, 4th ed. Oxford: Oxford University Press; 2002.
6. Doyal L. Gender equity in health: debates and dilemmas. Soc Sci Med. 2000;51: 931-9.
7. Evans T, Whitehead M, Diderichsen F, Bhuiya A, Wirth M. Challenging inequities in
health from ethics to action. New York, NY: OxfordUniversity Press; 2001.
8. Gostin LO (ed.). Public health law and ethics: a reader. California: University of
California Press; 2002.
9. Hawe P, Shiell A. Social capital and health promotion: a review. Soc Sci Med. 2000;51:
871-885.
10. Hertzman C, Siddiqi A. Health and rapid economic change in the late twentieth century.
Soc Sci Med. 2000;51: 809-19.

45
 MPH PROGRAMME

11. Lloyd SP. Population ageing in developed and developing regions: implications for
health policy. Soc Sci Med. 2000;51: 887-895.
12. Tangcharoensathien V, Harnvoravongchai P, Pitayarangsarit S. Kasemsup V. Health
impacts of rapid economic changes in Thailand. Soc Sci Med. 2000;51: 789-807.
13. Zakus JD, Lysack CL. Revisiting community participation. Health Policy Plan. 1998;13: 1-
12.

Students’ Evaluation:
Formative (50%)
Ongoing assessment through class participation and class exercises
Summative Assessment (50%)
Summative assessment consists of: MCQs and short essay questions.

46
 MPH PROGRAMME

10: Health Systems Analysis

Course Title: Health Systems Analysis
Course Credits:3

Introduction:
This three-credit course is offered to MPH participants in the first session to familiarize them
with the concepts of Health Systems. Health Systems Analysis is application of the systems
approach in health. It is an approach to examine all aspects of a Health System in a
systematic and organized way to learn about its strengths and find out ways to cover the
gaps.

Learning Goal:
The goal of this course is to enhance the participants’ comprehension of the basic concepts of
the health system at micro and macro level, for the purpose of ultimately improving health
service delivery in Pakistan and in other countries.

Learning Objectives:
At the end of the course students will be able to:

1. Understand the various concepts of Health Systems

2. Understand and enlist all essential components of the Health Systems Model
3. Understand and practice the steps of Health Systems Analysis
4. Identify indicators for each component of Health Systems Model
5. Develop a tool for Health Systems Analysis
6. Conduct Health Systems Analysis in the field
7. Analyze and interpret the findings from data collected through the Health Systems
Analysis Tool

Contents:
The following areas will be covered during the course:

1. Definitions of health input, output and outcomes

2. Health System: Conceptual Frameworks
3. Health System: Terms and Concepts
4. Systems Approach
5. Micro Health System: Kielmann Model
47
 MPH PROGRAMME

6. Health Indicators and their use

7. Situation Analysis Approach
8. Instrument for Health Systems Analysis
9. Macro Health System: WHO model
10. Health Management Information System
11. Field Visits for data collection(applied system analysis)
12. Health system functions
13. Health system outcomes
14. Primary Health Care
15. Linking the Micro and Macro Health models

Teaching Methodology:
Lectures, discussions, group work, presentations, assignments and supervised field trips

Recommended Readings:
1. Berman BA, Bossert TJ. A decade of health sector reform in developing countries:what
have we learned? Boston, MA: Data for Decision Making Project, International Health
Systems Group, Harvard ; 2000. Available from: URL:
http://www.hsph.harvard.edu/ihsg/publications/pdf/ closeout.pdf
2. Kemm J, Parry J, Palmer S (eds.). Health impact assessment: concepts, theory, techniques
and applications. Oxford: OxfordUniversity Press; 2004.
3. Kielmann AA, Siddiqi S, Mwadime RK. District health planning manual: toolkit for
district health managers.Islamabad, Pakistan: Multi-donor Support Unit, Ministry of
Health; 2002.
4. Kielmann, AA, Janovsky K, Annett H. Assessing district health needs, services and
systems: protocols for rapid data collection and analysis.London, UK: Macmillan
Education Ltd and AMREF, 1995.
5. Siddiqi S,Haq IU, Ghaffar A, Akhtar T, Mahaini R. Pakistan’s maternal and child health
policy: analysis, lessons and the way forward. Health Policy 2004;69:117-30.
6. Siddiqi S, Kielmann AA, Khan MS, Ali N, Ghaffar A, Sheikh U, et. al. The effectiveness
of patient referral in Pakistan. Health Policy Plan. 2001:16: 193-198.

48
 MPH PROGRAMME

7. Stevens A, Raftery J, Mant J, Simpson S (eds.). Health care needs assessment: the
epidemiologically-based needs assessment reviews, 2nd ed., vol. 2. Oxford: Radcliffe
Medical Press; 1994.
8. World Health Organization. The world health report 2000: Health systems – improving
performance. Geneva: World Health Organization; 2000. Available from:
URL:http://www.who.int/entity/whr/2000/en/whr00_en.pdf

Students’ Evaluation
Formative (20%)
Ongoing assessment through class participation and class exercises
Summative Assessment (80%)
Summative assessment consists of: MCQs and short essay questions

49
 MPH PROGRAMME

Annex 3: Courses for Session II

11: Research Process I and II
Course Title: Research Process I and II
Course Credit:2+2

Introduction:
This is a four credit hour course offered over two sessions; part one (credits 2) and part two
(credits 2).This is an applied subject utilizing the knowledge and skills acquired in the first
session. This includes the learning of skills of critically assessing the published articles in
medical journals based on the knowledge acquired earlier. Applying the knowledge of
epidemiology and biostatistics, population dynamics, qualitative research methods,
computer skills and health systems analysis, the student will learn the development of a
research question, giving essential background, making statements for objectives, data
collection, analysis applying statistical methods using the computer skills and present their
readings and research projects for the third session.

Learning Goal:
The goal of this course is to create a critical mass of trained persons well-oriented in writing
a research proposals for the dissertations and funding purposes. It will also enable the
health professionals to critically comprehend the concepts and at the same time apply the
epidemiological and statistical methods to develop a research protocol making use of
computer statistical softwares and information technology.

Learning Objectives:
The learning issues relating to the above objectives are as follows:

1. The critical analysis of the published scientific paper will be used as baseline to start
with the concept of writing a proposal to enable the students to identify the scientific
requirements of medical writing and the various components of the paper.
2. (This will be critical reading of a published paper in context with the background,
objectives, aims, study designs, data collection tool and their validity, data presentation
and interpretation, in terms of discussion and conclusions. Statistical methods will be
assessed for their applications and validity. The citation and listing of references will
also be examined using the guidelines for critical assessment of scientific papers).

50
 MPH PROGRAMME

 The definitions of research and its uses and advantages will be highlighted in context
with its importance in health and disease.
 The selection and prioritizing topic for research demands some underlying reasoning
which will be dealt with in this section requiring guidelines to select a topic.
3. Hands-on-training of the students will be made possible in searching for the relevant
literature using hand and web search.
 Providing a background to the study will be worked at through exercises using
several examples.
4. Formulation of objectives needs clarity of logical thinking which can focus on the
scientific principals and, at the same time, covering the language issues.
5. Formulation of hypothesis is critical in terms of stating them in measurable terms.
6. Through definitions of objectives and hypothesis, the identification of variables and their
types will be worked at.
7. Once the objectives and variables are identified, the design of the study will be identified
based on the prior knowledge of basics in epidemiology.
8. Sampling techniques employed will be qualified appropriate to the objectives and the
study designs. Probability and non-probability techniques will be applied on different
scenario to appropriate their use in research.
9. Sample size estimation based on objectives and study designs will be done using various
statistical applications.
10. Construction of Proforma and questionnaire appropriate to the study objectives and
variables.
 Validity of the measurements will be discussed for the documented variables.
 Importance of self- and interviewer administered questionnaire.
 Pre-testing the methodology of data collection
11. Outlining of the plan for data analysis will be carried out constructing dummy tables
and identifying appropriate statistical analysis.
12. Preparing of the work plan using the pattern of a Gantt chart.
13. Preparing budget and its justification for a proposal when seeking funding.
14. Writing the title of the study topic to include the study design, variables and statistical
analysis.
15. Abstract writing will be done according to different standards.
51
 MPH PROGRAMME

16. Presentation of the project will be the final step

Contents:
Following are the contents of the course:

1. Principles of critical reading of a scientific paper

2. Definition of research
3. Importance of research in public health
4. Selection of topic for research
5. Literature Search using internet and library
6. Preparing the background for the proposal writing.
7. Parts of proposal writing.
8. Study design, sampling techniques, inclusion and exclusion criteria.
9. Methodology
10. Choosing the statistical techniques.
11. Reference writing
12. Abstract writing
13. Title writing for the proposals

Teaching Methodology:
Interactive discussions, exercises, group discussions/work and hands-on training

Recommended Reading:
Same as the Basic Epidemiology, Basic Biostatistics, Computer Applications in Public Health,and
Foundations of Qualitative Research courses. Additionally:

1. Abramson JH, Abramson ZH. Survey methods in community medicine, fifth edition.
Edinburgh: Churchill Livingstone; 1999.
2. Altman DG. Practical statistics for medical research. London: Chapman and Hall; 1991.
3. Bowling A. Research methods in health: investigating health and health services, 2nd ed.
Buckingham: Open University Press; 1997.
4. Campbell DT, Stanley JC. Experimental and quasi-experimental designs for research.
Boston, MA: Houghton Mifflin Company; 1966.
5. Hall GM. How to write a paper, 3rd ed. London: BMJ Publishing Group; 1996.

52
 MPH PROGRAMME

6. Greenhalgh T. How to read a paper: the basics of evidence-based medicine, 2nd ed.
London: BMJ Publishing Group; 1997.

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and class exercises
Summative Assessment (80%)
Summative assessment consist of: MCQs and Short essay questions

53
 MPH PROGRAMME

12: Introduction to Reproductive Health

Course Title: Introduction to Reproductive Health
Course Credit:1.5 + 0.5

Introduction:
Although the economic condition of Pakistan is improving, the health indicators almost
remain stagnant with infant mortality at 76/1000 live births and maternal mortality at 250-
340/100,000 live births. One third of childbearing aged women have an unmet need for
contraception. The country is faced with many problems in the social and health sectors.
The social marginalization of women is reflected not only in their limited opportunities for
education and income but also in the health indicators. Not only are mother and infant
mortality rates very high, malnutrition and infectious diseases are particularly widespread
among women. This core course provides information on the reproductive health problems
of women and men and possible solutions.

Learning Goal:
The goal of this course is to enable the students to have the knowledge and skills to address
and provide solutions for a better reproductive health.

Learning Objectives:
By the end of the course, the students will be able to:

1. Describe the current reproductive health issues for women and men
2. Identify underlying causes and cross-linkages to different reproductive health outcomes
3. Address the need for improving women’s health status through a multi-dimensional and
inter-sectoral approach, and
4. Construct, design and apply appropriate interventions to address these concerns.

Contents:
The following areas will be covered during the course:

1. Basic concepts and landmark events related to reproductive health and its evolution
 Introduction to the course: Historical background of RH
 Life course perspective to RH
 ICPD, post ICPD, Beijing + 10
 Safe Motherhood and Continuum of Care
54
 MPH PROGRAMME

2. Reproductive behavior in Pakistan

3. Contraception as a preconceptional health intervention
4. Abortion as a public health issue
5. Antenatal and obstetricalcare models
 Determinants of maternal mortality
 Measurement of maternal mortality ratio and rates.
 Obstetrical care (EOC, EmOC, BOC)
 Unmet obstetrical need
 Delays in obstetrical care provision
 Integrated approach to newborn care
6. RH needs of special populations
 RH issues of adolescents and young adults
 RH needs of and issues for men
 Role of males in Safe Motherhood
7. Diseases of public health importance in RH, e.g.,
 Cancers of reproductive tract, STIs etc
 Cancers of breast
 Sexually transmitted infections
 HIV AIDS
8. Health systems issues, e.g.
 Access to services at various levels
 Role of the district health system in reproductive health
 Role of the tertiary care hospital in reproductive health
 Primary health care and reproductive health including community based
interventions
9. Cross cutting themes, e.g., research, monitoring and evaluation, quality of care
 Evidence-based reproductive health interventions
 Quality of care in RH
 Integrated approach to provision of reproductive health services
 Beyond numbers: Determinants of maternal mortality
 Socio-economics of Reproductive health care.

55
 MPH PROGRAMME

10. Data sources in reproductive health:

 Websites
 Reports, surveys and publications focusing on RH
 RH programs at the district level by UNFPA
 MIS in reproductive health

Teaching Methodology:
Lectures, discussions, readings, group work, assignments, field trip, plenary,

Recommended Readings:
1. Abou-Zahr CL, Wardlaw TM. Antenatal care in developing countries: promises
achievements and missed opportunities:an analysis of trends, levels and differentials,
1990-2001.Geneva: World Health Organization; 2003. Published jointly by WHO and
UNICEF. Available from: URL:
http://www.who.int/reproductive-health/docs/antenatal_care.pdf
2. Askew I, Berer M. The contribution of sexual and reproductive health services to the
fight against HIV/AIDS: a review. Reprod Health Matters. 2003;11: 51-73.
3. Aubel J, Toure I, Diagne M.Senegalese grandmothers promote improved maternal and
child nutrition practices. Soc Sci Med. 2004;59:945-59.
4. Bale JR, Stoll BJ, Lucas AO. Improving birth outcomes: meeting the challenge in the
developing world. Washington, DC: National Academies Press; 2003.
5. Bertrand JT, Magnani RJ, Knowles JC. Handbook of indicators for family planning
program evaluation. Chapel Hill, NC: The Evaluation Project; 1994. Available from:
URL: http://www.cpc.unc.edu/measure/publications/pdf/ms-94-01.pdf
6. BlancAK, Curtis SL, Croft TN. Monitoring contraceptive continuation: links to fertility
outcomes and quality of care. Stud Fam Plann. 2002;33: 127-40.
7. Bobadilla JL. Evaluation of maternal health programs: approaches, methods and
indicators. Int J Gynaecol Obstet. 1992;38 (suppl.):S67-73.
8. Bruce J. Fundamental elements of quality of care: asimple framework. Studies in Family
Planning 1990:21; 61-91.
9. Cleland J, Ali MM. Reproductive consequences of contraceptive failure in 19 developing
countries. Obstetrics & Gynecology 2004;104:314-320. Available from: URL:
http://www.greenjournal.org/cgi/reprint/104/2/314.pdf

56
 MPH PROGRAMME

10. Cleland JG, Boerma JT, Carael M, Weir SS. Monitoring sexual behavior in general
populations: a synthesis of lessons of the past decade. Sexually Transmitted Infections,
2004;80 (2 suppl.): ii1-7.
11. Creswell JW, Fetters MD, Ivankova NV. Designing a mixed methods study in primary
care. Annals of Family Medicine 2004;2: 7-12.
12. Davies J. The reproductive health staircase. NGORC Journal 2004;5: 21. Available from:
URL: http://www.ngorc.org.pk/journal/Archive/Journal-Mar2004.pdf
13. Douthwaite M, Ward P.Increasing contraceptive use in rural pakistan: an evaluation of
the lady health worker program. Health Policy Plan. 2005;20: 117-123.
14. Geyoushi BE, Matthews Z, Stones RW. Pathways to evidence-based reproductive health
care in developing countries. BJOG: An International Journal of Obstetrics &
Gynaecology 2003;110: 500-507.
15. Gillespie DG. Whatever happened to family planning, and, for that matter, reproductive
health? Int Fam Plan Perspect. 2004;30: 34-8. Available from: URL:
http://www.guttmacher.org/pubs/journals/3003404.html
16. John Snow, Inc. Safe motherhood indicators:lessons learnt in measuring progress.
MotherCare Matters – A Quarterly Newsletter and Literature Review on Maternal and
Neonatal Health and Nutrition 1999:8: 1-26. Available from: URL:
http://mothercare.jsi.com/pubs/mcmatters/pdf/Vol8%201.pdf
17. Johnston HB and Hill K. Induced abortion in the developing world: indirect estimates.
Inter Fam Plann Persp 1996; 22: 108-114. Available from: URL:
http://www.guttmacher.org/pubs/journals/2210896.pdf
18. Khalil L, Roudi-Fahimi F. Making motherhood safer in Egypt (MENA Policy Brief).
Washington, DC: Population Reference Bureau; 2004. Available from:
URL:http://www.prb.org/pdf04/MakMotherSaferEgypt_Eng.pdf
19. Koblinsky M. Essential obstetric care and subsets - basic and emergency obstetric care:
what's the difference? MotherCare Policy Brief #1. Arlington, VA: John Snow, Inc.; 1999.
Document no. M750. Available from: URL:
http://www.jsi.com/intl/mothercare/pubs/PolicyBriefs/policy_brief1.htm
20. Koblinsky M. Safe motherhood indicators - measuring progress. MotherCare Policy Brief
#2. Arlington, VA: John Snow, Inc.; 1999. Document no. M751. Available from: URL:
http://www.jsi.com/intl/mothercare/pubs/PolicyBriefs/policy_brief2.htm

57
 MPH PROGRAMME

21. Koblinsky MA, Campbell O, Heichelheim J. Organizing delivery care: what works for
safe motherhood? Bull World Health Organ. 1999;77: 399-406.
22. Koenig MA, Fauveau V, Chowdhury AI, Chakraborty J, Khan MA. Maternal mortality in
Matlab, Bangladesh: 1976-1985. Studies in Family Planning 1988;19: 69-80.
23. Lush L. Service integration: an overview of policy developments. International Family
Planning Perspectives, 2002;28: 71-76.
24. Marston C, Cleland J. The effects of contraception on obstetric outcomes. Geneva:
Department of Reproductive Health and Research, World Health Organization; 2004.
Available from: URL: http://whqlibdoc.who.int/publications/2004/9241592257.pdf
25. McCarthy J, Maine D. A framework for analyzing the determinants of maternal
mortality. Studies in Family Planning 1992;23: 23-33.
26. Medicam. Technologies appropriate and inappropriate. Safe Motherhood – A newsletter
of worldwide activity 1995;18.
27. Rashida G. Unwanted pregnancy and post-abortion complications in Pakistan: findings
from a national study. Islamabad, Pakistan: Population Council.
Available fromURL:
http://bvs.insp.mx/temas/aborto/unwanted_pregnancy_and_postabortion_complicati
ons_in_pakistan.pdf
28. Seltzer JR. The origins and evolution of family planning programs in developing
countries. Santa Monica: RAND; 2002.
29. Senlet P, Curtis SL, Mathis J, Raggers H. The role of changes in contraceptive use in the
decline of induced abortion in Turkey. Stud Fam Plann. 2001 Mar;32: 41-52.
30. Shelton JD, Fuchs N. Opportunities and pitfalls in integration of family planning and
HIV prevention efforts in developing countries. Public Health Rep. 2004;119: 12-5.
31. Sibley L, Sipe TA, Koblinsky M. Does traditional birth attendant training improve
referral of women with obstetric complications:areview of the evidence. Soc Sci Med.
2004;59:1757-68.
32. Siddiqi S, Haq IU, Ghaffar A, Akhtar T, Mahaini R. Pakistan’s maternal and child health
policy: analysis, lessons and the way forward. Health Policy. 2004 Jul;69:117-30.
33. Sullivan TM, Bertrand JT (eds.). Monitoring quality of care in family planning by the
quick investigation of quality (QIQ) country reports. Chapel Hill:

58
 MPH PROGRAMME

CarolinaPopulationCenter, University of North Carolina; 2000. MEASURE Evaluation

and Technical Report Series, No. 5. Available from: URL:
http://www.cpc.unc.edu/measure/publications/pdf/tr-00-05.pdf
34. Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Soc Sci Med.
1994;38: 1091-110.
35. The MEASURE Program. Investing in population, health and nutrition monitoring and
evaluation: lessons learned. MEASURE Evaluation Bulletin 2003;5. Available from: URL:
http://www.cpc.unc.edu/measure/publications/pdf/bu-03-05.pdf
36. TobinGA, Begley CM. Methodological rigor within a qualitative framework. Journal of
Advanced Nursing 2004;48: 388-396. Available from: URL:
http://www.ruralhealth.utas.edu.au/gr/resources/docs/tobin-and-begley-rigour.pdf
37. Trussell J, Ellertson C, Stewart F, Raymond EG, Shochet T. The role of emergency
contraception. Am J Obstet Gynecol 2004;190(4 suppl.): S30-8.
38. UNAIDS. The public health approach to STD control: UNAID technical update (UNAID
best practices collection). Geneva: World Health Organization; 1998. Available from:
URL: http://www.who.int/entity/hiv/pub/sti/en/stdcontrol_en.pdf
39. UNDP, UNFPA, WHO, World Bank Special Programme of Research, Development and
Research Training in Human Reproduction (HRP). WHO’s work in reproductive health:
the role of the Special Programme. Progress in Human Reproductive Research 1997;(42):
1-8. Available from: URL:
http://www.who.int/reproductive-health/hrp/progress/42/prog42.pdf
40. Varga CA.Pregnancy termination among south African adolescents. Studies in Family
Planning 2002;33: 283-98.
41. World Health Organization. Care in normal birth: a practical guide – report of a
technical working group. Geneva: Division of Reproductive Health, World Health
Organization; 1997. Document no. WHO/FRH/MSM/96.24. Available from: URL:
http://www.who.int/reproductivehealth/publications/MSM_96_24/care_in_normal_b
irth_practical_guide.pdf
42. World Health Organization. Reproductive health strategy: to accelerate progress toward
the attainment of international development goals and targets. Geneva: World Health
Organization; 2004. Available from: URL: http://www.who.int/reproductive-
health/publications/strategy.pdf

59
 MPH PROGRAMME

43. World Health Organization. Syndromic case management of sexually transmitted

diseases: a guide for decision-makers, health care workers, and communicators. Manila,
Philippines: WHO Regional Office for the Western Pacific; 1997. Available from: URL:
http://www.cadre.org.za/BAC/BACpdf/WHO_STD.pdf

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and class exercises
Summative Assessment (80%)
Summative assessment may consist of: MCQs and Short essay questions

60
 MPH PROGRAMME

13: Child Health Programmes and Interventions

Course Title: Child Health Programs and Interventions
Course Credit:1.5 + 0.5

Introduction:
This course focuses on the integration and building upon the basic concepts as well as to
allow them to use their quantitative and qualitative skills to enhance their understanding of
child health issues. The course will equip them to promote optimal health for the fetus,
newborn and the child in the context of underlying determinants of ill health, trends in
survival, morbidity, nutritional and environmental factors, immunizations, access to health
care and health policies. Injuries and disability will also be discussed.

Learning Goal:
The learning goal of the course is to equip the participants with the skills, knowledge and
principles to explore the risk factors for poor child health outcomes and manage and
evaluate effectively the child health programs at the national, provincial and district levels.

Learning Objectives:
At the end of the course, the participants should be able to:

1. Establish the Public Health perspective on Child Health, primarily focusing on

preventive aspects.
2. Describe the historical and current situation of fetal and child health in the country and
the region..
3. Understand the health problems among children using the framework emphasizing the
analysis of underlying principles and theories.
4. Use analytical tools of epidemiology, paediatrics, health services, developmental and
social sciences, demography and policy analysis in identifying problems and solutions in
child health.
5. Establish the current best practices in Child Health in light of the recent developments,
i.e. Millennium Development Goals, Bellagio Child Survival Study Group’s
recommendations, Lancet Neonatal Survival Program etc.

Contents:
The following areas will be covered during the course:

61
 MPH PROGRAMME

1. Introduction to Child Health

2. Child Health: The Public Health Perspective
3. Assessing newborn health: The Neonatal Survival
4. Assessment of child health using different tools in Epidemiology, Biostatistics and
Paediatrics.
5. Child Health: The Programmatic Issues in the contextual framework.
6. Strengthening The Health Systems For Child Health
7. Child Health: Global Issues

Teaching Methodology:
The teaching methodology will include Lectures, interactive discussions, group works and
assignments.

Recommended Readings:
1. Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every
year?Lancet. 2003;361:2226-34. Available from: URL:http://www.who.int/child-adolescent-
health/New_Publications/CHILD_HEALTH/CS/CS_paper_1.pdf
2. Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS; Bellagio Child Survival Study Group.
How many child deaths can we prevent this year? Lancet. 2003;362: 65-71.
3. Bryce J, el Arifeen S, Pariyo G, Lanata C, Gwatkin D, Habicht JP; Multi-Country Evaluation
of IMCI Study Group. Reducing child mortality: can public health deliver? Lancet. 2003;362:
159-64.
4. Victora CG, Wagstaff A, Schellenberg JA, Gwatkin D, Claeson M, Habicht JP. Applying an
equity lens to child health and mortality: more of the same is not enough. Lancet. 2003;362:
233-41.
5. Claeson M, Gillespie D, Mshinda H, Troedsson H, Victora CG; Bellagio Study Group on
Child Survival. Knowledge into action for child survival. Lancet. 2003;362: 323-7. Available
from: URL: http://www.who.int/child-adolescent-
health/New_Publications/CHILD_HEALTH/CS/CS_paper_5.pdf
6. Bawaskar HS. The world's forgotten children [editorial]. Lancet. 2003;361: 1224-5.
7. Lawn JE, Cousens S, Zupan J; Lancet Neonatal Survival Steering Team. 4 million neonatal
deaths: when? Where? Why? Lancet. 2005;365: 891-900.

62
 MPH PROGRAMME

8. Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L; Lancet Neonatal
Survival Steering Team. Evidence-based, cost-effective interventions: how many newborn
babies can we save? Lancet. 2005;365: 977-88.
9. Knippenberg R, Lawn JE, Darmstadt GL, Begkoyian G, Fogstad H, Walelign N, Paul VK;
Lancet Neonatal Survival Steering Team. Systematic scaling up of neonatal care in countries.
Lancet. 2005;365: 1087-98.
10. Martines J, Paul VK, Bhutta ZA, Koblinsky M, Soucat A, Walker N, Bahl R, Fogstad H,
Costello A; Lancet Neonatal Survival Steering Team. Neonatal survival: a call for action.
Lancet. 2005;365: 1189-97. Available from: URL:http://www.who.int/child-adolescent-
health/New_Publications/NEONATAL/The_Lancet/Neonatal_paper_4.pdf
11. Tinker A, ten Hoope-Bender P, Azfar S, Bustreo F, Bell R. A continuum of care to save
newborn lives [comment]. Lancet.2005;365: 822-5. Available from:
URL:http://www.who.int/child-adolescent-
health/New_Publications/NEONATAL/The_Lancet/2_The_Partnerships.pdf
12. Zaidi A, Khan T, Akram D. Early child health and survival strategies in Pakistan: a
situational analysis. In: Bhutta ZA (ed.). Maternal and child health in Pakistan: challenges
and opportunities. Karachi: OxfordUniversity Press; 2004.
13. Bhutta ZA, Ali N, Hyder A, Wajid A. Perinatal and newborn care in Pakistan: seeing the
unseen. In: Bhutta ZA (ed.). Maternal and child health in Pakistan: challenges and
opportunities. Karachi: OxfordUniversity Press; 2004.
14. Siddiqi S,Haq IU, Ghaffar A, Akhtar T, Mahaini R. Pakistan’s maternal and child health
policy: analysis, lessons and the way forward. Health Policy 2004;69:117-30.

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and class exercises
Summative Assessment (80%)
Summative assessment consist of: MCQs and Short essay questions

63
 MPH PROGRAMME

14: Applied Epidemiology and Biostatistics

Course Title: Applied Epidemiology and Biostatistics
Course Credit:2+1

Introduction:
This is a core course offered after the students have attended the basic courses in
epidemiology and biostatistics in the first term. This deals with the application of their
concepts and numerical skills to different public health issues. Some new concepts are
introduced and students are given datasets to work on with the help of statistical software.
The skill of interpretation of the applications is inbuilt.

Learning Goal:
The goal of the course is to improve the epidemiological and statistical skills for use in
research and evaluation in public health and to enable the students to understand and apply
the basic epidemiological and statistical knowledge and skills in addressing and solving
health and public health issues and developing research strategies using advanced statistical
methods and statistical software/s.

Learning Objectives:
At the end of the course, the student should be able to:

1. Apply measures of disease frequency in Public Health.

2. Describe further statistical procedures in Cohort and case-control studies.
3. Interpret the results of a study investigating the effects of Confounding and Interaction
4. Describe the methods adopted to control for Bias, Chance and Effect Modification in a
study
5. Apply screening in disease control.
6. Analysis of survival times
7. Applications of Standardization
8. Use the tests of significance for parametric data: three or more independent groups of
observations (ANOVA).
9. Use the tests of significance for categorical data:
 several proportions,
 analyzing frequency tables (22, n  k tables),
 large tables with ordered categories.
64
 MPH PROGRAMME

10. Use non-parametric tests for a single or more than one samples e.g. Wilcoxon’s Rank
sum tests, Mann-Whitney U-tests etc.
11. Investigate the relationship of two or more continuous variables using correlation –
partial correlation coefficients, coefficient of determination, interpretation and
presentation of correlation.
12. Investigate the relationship between several variables using:
 Multiple regression and
 Logistic regression.
13. Evaluation of interventions or programmes using appropriate epidemiological and
statistical methods.

Contents:
The contents of the course are as follows:

1. Disease frequency: Incidence and Prevalence

2. Proportional Morbidity and mortality
3. Details of measures of association and inference in cohort and case control studies
4. Further applications of Chance, confounding and bias in studies.
5. Interaction and effect modification.
6. Issues in screening.
7. Survival time analysis.
8. Standardization techniques in epidemiological studies.
9. Parametric test: ANOVA
10. Non Parametric tests: Chi square test for several proportions, n  k tables and tables with
ordered data, Fisher’s exact test, non-parametric tests for a single or more than one
samples e.g. Wilcoxon’s Rank sum tests, Mann-Whitney U-tests.
11. Partial correlation coefficients, coefficient of determination.
12. Multiple regression and
13. Logistic regression

Teaching Methodology:
1. Interactive discussions
2. Exercises
3. Group discussions
65
 MPH PROGRAMME

Recommended Readings:
Same as for Basic Epidemiology and Basic Biostatistics plus:

1. Baumgartner TA, Strong CH. Conducting and reading research in health and human
performance, 2nd ed. Boston, MA: Edward E. Bartell publishers; 1997.
2. Bennet J, Azhar N, Rahim F, Kamil S. Further observations on ghee as a risk factor for
neonatal tetanus. International Journal of Epidemiology 1998; 24: 643-47.
3. BhargavaSK, Sachdev HS, Fall CHD, et. al. Relation of serial changes in childhood body
mass index to imparired glucose tolerance in young adulthood. N Eng J Med 2004;350:
865-75.
4. Brown KH, Black RE. Infant feeding practices and their relationship with diarrhoeal and
other diseases in Huascar (Lima) Peru. Pediatrics 1989;83:31-40.
5. Clemens JD, Stanton S, Stoll B. Breast feeding as a determinant of severity in shigellosis.
Evidence for protection throughout the first three years of life in Bangladeshi children.
American Journal of Epidemiology 1986;123: 710-720.
6. Cochran WG. Sampling techniques, 3rd ed. New York, NY: Singapore: John Wiley &
Sons; 1909.
7. Deitz WH, Robinson TN. Overweight children and adolescents. N Eng J Med 2005;352:
2100-09.
8. Furness S, Connor J, Robinson E, Norton R. Car colour and risk of car crash injury:
population based case control study. British Medical Journal 2003;327: 1455-56
9. Jousilahti P, Toumilehto J, Vartialnen, Eriksson J and Puska P. Relation of adult height to
cause-specific and total mortality: A prospective follow up study of 31,199 middle-aged
men and women in Finland. Amer J Epidemiol 2000;151: 1112-20.
10. Khan SR, Zaman S, Jalil F, Lindblad BS, Karlberg J. Early child health in Lahore: X.
Mortality. Acta Paediatr Suppl 1993;390: 109-17.
11. Kruijshaar ME, Barendregt JJ, Hoeymans N. The use of models in the estimation of
disease epidemiology. Bull WHO 2002; 80: 622-28.
12. Lindblad BS, Patel M, Zaman S. Age and Sex are important factors in determining
normal retinol levels. J Trop Paediatr 1998;44: 96-99.
13. Mahalanabis D, Alam AN, Rahman N, Hasnat A. Prognostic indicators and risk factors
for increased duration of acute diarrhea and for persistent diarrhea in children. Int J
Epidemiol 1991;20: 1064-72.
66
 MPH PROGRAMME

14. Petro R, Darby S, Deo H, Silcocks P, Whitley E, Doll R. Smoking, Smoking cessation and
lung cancer in the UK since 1950: combination of national statistics with two case-control
studies. British Medical Journal 2000; 321: 323-329.
15. Stevens A, Raftery J (eds.). Health care needs assessment, Vol. 1:the epidemiologically
based needs assessment reviews. Oxford: Radcliffe Medical Press; 1994.
16. Vella V, Tomkins A. et al. Determinants of Stunting and Recovery from stunting in
Northwest Uganda. Int J Epidemiol 1994; 782-86.
17. Yaqoob M, Cnattingius S, Jalil F, Zaman S. Risk factors for mortality in young children
living under various socio-economic conditions in Lahore, Pakistan: with particular
reference to inbreeding. Clin Gen 1998;54: 426-34.

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and class exercises
Summative Assessment (80%)
Summative assessment consist of: MCQs and Short essay questions

67
 MPH PROGRAMME

15: Communicable and Non-communicable Disease Control

Course Title: Communicable and Non-communicable Disease Control
Course Credit:3

Introduction:
Communicable diseases continue to be major problem in Pakistan and its surrounding
region. However, non-communicable diseases are on the rise at the same time and thus
constitute a double burden for these countries undergoing transition. Injuries and disability
add to the burden on health systems to mount a response through inter-sectoral
collaborations. Effective control programmes and projects need to be in place to reduce the
burden of disease. In this context the economic, social science and policy aspects of the
disease need to be explored and discussed.

Learning Goal:
The goal of this course is to equip the students with knowledge and skills to prevent and
control communicable and non-communicable diseases including injury prevention.

Learning Objectives:
By the end of the course, the participants will be able to:

1. Describe key concepts of communicable and chronic non-communicable disease (NCD)

epidemiology with reference to developing countries in general and Pakistan in
particular.
2. Conduct an outbreak investigation with a relation to microbiological information.
3. nduct surveillance for communicable and non-communicable diseases and injuries.
4. Design and conduct a disease control programme for any disease /injury.

Contents:
The following areas will be covered during the course:

1. Introduction to Communicable and Non-communicable Diseases: concepts and

strategies
2. Epidemiology of communicable diseases: Basic Concepts
3. Surveillance
4. Outbreak Investigation
5. Polio Eradication: New challenges and strategies
68
 MPH PROGRAMME

6. Biological principles to development of disease prevention and control or management

programmes, including immunology and microbiology
7. Burden of Diseases
8. Communicable and Non-Communicable Diseases Trends and Policies
9. Injury and injury prevention.
10. Private Public Partnership in disease control: Integration of non-communicable disease
prevention and control within the context of primary and secondary health care
11. Role of NGOs in disease control
12. Disease Early Warning System
13. Epidemiology of Genetics and its role in Communicable and Non-communicable
diseases
14. Epidemiology of NCDs in Pakistan
15. The National Action Plan for NCD prevention, control and health promotion: concepts,
theory and practice

Teaching Methodology:
Interactive discussions, individual assignment, exercises and group discussions

Recommended Readings:
1. Bender AP, Williams AN, Johnson RA, Jagger HG. Appropriate public health responses
to clusters: the art of being responsibly responsive. Am J Epidemiol 1990;132:S48-52.
2. BenensonAS. Control of communicable diseases in man, 15th ed. WashingtonDC:
American Public Health Association; 1990.
3. Caldwell GG. Twenty-two years of cancer cluster investigations at the Centres for
Disease Control.Am J Epidemiol 1990;132:S43-7.
4. Dicker RC, et. al. Principles of epidemiology:an introduction to applied epidemiology
and biostatistics, 2nd ed. Atlanta, GA, USA: Centers for Disease Control and Prevention,
1992. Self-study course 3030-G. Available from: URL:
http://www.phppo.cdc.gov/PHTN//catalog/pdf-file/Epi_Course.pdf
5. Fiore BJ, Hanrahan LP, Anderson HA. State health department response to disease
cluster reports: a protocol for investigation. Am J E pidemiol 1990;132:S14-22.
6. Fraser DW, Tsai TY, Orenstein W. Legionnaires’ disease: description of an epidemic of
pneumonia. N Engl J Med 1997;297: 1189-97.

69
 MPH PROGRAMME

7. Gross M. Oswego Country revisited. Public Health Rep 1976;91:168-70.

8. Hertzman PA, Blevins WL, Mayer J, Greenfield B,ting M,Gleich GJ.Association of the
eosinophilia-myalgia syndrome with the ingestion of tryptophan. N Engl J Med
1990;322:869-73.
9. Hutchins SS, Markowitz LE, Mead P. A school-based measles outbreak:the effect of a
selective revaccination policy and risk factors for vaccine failure. Am J Epidemiol
1990;132:157-68.
10. Jamison DT, Mosley HW, Measham AR, Bobadilla JL. Disease control priorities in
developing countries. New York, NY: OxfordUniversity Press; 1993.
11. Khan OA, Hyder AA. Research report-Responses to an emerging threat: HIV/AIDS
policy in Pakistan. Health Policy Plan. 2001;16(2):214-218
12. Kuh D, Ben-Shlomo Y, editors. A Life Course Approach to Chronic Disease
Epidemiology. Oxford: Oxford Medical Publications; 1997.
13. MacDonald KL, Spengler RF, Hatheway CL. Type A botulism from sautéed onions. J Am
Med Assoc. 1985;253:1275-8.
14. Ministry of Health, Government of Pakistan, World Health Organization, Heartfile.
National action plan for prevention and control of non-communicable diseases and
health promotion in Pakistan: a public-private partnership in health. Islamabad,
Pakistan: tripartite collaboration of the Ministry of Health, Government ofPakistan;
WHO, Pakistan office, and Heartfile; 2004. Available from: URL:
http://www.heartfile.org/pdf/NAPmain.pdf
15. Murray CJL, Lopez AD. Mortality by cause for eight regions of the world:Global Burden
of Disease Study. Lancet 1997; 349:1269-76
16. Murray CJL, Lopez AD. Regional patterns of disability-free life expectancy and
disability-adjusted life expectancy: Global Burden of Disease Study. Lancet
1997;349:1347-52.
17. Neutra RR. Counterpoint from a cluster buster. Am J Epidemiol 1990;132:1-8.
18. Nishtar S. Cardiovascular disease prevention in low resource settings: lessons from the
Heartfile experience in Pakistan. Ethn Dis. 2003 Summer;13(2 suppl. 2):S138-48.
19. Nishtar S. Prevention of coronary heart disease in South Asia. Lancet 2002 Sep;360: 1015-
18.

70
 MPH PROGRAMME

20. Nishtar S. Public-private partnerships in health: a global call to action. Health Res Poliy
Syst 2004 Jul;2(1): 5.
21. OmranAR. The epidemiology transition theory revisited thirty years later. Wld hlth
statist.quart. 1998;99-119.
22. RosenbergMD, Hazlet KK, Schaefer J, Wells JG , Pruneda RC. Shigellosis from
swimming. J Am Med Assoc. 1976;236:1849-52.
23. Ryan CA , Nickels MK, Hargrett-Bean NT.Massive outbreak of antimicrobial-resistant
salmonellosis traced to pasteurized milk. J Am Med Assoc. 1987;258:3269-74.
24. Schulte PA, Ehrenberg RL, Singal M. Investigation of occupational cancer clusters:
theory and practice. Am J Public Health 1987;77:52-6.
25. Taylor DN, Wachsmuth IK, Shangkuan Y-H. Salmonellosis associated with marijuana: a
multistate outbreak traced by plasmid fingerprinting. New Engl J Med 1982;306:1249-53.
26. Webber R. Communicable disease epidemiology and control: a global perspective, 2nd
ed. Wallingford: CABI Publishing; 1996.

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and class exercises
Summative Assessment (80%)
Summative assessment consist of: MCQs and Short essay questions

71
 MPH PROGRAMME

16: Health Education and Health Promotion

Course Title: Health Education and Health Promotion
Course Credit:3

Introduction:
Pakistan is in the transitional phase of development with the issues of the fast changing
paradigms in the face of small expenditure on health. Faced with the fact that the health
problems are immense, health promotion is an important intervention to change behaviours
and attitudes of people to deal with largely preventable health problems. It needs the input
in the form of proper planning, implementation and evaluation of Health Promotion
Programmes and projects. Health Promotion is considered as the continuation of the skills
already learnt in the earlier courses.

Learning Goal:
Reorient the students to turn them into health promotion specialists and communicators.

Learning Objectives:
By the end of the course participants should be able to

1. Describe the major approaches to the promotion of health, including the underlying
theories and procedures used in evaluating them.
2. Design a health promotion campaign.
3. Describe the basic principles of behavior change and management, the scientific, social,
cultural and economic bases of health promotion, as well as the political and ethical
issues that affect health promotion activities.
4. Demonstrate the communication skills which public health specialists be called upon to
play in Health Promotion

Contents:
The following areas will be covered during the course:

1. Introduction to Health Promotion and Education

 Health promotion
 Risk transition
 Ottawa Charter
 Adelaide, Sundsval, Jakarta and Mexico, Bangkok conferences
72
 MPH PROGRAMME

 Life course perspective

 World Health Report 2002
2. Health perspectives and reflections
 Health as a continuum
 Approaches to Health Education
 Orientations for health education
3. Evidence-based Health Promotion and Planning
 Principles of Health Promotion
 Hierarchy of evidence
 Outcome model of Health Promotion
 A new evidence paradigm
 Health A new evidence paradigm
4. Health Promotion theoretical perspectives
 Ecological Models
 Community theories
 Diffusion of innovations
 Community organization theory
 Organizational change theory
 Interpersonal
 Social learning theory
 Social cognitive theory
 Individual
 Trans theoretical model / Stages of change model
 Health belief model
 Consumer information processing Model
5. Models of Health Promotion
 Aims of Health Promotion
 Towards a more integrated model
 Tanahills Model
6. Models of Health Promotion Planning
 PRECEDE-PROCEDE

73
 MPH PROGRAMME

 Social Marketing
 Logic Model
7. Health Communication
 Types and levels
 Principles of effective communication
 Message
 Audience
 HEALTHCOMS 5 step methodology
 CDC’s Health Communication Wheel
 “A” frame of advocacy
 7 C’s of effective communication
 “P” process
 Health Communication campaign
 Planning a comprehensive health communication campaign
8. Steps of the comprehensive health communication campaign
 Steps of the comprehensive health communication campaign
9. Social Marketing
10. Evaluating Health Promotion Programs
 Stages of research and evaluations for Health Promotion programs
 Best practices in health promotion
 Skills for evaluation
 Steps off evaluation process

Teaching Methodology:
Teaching is carried out in form of didactic and participative lectures and individual and
group exercises. The participants are supposed to complete a supervised class assignment
i.e. a mini project based on the PRECEDE-PROCEDE framework which entails fieldwork.

Recommended Readings:
1. Elder JP. Behavior change and public health in the developing world. Thousand Oaks,
CA; SAGE; 2001.
2. Ewles L, Simmett I. Promoting health: a practical guide, third edition. London: Scutari
Press; 1995.

74
 MPH PROGRAMME

3. Green LW, Kreuter MW. Health promotion planning: an educational and environmental
approach, second edition. Mountain View, CA: Mayfield Publishing Company; 1991.
4. Naidoo J, Wills J. Health promotion: foundations for practice, 2nd ed. London: Bailliere
Tindall; 1994.
5. Rogers EM, Kincaid DL. Communication networks: towards a new paradigm for
research. New York, NY: The Free Press; 1981.
6. Rogers EM. Diffusion of innovations, third edition. New York, NY: The Free Press; 1983.
7. Valente TW. Evaluating health promotion programs. New York, NY: OxfordUniversity
Press; 2002.
8. World Health Organization. Education for health: a manual on health education in
primary health care. Geneva: World Health Organization; 1988.

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation, class exercises and individual
assignments, i.e. developing a health promotion programme using PRECEDE-PROCEDE
framework.
Summative Assessment (80%)
Summative assessment consist of: MCQs and Short essay questions

75
 MPH PROGRAMME

17: Health Systems Management

Course Title: Health Systems Management
Course Credits:3

Introduction:
Pakistan has one of the best knitted network health care facilities in public sector. These
facilities mostly, face the problems of underutilization and under functioning along with the
technical and allocative inefficiency. The management of private sector has also been
considered inefficient and not very effective. Specific Management tools and techniques,
such as strategic management, management by objectives, quality assurance methods,
monitoring and evaluation of the health systems outputs and outcomes, and economic
appraisal are not practiced. Insufficient management knowledge, in appropriate attitude and
skills are reducing the capacity to improve the system.

Learning Goal:
The overall goal of the course is to enable the participants to describe the principal concerns
in Health Systems management in order to improve the management capacity of health
managers in terms of their knowledge, attitude and skills.

Learning Objectives:
By the end of the course, the participants will be able to:

1. Define management that encompasses the main aspects of problem-solving typically

faced by health managers;
2. Define and describe essential concepts, principles, methods and terms in management;
3. Apply certain techniques in the resolution of selected management issues and
4. Describe basic methods of quantitative analysis being used by health managers.
5. Demonstrate change management, communication and leadership skills.
6. Define what quality means from the standpoint of the variety of stakeholders.
7. Explain the relationship of cost and quality.

Contents:
The following areas will be covered during the course:

1. Introduction to Health System and Scope of Health Systems

2. Managing Health System for Better Outcomes, Global Issues and Priorities for Pakistan
76
 MPH PROGRAMME

3. Management: Traditional and Contemporary Issues and Challenge

4. Management and the Manager’s Job
5. An Introduction to Systems, Client Orientation, Process Analysis, Problem Identification
6. Evidence-based decision making
7. Use of HMIS in HSM
8. Supportive supervision &leadership
9. Capacity building in human resource management
10. Introduction to Human Resource Management: Competencies and Job Description
11. Challenges resolution techniques, staff motivation and performance appraisal
12. Functional and Task Analysis
13. Functional and Task Analysis: Exercise
14. Monitoring and Evaluation
15. Introduction to Financial Management
16. Performance Budgeting and Analysis in HSM
17. Financial Management in HSM
18. Financial Management in HSM: Exercise
19. Logistics Cycle in HSM
20. Quality Management
21. Quality Management:Exercise
22. Tools for Quality Assessment / improvement
23. Tools for Quality Assessment / improvement: Exercise

Teaching Methodology:
Lectures, discussions, assigned individual and group exercises, Role plays

Recommended Readings:
1. Amonoo-Lartson R, Ebrahim GJ, Lovel HJ. District health care: challenges for planning,
organization and evaluation in developing countries, 2nd ed. Hong Kong: Macmillan
Press; 1985.
2. Chanawongse K. Understanding primary health care management: from theory to
practical reality. Bangkok: Buraphasilp Press; 1990.

77
 MPH PROGRAMME

3. Gourlay R. Training manual on health manpower management (8 volumes). Geneva:

Division of Health Manpower Development, World Health Organization; 1988.
Document no. WHO/EDUC/88.195.
4. McMahon R, Barton E, Ross F. On being in charge: a guide to management in primary
health care, 2nd ed. Geneva: World Health Organization; 1992.
5. Reinke WA. Health planning for effective management (HPEM).New York,
NY:OxfordUniversity Press; 1988.
6. Shortell SM, Kaluzny AD. Health care management, 3rd ed. Albany, NY: Thompson
Delmar Learning; 2000.
7. World Health Organization. The world health report 2000: Health systems – improving
performance. Geneva: World Health Organization; 2000. Available from: URL:
http://www.who.int/entity/whr/2000/en/whr00_en.pdf

Students’ Evaluation:
Formative (20%)
Ongoing assessments, group works and exercises and an end of course test.
Summative Assessment (80%)
Session examination

78
 MPH PROGRAMME

18: Health Planning

Course Title: Health Planning
Course Credit:3

Introduction:
This course is offered to MPH participants to build upon their existing Health Systems
concepts. Health planning is major task of public health professionals working in the
government and the private sector in positions of programme and project managers, district
officers or hospital managers. Especially after many countries have decentralized their
administration to the districts and below public health professionals are required to have
sound knowledge and skills to plan and budget for health. The focus of this course is on the
tools and techniques of operational planning, whereas strategic planning is dealt with in the
elective course on health policy.

Learning Goal:
The goal of this course is to enhance the participants’ comprehension of the planning
process including budgeting, specifically at district and sub-district level leading to an
improvement in planning capacities of health care providers and professionals for the
purpose of ultimately improving health service delivery.

Learning Objectives:
At the end of the course students will be able to:

1. List the sequential steps of the micro planning cycle

2. Explain the difference and relationship between different types of planning
3. Apply certain Tools and Techniques for District Health and Project Planning
4. Develop a district health plan/programme implementation plan with an adequate
budget.

Contents:
The following areas will be covered during the course:

1. District Health System and Devolution

2. Introduction to Health Planning and Budgeting
3. The Planning Cycle and its steps
4. Essential Content of a district Health Plan Document

79
 MPH PROGRAMME

5. Glossary of Terms used in district Health Planning

Teaching Methodology:
Lectures, discussions, assigned individual and group exercises

Recommended Readings:
1. Green A. An introduction to health planning in developing countries,2nd edition. Oxford:
OxfordUniversity Press; 1999.
2. Kielmann AA, Siddiqi S, Mwadime RK. District health planning manual: toolkit for
district health managers.Islamabad, Pakistan: Multi-donor Support Unit, Ministry of
Health; 2002.
3. Kielmann, AA, Janovsky K, Annett H. Assessing district health needs, services and
systems: protocols for rapid data collection and analysis.London, UK: Macmillan
Education Ltd and AMREF, 1995.
4. Newell K. The way ahead for district health systems. World Health Forum. 1989;10: 80-7.
5. ReinkeWA. Health planning for effective management.New York, NY: OxfordUniversity
Press; 1988.
6. Van Lerberge W, Lafort Y. The role of the hospital in the district. Deliverin or supporting
primary health care? Current concerns. WHO SHS Paper 1990;2: 1-36.
7. World Health Organization. Making it work: organization and management of district
health systems based on primary health care. Geneva: World Health Organization; 1988.
Document no. WHO/SHS/DHS/88.1.
8. World Health Organization. The challenge of implementation: district health systems for
primary health care. Geneva: World Health Organization; 1988. Document no.
WHO/SHS/DHS/88.1/rev 1. Available from: URL:
http://whqlibdoc.who.int/hq/1988/who_shs_DHS_88.1_Rev.1.pdf
9. World Health Organization. The health centre in district health systems. Geneva: World
HealthOrganization; 1994. Document no. WHO/SHS/DHS/94.3.

Students’ Evaluation:
Formative (20%)
Ongoing assessments, group works and exercises and an end of course test.
Summative Assessment (80%), Session examination

80
 MPH PROGRAMME

Annex 4: Courses for Session III

19: Health Care Financing
Course Title: Health Care Financing
Course Credits:3

Introduction:
This course is an introduction to the field of health care financing and health economics. In
the past decade, some of the most controversial policies considered by governments have
involved issues that have been analyzed by health economists. For this reason, public health
professionals need to have a sound basis to understand economic and financing mechanisms
underlying changes occurring in the health sector.

Learning Goal:
The goal of this course is to improve the participants’ knowledge and skills to deal with
health economics and financing.

Learning Objectives
At the end of the course students will be able to:

1. Describe the basic microeconomic concepts

2. Apply these concepts to health and health care;
3. Explain the financing flows underpinning access to and delivery of health care services.
4. State the differences in financing the health care services among countries at different
levels of income and development.
5. Analyse health care financing options in a variety of countries and settings and making
informed recommendations on how to improve health financing.

Contents:
The following are the contents of the course:

1. Basic Economic concepts and tools.

 Definitions: Economics, Macro & Microeconomics, economic systems,
 Goals of an economic system,
 Efficiency (technical, allocative)
 Equity

81
 MPH PROGRAMME

 Demand & Supply

 Price, Market forces, Price equilibrium
 Types of Goods, Public, Private, Externalities, Opportunity cost
 Production Theory
 Markets, Competition, perfect, oligopoly, monopoly
2. Health & Economic Development
 GNP, GDP;
 Inflation,
 Health & economic Indicators
3. Cost Concepts
 Unit Cost Analysis (Step down approach)
 Costing for Intervention Package for Health Care
4. Economic Analysis of Health Sector Projects
 Cost Benefit,
 Cost Utility,
 Cost Effectiveness;
 Summary Measures for Health
 Average and Marginal Cost analysis
5. Health Care Financing
 Overview of Health Care Financing Concepts in Developing Countries
 Equity and Financial Fairness/HCF for Poor
 Economic development and resource allocation: Out of Pocket vs. Government:
Development- Non Development; Health Sector Reforms
 Social Health Insurance
 Private Health Insurance
 Community Financing
 User fees
 Provider Payment Method
 Health Insurance Implementation In Pakistan
 Health Insurance & Islam
 National Health Accounts

82
 MPH PROGRAMME

6. Health and Markets

 Health and Markets: Application of market concepts to Health
 Why Health is a Case of Market Failure
 Government and Health Care
 Managed Care
7. Globalization of Health
 The International Health Market: Providers, Purchasers, Pharmaceuticals
 Priority Setting in Developing countries
 International Resource flows: Developing countries & Health

Teaching Methodology:
The teaching methodology for this course will consist of lectures, classroom exercises,
assignments, presentations, role play and discussions

Recommended Readings:
1. Creese A, Parker D (eds.). Cost analysis in primary health care: a training manual for
programme managers. Geneva: World Health Organization in collaboration with the
United Nations Children’s Fund and the Aga Khan Foundation; 1994.
2. Donaldson C, Gerard K. Economics of health care financing: the visible hand, 2nd edition.
Basingstoke, UK: Palgrave Macmillan; 2004.
3. Drummond M, McGuire A. Economic evaluation in health care: merging theory with
practice. New York, NY: OxfordUniversity Press; 2001.
4. Drummond MF, O’Brien B, Stoddart GL, Torrance GW. Methods for the economic
evaluation of health care programmes, 2nd ed. Oxford: Oxford University Press; 1997.
5. Feldstein PJ. Health care economics. New York, NY: John Wiley & Sons, Inc; 1979.
6. Gold MR, Siegel JE, Russel LB, Weinstein MC (eds.). Cost effectiveness in health and
medicine.New York, NY: OxfordUniversity Press; 1996.
7. Government of Pakistan. Economic survey of Pakistan 2005-2006.Islamabad, Pakistan:
Government of Pakistan, Finance Division; 2006. Available from: URL:
http://www.finance.gov.pk/survey/home.htm
8. McDonald R. Using health economics in health services: rationing rationally?
Buckingham: Open University Press; 2002.

83
 MPH PROGRAMME

9. McPake B, Kumaranayake L, Normand C. Health economics: an international

perspective. London, UK: Routledge Publishers; 1997.
10. Mills A, Lee K. Health economics research in developing countries. Oxford:
OxfordUniversity Press; 1993.
11. Mishan EJ. Cost-benefit analysis: an informal introduction, 4th ed. London, UK: Unwin
Hyman Ltd; 1988.
12. PrekerAS, Carrin G. Health financing for poor people: resource mobilization and risk
sharing. WashingtonDC: The World Bank; 2004.
13. Spasoff RA. Epidemiologic methods for health policy. New York, NY: OxfordUniversity
Press; 1999.
14. Witter S, Ensor T, Jowett M, Thompson R. Health economics for developing countries: a
practical guide. London, UK: Macmillan Education Ltd; 2000.
15. World Health Organization. Macroeconomics and health: investing in health for
economic development – reportof the Commission on Macroeconomics and Health,
World Health Organization. Geneva: World Health Organization; 2001. Available from:
URL: http://whqlibdoc.who.int/publications/2001/924154550X.pdf
16. Zaidi SA. Issues in Pakistan’s economy.Karachi, Pakistan: OxfordUniversity Press; 1998.
17. Zaidi SA. The political economy of health care in Pakistan. Karachi, Pakistan: Vanguard
Books (Pvt.) Ltd; 1988.

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and class exercises
Summative Assessment (80%)
Summative assessment consist of: MCQs and Short essay questions

84
 MPH PROGRAMME

20: Applied Nutrition

Course Title: Applied Nutrition
Course Credit:3

Introduction:
It is essential that the students of Public Health understand the importance of absence of
good nutrition as a measure of physical, social and economic indicators of health and
development of a country. There is a need to comprehend the role of good nutrition in
development and maintenance of a healthy body. This will help in the identification of
common nutritional disorders at individual levels and also in advising mothers in matters
related to nutrition during periods of stress and for the optimal growth of the young
children.

Learning Goal:
The goal of this course is to create a group of trainees well-equipped in handling nutritional
problems at community and hospital level, enabling them to understand the fundamentals
of nutrition, nutritional deficiencies, preventing and managing nutritional problems in the
community and hospital.

Learning Objectives:
At the end of the module, the trainee should be able to:

1. List the types of foods and the nutritional requirements of the children, mothers and
people of old age.
2. Write a nutritional prescription for a child at different ages and the mothers.
3. Describe the nutritional requirements of the infants and young children.
4. List the nutritional requirements of Mothers during pregnancy and lactation.
5. Describe the nutritional aspects of human milk.
6. Define and Perform nutritional assessment of young children
7. Describe the nutritional effects on growth
8. Examine the development of growth charts and define their uses
9. Plan and perform nutritional surveillance using various indicators.
10. Define nutritional surveillance, indicators and methods.
11. Analyze nutritional data using EPINUT/Nutrisurvey.
12. Counsel mothers on infant feeding
85
 MPH PROGRAMME

13. Counsel mothers with malnourished child in problem solving in the community and the
hospital.
14. Identify common micronutrient deficiencies, management and prevention
15. Describe common nutritional problems (deficiency or excess of nutrients) and their
management and their prevention.
16. Carry out field visit to a restaurant and describe the food sanitation etc.
17. Write a report on field work and make a presentation of their work for critical appraisal.

Contents:
The following are the contents of the course:

A. Normal nutrition
1. Fundamental elements of human nutrition
2. Nutrition during growth and health
3. Nutritional requirements of neonates and infants 0-6 months
4. Nutrition requirements of infants 6-12 months
5. Nutrition requirements of children 1-5 years
6. Nutrition requirements of children 5-12 years
7. Nutrition requirements during physiological stress
8. Nutrition requirements of Adolescents
9. Nutrition requirements during Pregnancy
10. Nutrition requirements during Lactation
11. Household food safety
B. Assessment of Growth and Nutritional status of children:
1. Nutritional status: its assessment by field techniques
2. Nutritional status: Its assessment through anthropometry
3. Using Growth Charts as primary health care tool
4. Nutritional Prescription for children
5. 6-12 months of age
6. 12 months - 5 years of age
7. 5 - 12 years of age
8. Nutritional prescription of the mothers during normal health, pregnancy and
lactation

86
 MPH PROGRAMME

C. Human Milk and its importance:

1. Optimal Breastfeeding Practices
2. Advantages of breastfeeding and dangers of bottlefeeding
3. Exclusive breastfeeding
4. Complementary feeding
5. Perceived insufficiency of breastmilk/Lactation failure
6. Promotion and support of breastfeeding
7. Management of lactation problems
D. Malnutrition
1. Classification of Malnutrition
2. Causes of Malnutrition
3. Risk factors and their assessment
4. Management of Malnutrition
5. Clinical Assessment of Malnutrition
6. Protein energy malnutrition: Marasmus, PEM, Kwashiorkor
7. Micronutrient Deficiencies
8. Nutrition during special circumstances
9. Establishing a Lactation Management clinic
E. Health Education in Nutrition
1. Communication skills
2. Nutritional counselling
3. Nutritional and social rehabilitation
F. Monitoring and Evaluation of nutrition intervention programmes
1. National Nutrition Programmes
2. National Nutrition Surveys
3. Nutrition in IMCI
4. Breastfeeding Policy (International Code for Breastfeeding)
5. Expanded Programme for childhood illnesses and Nutrition
6. IDD control programme
G. Nutrition for children living in special situation:
1. Poverty
2. War
87
 MPH PROGRAMME

3. Natural calamities
4. HIV/AIDS
5. Food safety
6. Storage and Preservation of Foods at local and industrial level

Teaching Methodology:
Lectures, interactive teaching using problem-based learning/discussions, tutorials, seminars
and discussions, assignments and field work, using computer softwares, Practical Skills in
the community and hospital, Clinical Ward assignments.

Recommended Reading:
1. Allen LH. Nutritional influences on linear growth: a general review, Eur J Clin Nutr
1994;48(suppl 1): 75-89.
2. Ashraf RN, Jalil F, Khan SR, Zaman S, Karlberg S, Lindblad BS, HansonLÅ. Early child
health in Lahore, Pakistan: V. Feeding patterns. Acta Paediatr 1993;390(suppl.): S48-62.
3. Ashraf RN, Jalil F, Zaman S, Karlberg J, Khan SR, Lindblad BS, Hanson LÅ. Breast
feeding and protection against neonatal sepsis in a high risk population. Arch Dis Child
1991;66:488-90.
4. Atkinson SA, Hanson LA, Chanrdra RK (eds.). Breastfeeding, nutrition, infection and
infant growth in developed and emerging countries.Newfoundland, Canada: ARTS
Biomedical Publishers and Distributors; 1990.
5. Brown KH, Black RE, Lopez de Romana G, Creed de Kanashiro H. Infant feeding
practices and their relationship with diarrhoeal and other diseases in Huascar (Lima),
Peru. Pediatr 1989;83:31-40.
6. Cohen RJ, Brown KH, Canahuati J, Rivera LL, DeweyKG. Determinants of growth from
birth to 12 months among breast fed Honduran infants in relation to age of introduction
of complementary foods, J Pediatr 1995;96:504-10.
7. de Onis M, Blössner M. World Health Organization Global Database on Child Growth
and Malnutrition. Geneva: Programme of Nutrition, World Health Organization; 1997.
Available from: URL:
http://www.who.int/nutgrowthdb/database/en

88
 MPH PROGRAMME

8. Dewey KG, Heinig MJ, Nommsen LA, Peerson JM, Lonnerdal B. Breastfed infants are
leaner than formula-fed infants at 1 year of age: the DARLING study. Am J Clin Nutr
1993;57: 140-5.
9. Dewey KG. Infant nutrition in developing countries: what works [comment]? Lancet,
2005 28-Jun 3;365: 1832-4.
10. Diaz S, Herreros C, Aravena R, Casado ME, Reyes MV, Schiappacasse V. Breast feeding
duration and growth of fully breast fed infants in a poor urban Chilean population. Am J
Clin Nutr 1995;62:371-6.
11. Gross R, Kielmann A, Korte R, Schoeneberger H, Schultink W. Guidelines for nutrition
baseline surveys in communities. Jakarta: SEAMEO, TROPMED, GTZ; 1997.
12. Hanson L, Ashraf R, Zaman S, Karlberg J, Khan SR, Lindblad B, et al. Breastfeeding is a
natural contraceptive and prevents disease and death in infants, linking infant mortality
and birth rates. Acta Paediatr1994 Jan;83:3-6.
13. Hanson LÅ, Ashraf R, Zaman S, Karlberg J, Lindblad BS, Jalil F. Breast feeding is a
natural contraceptive and prevents disease and death in infants, linking infant mortality
and birth rates. Acta Paediatr 1994;83:3-6.
14. Hanson LÅ, Carlsson B, Jalil F, Hahn-Zoric M, Karlberg J, Mellander L, Khan SR,
Murtaza A, Thiringer K, Zaman S. Antiviral and antibacterial factors in human milk. In:
HansonLÅ (ed.). The biology of human milk, vol. 15. New York, NY:Néstle Nutrition
Workshop Series, Raven Press; 1989. p. 141-157.
15. Hanson LÅ, Carlsson B, Zaman S, Adlerberth I, Mattsby Baltzer I, Jalil F. The importance
of breastfeeding in host defense: production of the milk antibodies and the anti-
inflammatory function of human milk. Pak Paed J 1992;XV: 155-164.
16. Hanson LÅ, Silfverdal SA, Stromback L, Erling V, Zaman S, Olcen P, Telemo E. The
immunological role of breast feeding. Pediatr Allergy Immunol 2001;12 Suppl 14:15-9.
17. Hanson LÅ. Immunobiology of human milk:how breastfeeding protects babies.
Amarillo, TX, USA: Pharmasoft Publ; 2004.
18. Karlberg J, Ashraf RN, Saleemi MA, Yaqoob M, Jalil F. Early child health in Lahore,
Pakistan: XI. Growth. Acta Paediatr 1993;390 (suppl):119-49.
19. Karlberg J, Zaman S, HansonLÅ, KhanSR, LindbladBS, JalilF. Aspects of infantile growth
and the impact of breastfeeding: a case control study of the infants from four
socioeconomically different areas in Pakistan.Hum Lactat 1990;4: 219-47.

89
 MPH PROGRAMME

20. Pakistan Demographic and Household Survey, 1990-1994. Pakistan Institute of

Population studies and Govt of Pakistan, 1994.
21. Pelto GH, Santos I, Goncalves H, Victora CG, Martines J, Habicht JP.Nutrition
counseling training changes physician behavior and improves caregiver knowledge
acquisition. J Nutrruary 2004; 134: 357–362.
22. Penny ME, Creed-Kanashiro HG, Robert RC, Narro MR, Caulfield LE, Black RE.
Effectiveness of an educational intervention delivered through the health services to
improve nutrition in young children: a cluster-randomised controlled trial. Lancet 2005
28-Jun 3;365: 1863-72.
23. Saleemi MA, Ashraf RN, Mellander L, Zaman S. Determinants of stunting at 6, 12, 24
and 60 months and postnatal linear growth in Pakistani children. Acta Paediatr
2001;90:1304-8.
24. Tulchinsky TH, El Ebweini S, Ginsberg G, Abed Y, Montano-Cuellar D, Schoenbaum M,
et al. Growth and nutrition patterns of infants associated with a nutrition education and
supplementation program in Gaza, 1987-92. Bull WHO 1994;72:869-75.
25. Victora CG, Smith PG, Vaughan JP, Nobre LC, Lombardi C, Teixeira AM, et. al. Evidence
for protection by breast-feeding against infant deaths from infectious diseases in Brazil.
Lancet 1987 8;2:319-22.
26. Victora CG, Smith PG, Vaughan JP, Nobre LC, Lombardi C, Teixeira AMB, et. al.
Evidence for protection by breastfeeding against infant deaths from infectious diseases
in Brazil. Lancet 1987;2:319-21.
27. WHO Collaborative Study Team. Effect of breastfeeding on infant and child mortality
due to infectious diseasesin less developed countries: a pooled analysis, Lancet
2000;355:451-55.
28. World Health Organization, UNICEF. Global strategy for infant and young child
feeding. Geneva: World Health Organization; 2003. Available from: URL:
http://www.who.int/child-adolescent-
health/New_Publications/NUTRITION/gs_iycf.pdf
29. World Health Organization. Effect of breastfeeding on infant and child mortality due to
infectious diseases in less developed countries: a pooled analysis. WHO Collaborative
Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. Lancet
2000 5;355:451-5.

90
 MPH PROGRAMME

30. World Health Organization. Management of severe malnutrition: a manual for

physicians and other senior health workers. Geneva: World Health Organization; 1999.
Available from: URL:
http://whqlibdoc.who.int/hq/1999/a57361.pdf
31. World Health Organization. Management of the child with a serious infection or severe
malnutrition: guidelines for care at the first-referral level in developing countries.
Geneva: Department of child and adolescent health and development, World Health
Organization;2000. WHO document WHO/FCH/CAH/00.1. Available from: URL:
http://www.who.int/child-adolescent-
health/publications/referral_care/Referral_Care_en.pdf
32. World Health Organization. Measuring change in nutritional impact of supplementary
feeding programme for vulnerable groups. Geneva: World Health Organization; 1983.
33. Zaman S, Jalil F, Saleemi MA, Mellander L, Ashraf RN, Hanson LÅ. Changes in feeding
patterns affect growth in children 0-24 months of age living in socioeconomically
different areas of Lahore, Pakistan. Adv Exp Med Biol 2002;503:49-56.

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and class exercises
Summative Assessment (80%)
Summative assessment consist of: MCQs and Short essay questions

91
 MPH PROGRAMME

21: Hospital Management

Course Title: Hospital Management
Course Credit:3

Introduction:
In the developing countries, the situation becomes even more intimidating as the hospitals
have lesser space, equipment, hospital staff and are frequently overwhelmed and
overcrowded. A more sensitive delivery of care in a more therapeutic environment can
benefit patients and have a positive bottom-line impact on healthcare institutions. Poor
Quality of Hospital Services has been a major problem for Public sector hospitals in
Pakistan. One of the main contributors of the poor quality of hospital services, apparent to
patients and staff alike, is the inefficiency of hospitals’ management and its operations.
Ninth five plan of Pakistan (1999-2003) has documented that there are large variations in the
utilization of hospital services and that at present there are no quality control mechanisms in
place within hospital sector, as a result, the public hospitals are generally perceived to be of
low quality.

Learning Goal:
The goal of the course is to enhance the participants’ knowledge regarding management and
other issues faced by hospital managers and to develop their skills to address the managerial
and administrative issues of Public and Private sector hospitals at all levels.

Learning Objectives:
By the end of the course the participants will be able to:

1. Describe the management of hospitals in public and private sectors.

2. Describe the functional departments of a hospital.
3. Apply the management functions such as planning, organizing, staffing and controlling
in hospitals.
4. List out the problems that are being faced by hospitals in implementing effectively these
management functions.
5. Describe the expected role of hospital in the community.
6. Apply the principles and practice of Hospital Management.
7. Construct budgets, financial costing and cost effectiveness of the hospital services.

92
 MPH PROGRAMME

8. List the requirements for efficient management of hospital services and utilities like x-
rays, laboratory and indoor facilities.
9. Establish the concept of total quality management in health services.
10. Describe the dynamics of a Hospital as an Organization and the Corporate nature of a
Hospital.
11. Address efficiency issues in the management of a hospital through its resources.
12. Explore possible options for Cost Containment and profitability.

Contents:
The contents of the course are as follows:

1. Hospital System and its Role, Components of a Hospital System & Role of Hospitals in
PHC
2. Vision, Mission, Goals and Values of a Hospital
3. Role and Functions of Hospital Managers
4. Hospital Services Management
 Nursing Management
 Change Management
 Infrastructure Management
5. Inventory Management
6. Drugs Management in Hospitals-I and II
7. Human Resource Management
8. Financial Management
 Accounting rules and practices in a public & Private Hospital
 Financial Management
 Hospital Financing for Sustainability
 Cost Containment, cost effectiveness and profitability
 Costing and Cost implications of Hospital Services
9. RAP Tool
 Introduction to Rapid Appraisal Tool for assessment of Emergency of a Hospital
 Data Collection in Hospitals using RAP Tool
10. Preparing a Hospital Budget
11. Hospital Waste Management and infection control
93
 MPH PROGRAMME

 Hospital Environment & Hospital Waste Management

 Hospital Environment-related issues: lighting, ventilation, Cleanliness and tidiness,
horticulture and greenery, Clean, regular and safe water supply, standards of
personal hygiene, Control measures for hospital associated infections
12. Accident & Emergency /Trauma Management Services
13. Human Resource Management
 Human Resource Development: current status and future challenges
14. Infrastructure Management
 Hospital Planning and Design
 TQM and Medical Audit of the Hospital.
 Total Quality Management: key concepts and Introduction to some basic tools of
TQM
 Hospital Purchasing Process
 Hospital Purchase, Tendering and Processing
15. Hospital Ethical Concerns

Teaching Methodology:
A combination of various teaching methods such as lectures, individual and group exercises,
group presentations, Field visits to Private and Public Hospitals will be used.

Recommended Readings:
1. Barnum H, Kutzin J. Public hospitals in developing countries: resource use, cost,
financing.Baltimore, MD: JohnsHopkinsUniversity Press; 1993.
2. Blanchet KD, Switlik MM. The handbook of hospital admitting management. USA:
Aspen Publications; 1985.
3. Goel SL, Kumar R. Management of hospitals. New Dehli, India: Deep and Deep
Publications; 2002.
4. King M, Lapsley I, Mitchell F, Moyes J. Activity based costing in hospitals: a case study
investigation. London, UK: Chartered Institute of Management Accountants; 1994.
5. McMahon R, Barton E, Piot M, Gelina N, Rose F. On being in charge. Geneva: World
Health Organization; 1992.
6. PrekerAS, Harding A (eds.). Innovations in health service delivery: the corporatization
of public hospitals, vol. 1. WashingtonDC: World Bank; 2002.

94
 MPH PROGRAMME

7. Shepard DS, Hodgkin D, Anthony Y. Analysis of hospital costs in developing countries:

a manual for managers. Waltham, MA: Institute for Health Policy, BrandeisUniversity;
1997.
8. Willan JA. Hospital management in the tropics and subtropics. London, UK: Macmillan
Education Ltd, 1990.
9. World Health Organization. The hospital in rural and urban districts: report of a WHO
study group on the functions of hospitals at the first referral level. World Health Organ
Tech Rep Ser. 1992;819:1-74.

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and class exercises
Summative Assessment (80%)
Summative assessment consist of: MCQs and Short essay question

95
 MPH PROGRAMME

22: Advanced Epidemiology and Biostatistics

Course Title: Advanced Epidemiology and Biostatistics

Course Credits = 3

Introduction
In Biological sciences, sometimes the complexity of data collected is such that there is very
little choice left for the researcher to conduct simple analyses and assure the reader about
the authenticity of the data and the conclusions that are drawn. However, applications of
some advanced techniques to the complex data can be useful to learn and interpret
supporting the conclusions. This course is designed to answer the more complex questions
that a researcher raises. This will also enable the students to further their research for a
higher degree.

Learning advanced methods in Epidemiological and Biostatistical applications in Research

sometimes required for a more comprehensive and detailed presentation of data bases.
Statistical softwares like STATA and SAS are available for such analyses. This course is
designed to provide learning opportunities to students who are interested in such advanced
applications.

Learning Goal:

The learning goal of this particular course is to provide skills in understanding data and
developing analysis which may be useful in their applications in a wider scenario and
successfully using the statistical softwares as a form of help in analysis.

Learning Objectives:
At the end of the course, the student should be able to:

1. Apply statistical measures in the analysis of Cohort and Case control studies.

2. Analyse Disease Frequency in a wider perspective keeping the population dynamics in

view.

3. Effectively apply statistical modeling techniques in different study Designs.

4. Apply comparisons in several exposure groups.

5. Describe statistical applications in survival analysis using STATA and SAS

96
 MPH PROGRAMME

6. Apply the analysis for interaction when studying confounding etc.

Contents:

1. Measures of disease frequency and exposure effects

2. Rates and Risk measurements

3. Odds ratios as an estimate of Relative Risk

4. Confidence intervals for rates and rate ratio

5. Test for heterogeneity of Rate Ratios

6. Person-year Analysis : Cohort studies

7. Comparison of several exposure groups using different statistical techniques.

8. Exposed cohort compared to an external standard

9. Survival Analysis

10. Analysis of unmatched case-control studies

11. Selection Bias

12. Analysis of matched Case-control studies

13. Estimating Risk ratios and Rate Ratios in case-Control studies

14. Logistic regression I

15. Logistic Regression II

16. Likelihood Inference

17. Conditional Logistic Regression

18. Poisson Regression

19. Regression models for proportions

20. Strategies for Data Analysis

21. Proportional Hazards regression for Cohort studies.

22. Multiplicative and Additive Models

23. Clustering of cases of disease

24. Analysis of data with multiple episodes as outcome

25. Sample Surveys

26. Regression Analysis and analysis of variance

97
 MPH PROGRAMME

27. Laws of probability and Binomial Distribution

28. Conditional probability

29. Comparison of survivorship curves

30. Several Straight lines

31. Further analysis of Frequency data

32. Multiple comparisons and sequential trials

33. Time series

34. Non Parametric application on data of different nature.

35. Choice of a statistical technique based on study designs.

Recommended Readings:

1. Gordis L. Epidemiology. Philadelphia, PA: WB Saunders Company; 2008.

2. Hennekens CH, Buring JE. Epidemiology in medicine. Boston, MA: Little Brown and
Company; 1987.

3. Holford TR. Multivariate methods in epidemiology. New York, NY: Oxford

University Press; 2002.

4. MacMahon B, Thomas FP. Epidemiology: principles and methods, 1st ed. Boston,
MA: Little, Brown and Company; 1970.

5. Fletcher RH, Fletcher SW, Wagner EH. Clinical epidemiology: the essentials, 3rd ed.
Philadelphia, PA: Williams & Wilkins Publishers; 1996.

6. Szklo M, Neito FJ. Epidemiology: beyond the basics. Boston, MA: Jones and Bartlett
Publishers; 2000.

7. Korkwood BR Sterne JAC. Essential Medical Statistics. 2nd edition. Blackwell Science
Ltd. Blackwell Publishing Company, 2003.

8. Dupont WD. Statistical Modelling for Biomedical Researchers. A simple introduction

to the analysis of a complex data. 2nd edition. Cambridge University Press; 2008.

9. Altman DG. Practical statistics for medical research, 3rd ed. London, UK: Chapman &
Hall; 1991.

10. Colton T. Statistics in medicine, 1st ed. Boston, MA: Little Brown and Company ;
1994.

98
 MPH PROGRAMME

11. Selvin S (ed.). Statistical analysis of epidemiologic data, 3rd edition. New York, NY:
Oxford University Press; 1991.

12. Katz MH. Multivariable Analysis. A practical guide for Clinicians. Cambridge
University Press; 1999.

13. Schelsselman JJ. Case Control studies. Design, conduct, analysis. Oxford University
Press, New York, 1982.

Teaching Methodology:

Interactive (scenario-based learning), assignments, discussions and practical exercises,

lectures. Hands-on training using STATA and SAS.

Students’ Evaluation:

Formative (20%)

Ongoing assessment through class participation and class assignments/exercises

Summative Assessment (80%)

Summative assessment consists of: MCQs and short essay questions. Problem solving.

99
 MPH PROGRAMME

23. Health Policy

Course Title: Health Policy
Course Credit:3

Introduction:
Over the past 60 years,Pakistan has developed a health system which includes a number of
programmes aiming at promoting health recognized as the developmental need, based on a
set of policies and with increasing financial support over the years. However, there are a
number of gaps in the implementation of policies for a number of reasons not leading to a
translation into desired outcomes.

Learning Goal:
The overall goal of the course is to provide the participants a basis on how to critically
analyze, develop and improve health policies.

Learning Objectives:
By the end of the course, the participants will be able to:

1. Describe concepts and tools used in health policy.

2. Conduct a stakeholder analysis in the process of policy development.
3. Comprehend the inter-relationship between policy, plan, program and project as well as
planning at macro and macro levels.
4. Understand the implementation modalities of macro-level and micro-level policy
decisions at micro-levels (translation of policies into actions).
5. Appreciate extra-health-policy factors that influence health policies and their desired
outcomes.
6. Describe the policy procedures that exist in Pakistanand in other countries and critique
their strengths and weaknesses.
7. Understand methods and importance of monitoring, evaluation and research for health
policies.
8. Advocate health sector reform agenda effectively.

Contents:
The following are the contents of the course:

1. Introduction to Health Policy and Planning, what and why?

100
 MPH PROGRAMME

2. Policy Perspectives (I) Macro Policy

3. Policy Perspectives (II) Macro Policy
4. Policy Perspectives (III) Micro Level
5. Policy Perspectives:A comparison between Macro and Micro Level Policies
6. Impact of other National Policies on Health System
7. Devolution Plan: Past to Present (I)
8. Devolution Plan: Past to Present (II)
9. Health Sector Reforms: What and why?
10. Health Sector Reforms: Role of stakeholders and stakeholder analysis
11. Policy versus Planning
12. Role of International Commitments on Health Policies (MDGs,)
13. Research and Policy
14. National Policies and their implications and National Health Outcomes: Sustainability
Issues
15. National Policies and their implications and National Health Outcomes: Sustainability
Issues
16. Health Sector Performance as a determinant of National Health Policy
17. Evidence-based Policy Making
18. Advocacy
19. Policy and Politics
20. Leadership and Policy

Teaching Methodology:
Lectures, discussions, group work, simulations and role plays, individual assignments, and
presentations.

Recommended Readings:
1. Abel-Smith B. An introduction to health: policy, planning and financing. London:
Longman Group Ltd; 1994.
2. Bennett S, McPake B, Mills A. Private health providers in developing countries: serving
the public interest? London, UK: Zed Books; 1997.
3. Berman P (ed.). Health sector reform in developing countries: making health
development sustainable. Boston, MA: HarvardUniversity Press; 1995.

101
 MPH PROGRAMME

4. Danis M, Clancy C, Churchill LR. Ethical dimensions of health policy. New York,
NY:OxfordUniversity Press; 2002.
5. de Weil C, Alicbusan AP, Wilson JF, Reich MR and Bradley DJ. The impact of
development policies on health: areview of literature. Geneva: World Health
Organization; 1990.
6. Grindle MS (ed.). Getting good government: capacity building in the public sectors of
developing countries. Boston, MA: HarvardUniversity Press; 1997.
7. Harding A, PrekerAS. Private participation in health services. WashingtonDC: The
World Bank; 2003.
8. Hunter, DJ. Public health policy. Cambridge, MA: Polity Press; 2003.
9. Intersectoral linkages and health development:case studies in India (KeralaState),
Jamaica, Norway, Sri Lanka, and Thailand.WHO Offset Publ. 1984;(83): 4-53.
10. Lashari, T. Pakistan’s national health policy: quest for a vision. Islamabad, Pakistan:
Health Policy Unit, The Network for Consumer Protection; September 2004.
11. Ministry of Health, Government of Pakistan. National health policy: the way forward –
agenda for health sector reform. Islamabad, Pakistan: Ministry of Health, Government of
Pakistan; December 2001. Available from: URL:
http://lnweb18.worldbank.org/sar/sa.nsf/Attachments/Pak-NHP/$File/Pak-
NHP.pdf
12. Ministry of Health, Government of Pakistan. National health policy. Islamabad,
Pakistan: Ministry of Health, Government of Pakistan; 1997.
13. Nishtar, S. The gateway paper: health systems in Pakistan – a way forward.
IslamabadPakistan: Pakistan’s Healthy Policy Forum and Heartfile; 2006.
14. Steiner GA, Miner JR, Gray ER. Management policy and strategy. New York, NY:
Macmillan Education Ltd; 1986.
15. Townsend P, Whitehead M, Davidson N (eds.). Inequalities in health: the black report
and the health divide, 2nd ed. London: Penguin Group, 1992.
16. Lin V, Gibson B. Evidence-based health policy: problems and possibilities. Melbourne,
Australia: OxfordUniversity Press; 2003.
17. Walt G. Health policy: an introduction to process and power. London: Zed Books; 1994.
18. Williamson C. Whose standards? Consumer and professional standards in health care.
Buckingham: Open University Press; 1992.

102
 MPH PROGRAMME

19. World Bank. World development report 1993: investing in health. WashingtonDC:
OxfordUniversity Press; 1993.
20. World Health Organization. Alma-Ata 1978: Primary health care. Geneva: World Health
Organization; 1978. HFA Sr. No. 1.
21. World Health Organization. Macroeconomics and health: investing in health for
economic development. Geneva: World Health Organization; 2001.
22. World Health Organization. The Adelaide recommendations on healthy public policy.
Geneva: World Health Organization; 1988. Document no. WHO/HPR/HEP/95.2.
Available from: URL:
http://www.who.int/hpr/NPH/docs/adelaide_recommendations.pdf

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and class exercises
Summative Assessment (80%)
Summative assessment consist of: MCQs and Short essay questions

103
 MPH PROGRAMME

24: Community-based Reproductive Health Interventions

Course Title: Community-based Reproductive Health Interventions
Course Credit:3

Introduction:
This elective course is offered in the third session to integrate and build upon courses offered
in the MPH programme, particularly courses numbers: 11, 12 and 08 , employing qualitative
and quantitative research skills gained in courses numbers: 10, 06, 02, 03, and 13, as well as
planning concepts (09 and 17). This acquired knowledge and skills are applied to assessing
appropriate community-based interventions. Students spend the first part of the course
preparing the community-level assessment tools and the second part collecting the
information in the field. Assessments are conducted at volunteer tehsil health centres where
local health officials and community providers can guide the types of information needed.
Course participants analyze the collected data and prepare written and oral reports which are
shared with the local health unit. Appropriate community-based interventions are then
suggested from the needs assessment.

Learning Goal:
The goal of this course is to equip the participants with the skills, knowledge and principles
to design and manage effective community-based reproductive health programmes at the
national, provincial and district levels.

Learning Objectives:
By the end of the course, the participants will be able to:

1. Identify types of community-level interventions effective in improving individual and

family-level health outcomes
2. Describe elements of effective community-based reproductive health interventions
3. Design, conduct and present a needs assessment for community-level RH interventions,
working with information from the health facilities, providers and community leaders
garnered through qualitative and quantitative data collection
4. Critically evaluate the effectiveness of community-based interventions in producing
reproductive health at the household and individual levels

104
 MPH PROGRAMME

Contents:
The following are the contents of the course:

1. RH at the community, household and individual levels

2. Overview of effective community-level interventions for RH
3. Planning community needs assessment to cover:
 Significance of reproductive health needs in the community
 Background of community
 Specific aims
4. Selecting data collection methods, including
 Focus group discussions
 In-depth/key informant interviews
 Record review
 Facility assessment
 Client exit interview
 Community-level rapid assessment survey
5. Design of a community-based RH intervention to respond to identified needs
 Rationale for expected effectiveness
 Targeted beneficiaries
 Types of intervention activities
 Implementation plan and schedule, including budget
 Expected outcomes and measures
 Potential barriers to implementation
 Monitoring and evaluation plans

Teaching Methodology:
Students are provided with guidelines for conducting an RH needs assessment and taken
through skill-building exercises at needs assessment design, data collection protocols,
execution, data review, analysis and interpretation, and dissemination. Students develop
the final tools that they administer in a local community working with the government
health centre, collect, analyze and interpret the data, and report their findngs back to centre
health officials. Community-based interventions appropriate for development, based on the

105
 MPH PROGRAMME

needs assessment, are identified and discussed at the final presentation. A written report is
collectively prepared by course participants.

Recommended Readings:
1. Abel-Smith B. An introduction to health: policy, planning and financing. London:
Longman Group Ltd; 1994.
2. Afsar HA, Younus M, Gul A.Outcome of patient referral made by the lady health
workers in Karachi, Pakistan. J Pak. Med Ass 2005:55; 209-11.
3. Ali M, Hotta M, Kuroiwa C, Ushijima H. Emergency obstetric care in Pakistan:
potential for reduced maternal mortality through basic EmOC facilities, services and
access. International Journal of Gynecology and Obstetrics (in press).
4. Chhetry S, Clapham S, Basnett I. Community-based maternal and child health care in
Nepal: self-reported performance of maternal and child health workers. Journal of Nepal
Medical Association 1005:44; 1-7.
5. Clift E. IEC interventions for health: a 20 year retrospective on dichotomies and
directions. Journal of Health Communication 1998:3; 367-375.
6. Douthwaite M, Ward P. Increasing contraceptive use in rural Pakistan: an evaluation of
the Lady Health Worker Programme. Health Policy Plan. 2005:20; 117-23.
7. Jokhio AH, Winter HR, Cheng KK. An intervention involving traditional birth
attendants and perinatal and maternal mortality in Pakistan. New England Journal of
Medicine 2005:352; 2091-9.
8. Kironde S, Klaasen S. What motivates lay volunteers in high burden but resource-limited
tuberculosis control programmes? Perceptions from the Northern Cape province, South
Africa. The International Journal of Tuberculosis and Lung Disease 2002:6; 104-110.
9. Nsutebu EF, Walley JD, Mataka E, Simon CF. Scaling-up HIV/AIDS and TB home-based
care: lessons from Zambia. Health Policy Plan. 2001:16; 240-7.
10. Nyonator FK, Awoonor-Williams JK, Phillips JF, Jones TC, Miller RA. The Ghana
community-based health planning and services initiative for scaling up service delivery
innovation. Health Policy Plan. 2005:20; 25-34.
11. Stoebenau K, Valente TW. Using network analysis to understand community-based
programs: a case study from highland Madagascar. International Family Planning
Perspectives 2003:29; 167-73.

106
 MPH PROGRAMME

12. Sultan M, Cleland JG, Ali MM. Assessment of a new approach to family planning
services in rural Pakistan. American Journal of Public Health 2002:92; 1168-72.
13. Supratiko G, Wirth M, Achadi E, Cohen S, Ronsmans, C. A district-based audit of the
causes and consequences of maternal deaths in South Kalimantan, Indonesia. Bull
World HealthOrgan. 2002:80; 228-234.
14. Upvall MJ, Sochael S, Gonsalves A. Behind the mud walls: the role and practice of lady
health visitors in Pakistan. Health Care for Women International 2002:23; 432-41.
15. Weisman C, Grason H, Strobina D. Quality management in public and community
health: examples from Women’s Health. Quality Management in Health Care 2001:10;
54-64.

Students’ Evaluation:
Formative (20%)
Ongoing assessment through class participation and class and field assignments
(individual/group)
Summative Assessment (80%)
Summative assessment may consist of: MCQs and short essay questions

107
 MPH PROGRAMME

Annex 5: Dissertation Guidelines (Session III)

25: Dissertation
Course Title: Dissertation
Course Credit: 2+8

Introduction:
The exposure to community-based and health systems research is an essential element that
the current MPH programme supports to fulfill. This helps in the conceptualization of this
research experience and converting it into a scientific write-up to complete the requirements
for the third session of MPH programme.

The document serves to assist students in understanding the section of the topics for
research, write the proposal for approval by ’s Institutional Review Board (IRB) and the
funding agencies. Dissertation writing is required from each student of MPH to generate a
meaningful academic product that demonstrates the student’s application of crucial
knowledge and skills including:

 Aspects of relevant disciplines like epidemiology, biostatistics, qualitative research

methods etc.
 Conceptual framework for the working hypothesis or research question.
 Research objectives, hypotheses and research questions formulation in measurable
terms.
 Study design, study population and selection processes correctly according to the
objectives.
 Interpretation and analysis of data in support of a decision or conclusion.
 Correctly written bibliography.
 Oral and written communication and presentation of the product.
 Development of and adherence to a schedule/time frame.
 Formulation of a realistic budget and its defense.

Every student is required to show substantial work done under the supervision of the
academic advisor.

The following sections provide detailed guidelines for dissertation writing.

108
 MPH PROGRAMME

1. Dissertation:
The dissertation requires the generation of new applied knowledge through the
comprehensive application of the research process. The thesis option is a better choice for
students who desire to gain confidence in their ability to plan, conduct, and write a research
work and wish to gain confidence in their ability to critically apply existing knowledge and
methods to the solution of a problem in public health.

Given the inherent complexity of activities and time demands, 10 credit hours of research
are allocated for a dissertation.

The topic for research will be chosen in consultation with the academic advisor.

2. Overview:
By completing their dissertations MPH students are able to demonstrate their understanding
of core competencies through the successful application of core knowledge and principles,
critical thinking and analytic reasoning skills.

The student is advised to select a topic for research consistent with his/her professional
requirements while going through the course on Research Process Part I during the first and
second session. In the beginning of third session, the student will be guided to complete the
research tools and complete the proposal in light of the training during the classwork.

Students are advised to plan ahead for each step. The proposal formulated has to be
critically appraised by the Academic Council of the and simultaneously the Institutional
Research Board (IRB) within 3 weeks of the third session which is before the student is
allowed to start with the data collection. The committee can suggest changes which will be
communicated to the student at the time of critical appraisal.

The students will carry out data collection, data analysis, interpretation and presentation of
the results leading to conclusions from the study under the dissertation writing guidelines
during the third session (see below).

The Examiners (one internal and one external) for the viva voce examination will be
approved by the University’s Controller of Examinations. This process has to be started at

109
 MPH PROGRAMME

least 6 weeks before the exams are scheduled. The examiners should be provided the written
dissertation at least 15 days in advance of the scheduled defense.

It is the institutional responsibility to identify the examiners, coordinate a time that is

acceptable to all members; to arrange for any needed audio-visual support, and to ensure
that the examiners are notified of the location of the defense.

3. Proposal Format:
Proposal for the Dissertation: The proposal submitted for a dissertation should follow the
outline listed below. The outline corresponds to the major chapters expected in a thesis.
Deviations from the content in this outline should be discussed and approved by the advisor
(and committee in advance of submitting the proposal for the defense).

3.1 Introduction
(a) Establish importance of topic
(b) Conceptual model/relationship of independent and dependent variables
(c) Summary of what is/is not known
(d) What gap the study is filling
(e) Statement of research purpose(s)

3.2 Aims and Objectives/Hypotheses or research questions including operationaldefinitions

3.3 Material and Methods

(a) Study design

(b) Duration of study
(c) Study population
 Sampling methods
 Sample size/power
 Sample recruitment: Inclusion and Exclusion criteria
(d) Data Collection Procedure: Identify the recruitment of the population to the
collection of :
 Variables
 Measurements

110
 MPH PROGRAMME

i. instruments (include copies of relevant instruments (surveys, etc) as

appendices)
ii. standards
iii. reliability
iv. validity
(e) Data analysis plan (including software to be used and tables if applicable)

3.4Rationale of the study

3.5Human Subject Protection*

i. Informed Consent Procedures

ii. Confidentiality
iii. Risks
iv. Benefits
v. Permission to access data (if applicable)
*should also attach an approval by the IRB.

3.6References listing

Reference listing is to be done at the end of the proposal. (Thereferences should consist
of at least 6 references from not older than last 5 year; preferably from the published
articles and only occasionally from the books).

3.7Timeline

A timeline should be attached as an annexure.

3.8Proposed budget

A proposed budget should be given at the end of the proposal.

4. Outlines for the Dissertation:

Part I: Consisting of:

(a) Title page with the name of the student and the programme they are working under,
i.e. name and MPH with year.
(b) Declaration duly signed by the Advisors/Supervisors
111
 MPH PROGRAMME

(c) Acknowledgements
(d) Table of Contents
(e) List of Tables/Figures with page numbers
(f) List of Abbreviations used

All pages are to be given Roman numerals before the summary.

Summary
A structured summary should be the first part of the dissertation write up. Introduction,
Objectives, material and methods: Study design, duration, sample population including
sampling techniques, sample size and sample selection and statistical analysis. Brief
results and conclusions. Key words: 3-5 words best describing the study.

Part II

4.1 Introduction
It shall cover:
(a) Establish importance of topic
(b) Conceptual model/relationship of independent and dependent variables
(c) Summary of what is/is not known
(d) What gap the study is filling
(e) Statement of research purpose(s)

4.2Literature Review
It shall cover:
(a) General overview
(b) Theoretical models/conceptual frameworks
(c) Relationships among variables
(d) Other relevant literature

4.3a. Aims and

4.3b. Objectives (or research questions)

4.4Material and Methods

(a) Study design
(b) Duration of study

112
 MPH PROGRAMME

(c) Conceptual models/conceptual frameworks

(d) Study population
i. Sampling techniques
ii. Sample size/power
iii. Sample recruitment: Inclusion and Exclusion criteria

4.5 Data Collection Procedure*

Identify the recruitment of the population to the collection of:
i. Variables: how measured
ii. Measurements: how performed?
iii. instruments*: questionnaires etc.
iv. reliability
v. validity
*include copies of relevant instruments (surveys, etc) as appendices.

4.6 Data analysis plan

How was the data analyzed? Procedures for statistical application and statistical
software/s used should be outlined in sufficient details

4.7 Ethical Considerations

Consent form must be attached as an Annexure. Ethical clearance should be attached
from the IRB. Informed Consent Procedures: Consent Form.

4.8 Results
This chapter includes presentation of results as tables, figures etc. based on the statistical
applications and not as computer outputs. The results should be described in adequate
details indicating the major findings. The results should be in line with the objectives of
the study. The results should be on separate pages; one table/figure on one page. Same
tables cannot be replicated as figures.

4.9Discussion
In this chapter a detailed discussion of the results and comparisons with other study
reaching to a conclusion in accordance will be made.

4.10Conclusions
The conclusions should be in line with the objectives and the results.

113
 MPH PROGRAMME

4.11References
The reference list consists of published articles not older than 5 years unless required for
the work. References from books are not the preferred method. The number of references
should not be less than 30. Vancouver style is the recommended method of referencing.

The pages should be numbered from (Introduction to references) in Arabic numerals.

5. Defense Process:
The defense begins with administrative/introductory remarks by the Chair who will review
the process and procedures for the defense, including any ground rules set forth for the
specific defense with the internal and external examiners. The student will then make a
prepared 10-15 minute (proposal) or 20-25 minute (dissertation) presentation which
summarizes the proposal/dissertation.

The Chair will announce in advance whether questions may be asked during the
presentation or held to the end. Normally, clarifying questions will be permitted during the
presentation with probing/analytic questions following the presentation.

Following the formal presentation and clarifying questions, questioning/critiquing by the

Examiners then begins. For the proposal defense, emphasis is on the suitability of the
proposed research/project and the design/methods/analytic plan/approach. For the final
defense, emphasis is on the results, lessons learned, and implications.

In both cases, questions related to application of core competencies may be asked, even if
they are per or in relation to the proposal/dissertation under review. The session concludes
when the examiners have finished questioning or the allotted time has elapsed. Fifteen
minutes at the end of the session are reserved for the Examiners’ deliberations and finalizing
of their results. The student may be excused from the room while the Examiners deliberate.
The students will be informed of the formal results after approved by the University,
Controller of Examinations.

6. Presentation Evaluation:
Effective presentation and oral communication skills are core competencies expected of
MPH graduates. Consequently, separate from the content assessment of the
proposal/dissertation, the Examiners will evaluate the student’s presentation skills. During

114
 MPH PROGRAMME

the proposal defense, the assessment will be used to advise the student of perceived
strengths and weaknesses and recommended actions to ensure a strong presentation during
the final defense (diagnostic). For the dissertation defense, the examiners will formally
assess the student’s presentation/oral communication skills (evaluative). Successful mastery
of the communication skills is a requisite for passing the defense.

7. Outcomes:
There are 3 possible outcomes for a defense (be it proposal, thesis, or project): unconditional
pass, and conditional pass, and fail.

 Unconditional Pass is associated with consensus scores of 3 or more in all areas. It may,
however, include requests for minor revisions which are reviewed and accepted by the
advisor on behalf of the Committee.
 Conditional Pass (Result Later On) is associated with a score of 2 or less in one or more
areas where the shortcomings may range from being technical in nature, easily corrected,
and/or for which the student demonstrates understanding during the defense to more
substantive issues ranging from general weakness to a critical weakness in a specific
area. The student works with the advisor to correct the deficiencies identified by the
examiners. The revisions will be accepted by the examiners and notified to the
University.
 Fail is associated with poor performance and evidence of gaps in knowledge and critical
reasoning skills during the defense. The deficiencies are such that the Examiners wish to
see a re-defense of the revised dissertation/proposal. (Students are permitted only one
re-defense of the Dissertation. Students work with their advisor and committee to correct
any deficiencies in the proposal/manuscript and other areas as needed prior to
scheduling a re-defense. The date of re-defense will be notified in one month’s time to
the student.

Proposal Critique and Evaluation Guidelines

The Proposal manuscript (synopsis) is evaluated to ensure it adequately demonstrates core
competencies and the correct application of a specific set of competencies to the research of a
public health problem.

115
 MPH PROGRAMME

1. Demonstration of Core Competencies: Evaluation Guidelines

The primary educational objective of the dissertation is to demonstrate appropriate
consideration and application of core concepts, skills, and knowledge in analyzing a public
health problem within any of the proscribed frameworks. The core area competencies must
be addressed in each project.

These competency areas cut across the domains identified for each specific framework. For
example, quantitative competence may be demonstrated in the literature review and/or
methodology section and/or results and/or discussion section of a publication framework.
All papers are required to demonstrate minimum competence, but are held accountable to a
level of competence consistent with the problem and framework as defined by the student.
An example of this is when a student refers to an advanced statistical analysis in his/her
design. Although the statistical test may exceed the competence expected of a graduate, by
virtue of having introduced it, that student is accountable to correctly describe and apply it.

1. History: Appropriate and sufficiently thorough consideration of relevant historical

information surrounding the problem ranging from trend information to assessments of
previous efforts and related research

2. Quantitative Sciences (assessment/analysis):Appropriate and sufficiently thorough

consideration of epidemiology, demography, vital statistics, and biostatistics (analytical
planning, sample size, etc.)

3. Biological considerations (determinants): Appropriate and sufficiently thorough

consideration of biologic concepts (genetics, physiology, immune response, life cycles,
processes such as aging, growth, and development, and physiologic measurements)

4. Social/cultural/behavioral considerations (determinants): Appropriate and sufficiently

thorough consideration of socio-cultural and behavioral factors which directly or
indirectly impact on the problem under consideration

5. Environmental and/or occupational considerations (determinants/

impacts):Appropriate and sufficiently thorough consideration of the role and interaction
of the physical environment – which can include both the physical and natural
environment.
116
 MPH PROGRAMME

6. Management and/or policy and/or resource utilization considerations: Appropriate

and sufficiently thorough consideration of management precepts ranging from the
domains of administration to leadership to financial planning (budgeting) to policy
setting to implementation and planning (logistics).

2. Dissertation Competency: Evaluation Guidelines

The following are some guidelines for evaluating dissertations.

1. Importance of the problem to public health

 has the magnitude of the problem been characterized?
 is a case made for its importance?
2. Organization/ Presentation
 easy to read/understand
 quality of tables and figures
 logical progression of ideas
 conformity with guidelines of target publication/standard format
3. Abstract appropriately structured and an adequate reflection of paper’s content
4. Introduction places the current study in the context of current knowledge
 quality/thoroughness of literature review
 demonstrates where this project fits in
5. Design appropriate to answer the question
 consideration given to options
 rationale given for choosing design
 strengths and limitations inherent in design discussed (validity)
 strengths and weaknesses of measurements (reliability)
6. Population appropriate to answer the research question
 considerations/advantages/disadvantages of choice
7. Analysis appropriate to answer the question
 methods described; limitations noted
 plan sufficient to address research question
 level of data collection/coding sufficient
 confounding/interaction/bias/design limitations accounted for
 issues of power sample size addressed
117
 MPH PROGRAMME

8. Plausibility of results appropriately addressed

9. Public health implications appropriately addressed
10. References complete and adequately reflecting current literature on the topic; peer-
reviewed sources provide adequate support for assumptions or background
information.
11. Overall scientific merit
 is the study design appropriate to the stated objectives?
 is the appropriate level of data used?
 has an appropriate literature review been included?
 does the project increase our understanding or to replicate
inconclusive/controversial findings?

Dissertation Critique and Evaluation Guidelines

1. Executive Summary
Briefly summarizes problem, magnitude, key determinants, recommended course of action

2. Statement of Problem
 Was the problem clearly identified and defined?
 Is it an appropriate/relevant public health problem?
 Is the group/organization/agency selected to hear the argument appropriate?

3. Magnitude of the problem

 Is the magnitude of the problem clearly identified?
 Are the strengths and limitations of the measures/estimates discussed?
 Does the paper make a compelling case that the problem is significant enough to warrant
attention?

4. Key Determinants
Are the appropriate biological, behavioral, and environmental determinants of the problem
addressed?

5. Prevention/Intervention Strategies
 Are current efforts summarized?
 Are a sufficient breadth of options/strategies considered?
 Do the options follow from the key determinants discussed?
118
 MPH PROGRAMME

6. Policy & Priority Setting

 Are the relative advantages and disadvantages of each option/strategy considered?
 Are the benefits/risks compared at individual, community, and societal levels?
 Are political, economic, and technical feasibility considered?

7. Recommendations
Are the recommendations consistent with the analysis of the problem?

8. Implementation and Practice

 Are the likely barriers to implementation addressed?
 Are logistical/technical/resource concerns addressed?

9. Evaluation
 Is the impact of the proposed intervention measurable?
 Is ‘success’ defined?
 Are provisions made for evaluating the impact of the recommended course of action?

10. Overall Impression

Is a compelling argument made that would convince you to adopt the recommended
strategy? Is the argument presented succinctly and effectively?

119
 MPH PROGRAMME

ORAL PRESENTATION CRITIQUE SCORE SHEET

Student Name: Date:

Grade (4=exceptional; 3=fully met; 2=partially met; 1=not met/missing):

Area Grade
1. Content
 Was the target audience identified?
 Was the appropriate content presented?
 Was the issue clearly identified and defined?
 Was the presentation appropriate to the target audience?
 Was sufficient supporting detail provided?
 Were the recommendations/assertions supported
2. Organization
 Was the content organized and presented in a coherent manner?
 Were new or unfamiliar terms explained?
 Did the presentation of ideas flow smoothly?
3. Style
 Did the speaker(s) hold your interest?
 Was the speaker convincing/effective?
 Was the speakers’ voice loud enough? understandable?
 Did the speaker make eye contact with the audience?
4. Audio-visuals
 Were visuals (graphics, transparencies/slides) used effectively?
 Was the quality of the slides appropriate (readable, not cluttered)?
 Was an appropriate number of visual aids used?
 Were visuals clearly explained?
 Did the visuals add to the presentation?
5. Time Utilization
 Was time appropriately allocated to parts of the presentation?
 Were the time constraints followed?
 Did it appear that the presentation had been rehearsed?
6. Questioning

120
 MPH PROGRAMME

 Were questions addressed with confidence and knowledge?

 Did the speaker interact with the audience?

7. Overall Impression
 Was the target audience identified?
 Was the appropriate content presented?
 Was the issue clearly identified and defined?
 Was the presentation appropriate to the target audience?
 Was sufficient supporting detail provided?
 Were the recommendations/assertions supported?

Result: Unconditional Pass Conditional Pass

Comments/specific instructions:

Signature of evaluator:

121
Annex 6: Practicum for Session IV
26: Practicum (On-the-job Assignment)
Course Title: Practicum (On-the-job Assignment)
Course Credit:2

Introduction:
Public health focuses on monitoring, achieving and improving the health of a
population and is practiced in a variety of settings. The public health professional
applies knowledge and skill from the core content areas of public health
(biostatistics, epidemiology, environmental health, health services management, and
social and behavioural sciences) to design, manage and evaluate solutions to public
health problems. Using the practicum (on-the-job assignment) as the “organizational
laboratory,” the Master of Public Health (MPH) student begins to develop the
necessary skill sets for becoming a successful public health professional. The
practicum is intended to develop direct understanding and experience in public
health or health promotion organizations, thereby exposing the student to
organizational cultures, management systems, operations and resources, programs
and services and target populations. Such knowledge, skills, abilities, and
experiences will continue to develop and grow as each student graduates and
becomes a life-long learner and practitioner of public health.

Learning Goal:
The goal of the practicum is to provide a structured and supervised opportunity for
the student to apply the theories, principles, knowledge and skills of public health
and health promotion, as learned in the classroom, in a practice setting. The practice
experience occurs in a carefully-selected health services organization approved by
the MPH Program Coordinator and is supervised by faculty and an immediate
supervisor/mentor. This takes into account the transition from education to
professional practice.

Learning Objectives:
The objectives of the practicum (on-the-job assignment)are to:

 Provide a practice setting for the student’s application and integration of the core
public health knowledge.

122
 MPH PROGRAMME

 Prepare the student with inter-disciplinary skills and competencies, including

leadership, communication, professionalism, cultural proficiency, program
planning and assessment and systems thinking.

Upon successful completion of this course, each student will be able to:

Leadership
 Create and communicate mutually-established project goals and objectives.

Communication
 Demonstrate the ability to give, solicit, and receive oral and written information.
 Prepare relevant, integrated, and comprehensive written project report(s).
 Use various communication methods and media to complete project activities.

Professionalism and Cultural Proficiency

 Demonstrate the ability to manage time and prioritize workload.
 Display professionalism, sensitivity, and tact in an organizational/community
setting.
 Interact productively with supervisors, colleagues, and community stakeholders.

Program Planning and Assessment

 Plan, manage, and monitor a project plan in order to meet established goals and
deadlines.
 Prepare a written proposal for project approval from internal and external
sources.
 Identify, collect, and analyze data for a practical public health issue or concern.

Systems Thinking
 Assess the roles and responsibilities within a public health organization.
 Describe the interactions and inter-dependencies among various public health
organizations.
 Demonstrate and integrate knowledge of core public health concepts into a
practice setting.
 Evaluate methods of instruction and learning.

123
 MPH PROGRAMME

Prerequisites and Requirements:

 Students must have completed all the course work and defended the dissertation
before registering for the practicum.
 In consultation with the practice site or organization, the student must develop a
short, formal proposal of the work or project to be accomplished by the student
during the assignment.
 The student will complete 160 hours of public health practicum experience with
the selected organization.
 The student will write a well-constructed report (10 – 15 pages, excluding
appendices) detailing their experience, referencing and integrating core public
health knowledge.
 The student will be evaluated by an immediate supervisor/mentor of the
participating organization.

Role of Immediate Supervisor/Mentor

 The immediate Supervisor/Mentor is responsible for the student’s learning
during the practicum.
 The immediate Supervisor/Mentor serves as a role model for the student and
advises the student routinely.
 The immediate Supervisor/Mentor periodically consults with responsible faculty
on the student’s progress.
 The immediate Supervisor/Mentor completes a student evaluation form at the
end of the practicum.

Role of MPH Program Coordinator

The MPH Program Coordinator serves as the liaison between the student, the
immediate supervisor/Mentor, and the University. He/she assists in the selection of
participating organizations and maintains communication with the student and
immediate Supervisor/Mentor throughout the practicum. The MPH Program
Coordinator determines the completeness of assignments and assigns the course
grade.

124
 MPH PROGRAMME

Course Evaluation
The course is graded on a Pass/Fail basis; the final grade will be determined by the
MPH Program Coordinator and will be based on each student’s performance on the
following criteria:

Evaluation Criteria Relative Weight

Immediate supervisor/Mentor/ 40%
Mentor Evaluation
Student Executive Summary and 60%
Internship Report

To demonstrate application of public health knowledge and skills, summarize

accomplishment of established goals, and assure accountability during the field
experience, each student intern is required to prepare and submit a report based on
the following format.

PRACTICUM (ON-THE-JOB ASSIGNMENT) REPORT

TITLE PAGE
EXECUTIVE SUMMARY
Concisely describes the practicum and the salient results and conclusions.

TABLE OF CONTENTS

1.0 INTRODUCTION
1.1 Problem or Issue (Statement of the public health problem(s) or issue(s))
1.2 Objectives (Learning/outcome Objectives)
1.3 Literature review/background (Review of the relevant literature (if any),
organizational context)

2.0 METHODS
2.1 Setting (Description of the site at which you did the practicum)
2.2 Oversight (The role(s) of your immediate Supervisor/Mentor(s))
2.3 Methods (methods used to achieve each project objective in 1.2)
125
 MPH PROGRAMME

2.4 Timeline (outline of key project activities/dates)

3.0 RESULTS

4.0 DISCUSSION AND CONCLUSIONS

(Feel free to add any other relevant items or issues in any section of your report.)

126
 MPH PROGRAMME

IMMEDIATE SUPERVISOR/MENTOR EVALUATION OF STUDENT

MASTER IN PUBLIC HEALTH PROGRAMME
PRACTICUM (ON-THE-JOB ASSIGNMENT) EVALUATION BY IMMEDIATE
SUPERVISOR/MENTOR

Thank you for your sponsorship of this student. Please complete this evaluation
form. The information will be useful in preparing this student for future work and
help us enhance the MPH Program.

STUDENT’S
NAME:

IMMEDIATE
SUPERVISOR’S/
MENTOR’S NAME:
TITLE:
DATE:
ORGANIZATION:

Using the rating scale below, please circle the student’s level of performance
during the practicum on the criteria listed below:
1 = Exceeded expected performance level
2 = Met expected performance level
3 = Failed to meet the expected performance level
NA = Not applicable

CRITERIA RATING
Student met agreed-upon time commitment.
1 2 3 NA

Student was dependable and responsible in

1 2 3 NA
carrying out assignments and duties.

Student functioned well within the organization.

1 2 3 NA

Student functioned well with community

stakeholders 1 2 3 NA
and/or clients.

127
 MPH PROGRAMME

Student was able to identify sources of data and

1 2 3 NA
information required for the practicum.

Student was able to analyze and/or synthesize

data 1 2 3 NA
and information.

Student completed the necessary background

1 2 3 NA
research.

Student completed assignments/projects in the

1 2 3 NA
agreed-upon time frame.

CRITERIA RATING
Student’s written work was completed and well
1 2 3 NA
prepared.

Student had the necessary knowledge and skills

1 2 3 NA
for this practicum.

Student conducted him/herself in a professional

1 2 3 NA
manner.

Student worked well with others. 1 2 3 NA

COMMENTS
Please provide comments on the following items.

1. Any of the previous criteria on which the student was rated as 3 (Failed to meet
expected performance level):

2. Your overall impression of the student’s work on this practicum.

128
 MPH PROGRAMME

3. Any areas where the student’s academic preparation for assigned work could
be improved.

4. How useful the practicum was for your organization.

5. Would you be willing to sponsor another student of the ’s MPH Program?

IMMEDIATE SUPERVISOR’S/MENTOR’S SIGNATURE:

DATE:

129
Annex 7: Core Competency Model

Epidemiology

Interdisciplinary and cross cutting

Biostatistics competencies Health
Systems
Analytical/Assessment Skills

Systems Thinking

Leadership Skills

Financial Planning/Managerial Skills

Social & Policy development/Program planning Environmental

Behavioral Skills &
Sciences Occupational
Communication and Advocacy Skills
Communication and Advocacy skills
Cultural competency Skills

Community Dimensions of Practice skills

Reproductive & Disease

Child Health Control

132
Annex 8: Admission Criteria and Procedures
Introduction
The institutions must abide strict merit-based criteria with absolute
transparency to select its students for the MPH programme. Every year, the
number of Pakistani and foreign students may be increased to more than 30
depending on the requirement.

Eligibility Criteria

 Basic Qualifications
The candidate should possess one of the following qualifications or an
equivalent degree from a recognized university or accrediting body.

(a) MBBS (Bachelor of Medicine & Bachelor of Surgery)

(b) BDS (Bachelor of Dental Surgery)
(c) M Pharmacy (Master’s in Pharmacy)
(d) BSc Nursing (Bachelor of Sciences in Nursing)
(e) DVM (Doctor of Veterinary Medicine)
(f) Master’s Degree in a relevant subject such as Anthropology, Business
Administration, Economics, Human Nutrition, Microbiology,
Physiology, Psychology, Public Health Engineering, Sociology,
Statistics/Biostatistics and Zoology.

 Experience
The candidate should minimally have three years of full-time work
experience (in the case of medical doctors, after the house job) in public
health-related fields in either the private sector or the public sector,
including the armed forces, such as:

(a) Primary health care settings (public, private or semi-private);

(b) Recognized training and research institutions, such as departments of
community medicine/school of nursing/public;
(c) Public health related vertical programmes/planning/management
and policy positions at the federal and provincial level.

133
 MPH PROGRAMME

 Age Limit
Candidates should preferably be not over 45 years of age at the time of
the beginning of the course although there will be no age limit. In case of
a tie in the process of fulfillment of selection criteria, preference shall be
given to those of younger age.

 Quotas
All Pakistani students shall be selected on the basis of merit, out of which:

o a minimum of 35% of seats are reserved for women;

o a minimum of 10% of the seats are reserved for non-physicians;
o a minimum of 20% of the seats are reserved for candidates from
other provinces, disabilities and foreigners.

In addition to Pakistani students, a limited number of seats is available for

foreign students. Applicants with disabilities will be given due
consideration within the prescribed merit-based system.

 English Language Requirements

Applicants should have an appropriate level of English language
proficiency. Foreign applicants from non-English speaking countries who
submit results for English proficiency tests such as TOEFL or IELTS will
be given preference. A minimum TOEFL score of 450 on the paper-based
test or 200 on the computer-based test is recommended; a minimum
IELTS score of 6 is recommended.

 Computer Skills Requirements

Additionally, given that most assignments will be computer-based, all
applicants are required to have basic computer skills, including word
processing, spreadsheet processing and using basic Internet services such
as the world wide web and e-mail. Following admission to the MPH
programme but before the start of the course on computer applications in
public health, applicants without the required computer skills will not be
allowed to attend this course without either taking anon-credit course in

134
 MPH PROGRAMME

basic computer skills offered at the institution, or a similar course offered

at a reputed training institute.

Application Procedures
Applications must be made on the prescribed original application form
available in the prospectus of the institution. The prospectus may be obtained
after payment in the following ways:

 directly from the office;

 by sending a written request and postal order in favour of the institution
for delivery by mail. The envelope, containing the request and postal
order should be sealed and marked ‘MPH Prospectus’.

 A non-refundable entrance examination fee will have to be paid as well.

Completed applications should enclose the following:

 Domicile certificate  Attested photocopy of

 Final degree/s, certificate National identity card
/s, along with transcripts  4 passport-sized photographs
 Attested photocopies of  Professional resume (one page)
any language proficiency  Attested photocopies of
tests taken such as TOEFL experience certificate(s)
(foreign students only)  Two-stamped envelopes

Completed applications must reach the Office of the institution on the

address given by the closing date. Incomplete applications and applications
received after the closing date will not be entertained.

The final decision regarding appropriateness of a candidate’s public health

experience rests with the MPH Admissions Committee, .

135
 MPH PROGRAMME

Admissions Procedures
MPH Admissions Committee
Each training institution would have has its own MPH Admissions
Committee, constituted by the Principal. The MPH Admissions Committee
has the responsibility for the selection of applicants to be admitted to the
MPH Programme. It establishes procedures for the timely review of
applications to the Programme. Deferrals of admission are at the discretion of
the MPH Admissions Committee.

Final Selection
The applicant’s acceptance is contingent upon the receipt of all required
documents including official transcripts. The MPH Admissions Committee is
responsible for identifying those students with missing documents and/or
credentials which do not meet eligibility standards.

Candidates fulfilling the eligibility criteria will take a written screening exam.
Based on the performance in the screening test, the candidates will be short-
listed for an interview.

The final selection shall be done on the basis of the following distribution of
marks:

Criteria Maximum
Weightage%
Previous academic record score* 10

Previous public health experience score, scored as 10

follows out of the total

Screening examination score 50

Interview score 30
Total score 100

* The marks obtained in the final examination of the qualifying degree as mentioned
in the eligibility criteria.

136
 MPH PROGRAMME

The final decision regarding the selection of the candidates rests with the
MPH Admissions Committee.

137