Public Health Technician
Public Health Technician
Public Health Technician
Curriculum
for the
Diploma in
Public Health Technology
(New Scheme)
First Edition 2013
0
Curriculum Public Health Technician
Table of Contents
Page
Preface 2
General Outline 3
Section 1 (Paper I) 7
Unit 1: Control of Communicable Diseases 8
Unit 2: Elementary Entomology and Parasitology 9
Unit 3: Immunity and Vaccination 10
Unit 4: Vector Born Diseases 11
Unit 5: Public Health Administration 13
Unit 6I: Vital Statistics 14
Section 3
Practical Training Component 26
Recommended Reading for Teachers 30
Acknowledgments 31
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Curriculum Public Health Technician
Preface
After introduction of the new service structure for Allied Health Professionals (AHPs) in 2012, the
qualification requirement for entry in service has been changed to a diploma of two years’ duration.
This decision has necessitated the development of curricula for the new scheme of studies. The
evolving health needs of the community, exponential advances in medical and allied technologies
and changes in health services provision, functions and structure also demand continual and
responsive changes in education and training programs meant for AHPs. The revised curricula would
carry out the following important functions:
link pre-service education and training with actual tasks AHPs have to perform after being
employed, especially in the public sector
modernize training program by weeding out subjects that have become obsolete and
including subjects that are currently considered essential
provide clarity on subjects and topics to be taught delimiting the breadth and depth of
teaching
give clarity to examiners on what is to be tested and how
stimulate critical faculties of both teachers and students to conceptualize topics rather
than memorizing them.
Focus of the new curricula would be on integration of tasks and multi-skilling of students. Thus there
would be a common knowledge base for all courses in the form of a Core Course which would
provide insight into essential technical knowledge besides providing base for development of the
education for Allied Health Sciences up to post graduate level. The goal of this document has been to
outline a common body of knowledge that is essential for entry-level public health technicians.
The new curriculum for Public Health Technology replaces and augments the previous curriculum for
Sanitary Inspectors. This needs based curriculum places practical skills development at high priority.
The successful students will have a broader horizon, have multiple skills and will be competent to
perform duties of existing cadres of Sanitary Inspectors, Vaccinators and Communicable Diseases
Supervisors. This training program will cater to needs of the following cadres depicted in the new
service rules for allied health professionals (2012): Public Health, PHC, Healthcare Outreach, and
Nutrition.
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Curriculum Public Health Technician
General Outline
Aim of this curriculum is to equip students with the relevant professional knowledge, skills and
techniques to enable them to apply their acquired expertise for efficient health service delivery. At the
end of training the student should be able exhibit the following general and specific competencies:
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Curriculum Public Health Technician
4
Curriculum Public Health Technician
Total 2000
Subject Marks
First Year
Viva 100
Second Year
Section I 100
Section II 100
Total: 600
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Curriculum Public Health Technician
The different units presented in the subsequent sections would comprise of the following
components, not essentially in the sequence depicted below:
a. Learning Focus (contents, hours, weightage for assessment)
b. Rationale
c. Scope
d. Learning Objectives (aims and learning outcomes)
e. Practical Learning Component (where applicable)
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Curriculum Public Health Technician
SECTION 1
(Paper I)
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Curriculum Public Health Technician
Unit 1
Control of Communicable Diseases
1. Learning Focus
2. Rationale
The overall understanding of mechanism of spread of infectious diseases would help PHTs to
better perform their primary task i.e. prevention and control of diseases. The goal of this unit,
therefore, is to impart an appreciation of the broader concepts of sources of infections and
identification of specific communicable diseases in order to participate in prevention and control
programs.
3. Scope
This unit would focus on imparting concepts of causation, spread and manifestation of diseases
of communicable nature. Only broad areas would be covered and treatment component would
not be included. The diseases briefly covered would include: diarrhea and dysenteries, enteric
group of fever, trachoma, influenza, T.B., diphtheria, infective hepatitis, scabies, mumps,
measles, chicken pox, poliomyelitis, anthrax, tetanus, yellow fever, brucellosis, rabies, whooping
cough, leprosy, AIDS, malaria, cholera and plague.
4. Learning Objectives
After completing unit 1 the students will be able to:
i. define Incubation and infective periods; carrier states
ii. appreciate the spread mechanisms of communicable diseases
iii. categorize common diseases of infectious nature
iv. list out notifiable diseases
v. describe the steps for controlling infections: notification; early detection and prompt
treatment; isolation; disinfection; investigation of attack of illness
vi. describe management of biting animals
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Curriculum Public Health Technician
Unit 2
1. Learning Focus
2. Rationale
Public health is a comprehensive subject and deals in particular with the mode of transmission of
communicable diseases which may be protozoal or helminthic in origin. Similarly insects act as
vectors of bacteria, viruses, ricketsial and parasitic infections. A brief resume of subject is,
therefore, included to assist the students in appreciating the mode of transmission and the
prophylactic measures for the prevention of parasitic infections of individuals and communities.
3. Scope
Students will be apprised about the relationships between parasites, intermediate host and
definite host. They will also understand the life histories of important parasites, helminthes and
vectors. The parasites would include: Entamoeba histolytica and Plasmodium. The helminthes
would include different intestinal worms, whereas insects would include mosquitoes transmitting
malaria and dengue fevers.
4. Learning Objectives
After completing unit students will be able to:
i. list out the important parasites, worms and insects of medical importance
ii. understand the life cycles of important parasites, worms and insects
iii. appreciate the mechanisms of interactions between parasites, worms and insects with
humans.
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Curriculum Public Health Technician
Unit 3
Immunity and Vaccination
1. Learning Focus
2. Rationale
Vaccination has become the foremost activity for prevention of communicable diseases and the
PHTs need to have a thorough understanding of the processes involved. The goal of this unit is to
impart an understanding of the concept of immunity and make students proficient in the
techniques of vaccination
3. Scope
This unit will prepare the PHTs to efficiently take up vaccination activities. The understanding of
antigen and antibody interaction will form the basis for understanding the importance of
immunization as an important public health activity. More emphasis would be on skill
development and a substantial portion of this unit would be assigned for field activities.
Importance of integrating immunization activities with provision of all other services would be
highlighted.
4. Learning Objectives
After completing this unit students will be able to:
i. understand the concept of immunity and its significance in prevention of diseases
ii. list out the vaccine preventable diseases
iii. appreciate the importance of maintenance of cold chain and significance of safe
injection practices
iv. develop skills to administer vaccines proficiently
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Curriculum Public Health Technician
Unit 4
Vector Born Diseases
1. Learning Focus
2. Rationale
Even with advancements in Public Health, old vector born diseases (VBDs) like malaria are not
only resurgent but have also developed drug resistance. New diseases like dengue fever are
becoming endemic and pose serious threats every year. The goal of this unit is to make students
understand interactions of parasite, vector and host and make them skillful in prevention and
control activities.
3. Scope
This unit will prepare the PHTs to efficiently take up prevention and control activities for VBDs.
For undertaking such activities an understanding of life cycles of both parasites and vectors will
be essential. Specific larvicidal and mosquito control techniques will be taught with special focus
on skill development for spraying activities.
4. Learning Objectives
After completing unit students will be able to:
i. understand the life cycles of important parasites and vectors
ii. skillfully undertake different vector control activities including:
a. mechanical, biological and chemical interventions
b. planning and execution of spraying operations including important precautions
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Curriculum Public Health Technician
Unit 5
Public Health Administration
1. Learning Focus
2. Rationale
Serving the communities and promotion of their health is the foremost responsibility of PHTs.
They need to understand the principles of public health and community medicine in order to
practice them. The goal of this unit, therefore, is to lay down the foundations for practicing
public health according to the specified job description.
3. Scope
This unit will build upon the knowledge gained in core course regarding health and primary
health care. Common definitions and basics of community medicine will be taught; however,
details of management and supervision will not be covered.
4. Learning Objectives
After completing this unit the students will be able to:
i. define public health and community medicine
ii. appreciate the general principles of public health
iii. practice the routines for prevention and control of diseases as part of health team
members
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Curriculum Public Health Technician
Unit 6
Vital Statistics
1. Learning Focus
2. Rationale
Collection and analysis of data is important for meaningfully undertaking any disease control
activity. PHTs, as frontline health team members, will have an important role in this regard. The
goal of this unit is to give a broad understanding of means of data collection, converting data into
significant information and analyzing this information for formulating disease control strategies.
3. Scope
Learning and understanding will focus on means of data collection, its presentation and
submission. The scope of teaching will be less than graduate and post-graduate students.
4. Learning Objectives
After completing this unit students will be able to:
i. understand the various tools and methods of data collection i.e. census, keeping of birth and
death register in village and towns and other elementary statistical methods.
ii. perform basic statistical techniques including calculation of rates and means
iii. prepare and submit periodical reports and returns
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Curriculum Public Health Technician
SECTION 2
(Paper II)
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Curriculum Public Health Technician
Unit 1
1. Learning Focus
2. Rationale
One important duty of PHTs would be to ensure regulation regarding food quality control.
However, for this purpose a basic understanding of constituents of food, their nutritional
significance and the consequences of poor food quality must be understood.
3. Scope
Students will learn about the ingredients of food and importance of balanced diet. They will also
be apprised about consequences of poor food intake. This unit will lay foundations for the
learning of the next one on ‘Food Adulteration’.
4. Learning Objectives
After completing the unit students will be able to:
i. Realize the importance of different constituents of food and a balanced diet
ii. Appreciate the relative values of various food stuffs e.g., cereals, pulses, vegetables,
fruits, nuts, milk products, beverages, etc.
iii. Understand the ways diseases are caused by substandard food
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Curriculum Public Health Technician
Unit 2
Food Adulteration
1. Learning focus
2. Rationale
A society without execution of vital civic responsibility of adequate food quality is considered
incomplete. Ensuring quality of food quality is one of the fundamental duties of a PHT. This
function is of utmost importance for prevention of food born diseases.
3. Scope
Students will learn about basics of regulatory framework for food quality control including the
concerned laws and statutory bodies established for the purpose. Emphasis will be on
developing demonstrable skills in carrying out this important task, including .
4. Learning Objectives
After completing unit 4 students will be able to:
i. Understand and implement food hygiene and food standards
ii. Undertake inspections of eating places, slaughterhouse, food sellers
iii. List out food born diseases
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Curriculum Public Health Technician
Unit 3
General Hygiene
1. Learning Focus
Hygiene and its importance 6 hours
Good personal hygiene and disease implications of poor personal hygiene 6 hours
Cleanliness of the place of living 8 hours
Class Room Teaching 20 hours
2. Rationale
One of the main roles of PHTs is to promote hygiene i.e. practices which are associated with
ensuring good health, disease prevention and cleanliness. They also educate people about
hygiene with a view to forming habits which will lead to a healthy mode of living. They routinely
visit places where food, in one form or another, is handled such as restaurants, hotels, bakeries,
slaughter houses etc and where they inspect workers’ personal hygiene.
Clear concepts of hygiene will form the basis of PHT training. If their foundation of learning is
weak it cannot be expected from them to do justice to their day to day job duties. This could
have a far reaching hazardous impact on the health of individuals, families, communities, health
facility staff and PHTs themselves. This unit addresses basic concepts of general hygiene which
play a major role in promoting health and disease prevention. The goal of this unit is for the PHT
to become proficient in general hygiene-related issues.
3. Scope
Learning will focus on developing a basic understanding of the concept of hygiene. Stress will be
placed on ensuring that Public Health Technicians not only practice good hygiene themselves but
can demonstrate good hygiene practices to their clients. Emphasis would be on following areas:
personal habits, eating and drinking, smoking, cleanliness and physical aspects of personal
hygiene including: housing, food, clothing, bathing, oral hygiene, care of hands, nails, care of
face, scalp, eyes, ears, nose, feet, exercise.
4. Learning Objectives
After completing this Unit students will be able to:
i. Define the term hygiene and its importance in maintaining health
ii. Define and describe good personal hygiene and disease implications of poor hygiene
iii. Describe occasions when hand washing becomes essential
iv. Demonstrate proper hand washing technique
v. Describe cleanliness of the place of living.
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Curriculum Public Health Technician
Unit 4
Environmental Hygiene
1. Learning Focus
Water
o Source of water supply
o Impurities of water 16 hours
o Methods of purification
o Water sampling and testing
Air
o Composition and properties
o Types of ventilation
o Impurities of air 12 hours
o Diseases produced by impure air and their prevention
o Purification of air
Soil
o Healthy and unhealthy soil
o Importance of soil and limitation of soil in relation to disposal
12 hours
of organic wastes
o Diseases resulting from pathogens living in soil
2. Rationale
PHTs play a very important role in conducting activities which are aimed at improving or maintaining
the standard of basic environmental conditions affecting the well being of people. These
environmental conditions include (1) clean and safe water supply, (2) clean and safe air, (3) efficient
and safe industrial waste disposal and (4) adequate housing in clean and safe surroundings.
This unit addresses the basic issues related to environmental hygiene. It is important to teach
students about the quality of human environment and prevention and control measures used to
improve the basic environmental conditions affecting human health. Students need to know about
the potential health hazards arising from consumption of unsafe water, living in bad housing, and
living and working in areas where the ambient air is unclean.
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Curriculum Public Health Technician
3. Scope
Students will learn about air and water pollution, their causes and deleterious effects. Related to
water they will acquire skills of obtaining water samples for testing and learn about water
purification techniques. Learning will include topics related to soil such as its types with a special
reference to sandy soil and diseases related to soil. Another aspect of environmental hygiene relates
to housing; in this context learning will focus on healthy and unhealthy housing, diseases caused by
residing in unhealthy houses and sanitation issues to be considered at the time of planning houses.
4. Learning Objectives
After completing this Unit students will be able to:
i. Define the term air pollution and give examples of common air pollutants
ii. Describe the harmful effects of air pollution on human health
iii. Describe the World Health Organization standards for safe water
iv. Describe water supply surveillance system
v. Define the term water pollution and give examples of common water pollutants
vi. Define the term water borne disease, list common examples of water borne diseases and
describe their preventive measures
vii. Describe the process and frequency of obtaining water samples and the types of testing carried
out on water samples
viii. Describe the various methods of purification of water with their advantages/disadvantages and
the process of purifying water that has been stored in reservoirs
ix. List the different types of soil
x. List the pathogens found in soil and describe the diseases resulting from them
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Curriculum Public Health Technician
Unit 5
1. Learning Focus
2. Rationale
The population residing in the urban and rural areas faces various public health problems. Students
will explore rural /municipal hygiene in order to understand sanitation issues that may arise for
people. This knowledge will help them in preventing diseases - whether sporadic or epidemics - and
promote citizens health.
3. Scope
PHTs would be enabled to deal with tasks such as giving advice on construction of latrines, wells, and
hand pumps; managing safe water supply including chlorination and disinfection of wells etc.
Learning will focus on water and sanitation issues related to safe water supply, proper disposal of
liquid wastes (sullage), solid waste management including disposal of dung and dead animal bodies.
4. Learning Objectives
After completing this Unit students will be able to:
i. Develop an understanding of the health problems faced by people living in rural and urban
areas
ii. Describe appropriate locations for building cattle sheds and their salient features and the
corrects ways of storing water and fodder for cattle
iii. Describe sanitary hand pumps and different types of wells and latrines
iv. Describe the protection and maintenance of ponds, methods for drawing water from ponds,
and the precautionary measures taken to make pond water safe for human consumption
v. Define the term catchment areas of drinking water and describe protection measures against
impurities found in catchment areas
vi. Describe drainage of water from villages and methods of disposal of waste water (sullage).
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Curriculum Public Health Technician
Unit 6
Hospital Hygiene
1. Learning Focus
2. Rationale
Hospitals are the public face of health department. Nuisance is a common happening here due to
aggregation of lot of people. PHTs will have to deal with public health issues specific to hospitals.
The goal of this unit is for the Public Health Technician to become proficient in promoting
cleanliness and curbing harms caused by rodents and insects.
3. Scope
Learning will focus on developing skills for promotion of safe hygienic environment in hospitals.
Students will learn about prevention of diseases spread by rats and how to perform rat proofing of
hospital building. Emphasis would also be on maintaining total cleanliness in hospitals.
4. Learning Objectives
After completing Unit 1, students will be able to:
i. Understand the issues of public health significance specific to hospitals
ii. Execute rodent and insect proofing of hospitals
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Curriculum Public Health Technician
Unit 7
Occupational Hygiene
1. Learning Focus
Types of workplace hazards and preventive measures against physical,
chemical and biological hazards 15 hours
Assessment of temperature extremes (heat and cold), noise, indoor air
quality, and lighting of workplace 15 hours
2. Rationale
Incidence of workers’ injuries and illnesses is quite high in Pakistan as workers are routinely exposed
to workplace hazard. Moreover, regulations regarding occupational health and safety laws are not
properly exercised. Students will explore occupational hygiene in order to understand how
workplace hazards can affect the health of people not only working in such places but also of those
who work or live in the neighborhood and how to prevent them.
The goal of this unit is for the PHTs to learn about public health issues related to workplace.
3. Scope
This unit addresses the basic issues related to occupational hygiene. Students will learn about the
different kinds of hazards that can be found in workplace, their harmful effects on the health of
people working in such a place or living in its neighborhood, and about the preventive measures that
could be taken against these hazards. Emphasis will be on the assessment of heat and cold extremes,
noise, indoor air quality, and lighting of a workplace. They will be taught about preventive measures
against accidents at workplace. Finally students will learn about the different trades that classify as
offensive trades.
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Curriculum Public Health Technician
4. Learning Objectives
After completing this Unit students will be able to:
i. List the different types of workplace hazards and give examples
ii. Describe diseases and other ill effects that are caused by workplace hazards and the
preventive measures which should be taken against physical, chemical and biological hazards
in workplace
iii. Describe the measures needed to prevent accidents at workplace
iv. Describe the various offensive trades, businesses, and processes
v. Describe the steps needed to preserve health and welfare of workers in non-industrial
establishments
vi. Demonstrate skills needed to assess heat and cold extremes, noise, indoor air quality, and
lighting of workplace and describe the effects of extreme cold and heat on human health
vii. Describe the ill effects of industrial and agricultural chemicals on health.
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Curriculum Public Health Technician
Unit 8
2. Rationale
At the rural level, PHT is responsible for inspecting residential, commercial and industrial
sewerage system lines before they are being laid, and inspecting open drains. He takes sewage
samples for the purpose of finding out how well a treatment plant is working and what operating
changes may need to be made.
The goal of this unit is for the PHT to learn about sanitary engineering and housing.
3. Scope
This unit addresses the basic issues related to sanitary engineering. Students will explore sanitary
engineering-related issues such as sewers, sewage treatment, and waste water treatment to gain
skills primarily for maintaining the cleanliness of the area under their jurisdiction and for
achieving the ultimate goal of disease prevention. They will also be taught about sewage system
– its construction, characteristics of sewage and sewage sampling techniques with an emphasis
on precautions needed for sampling. Additional topics will include components and principles of
house drainage system, surface drainage system including its essential criteria and shapes, slope
of house drains, and various methods of construction of drains and pavements.
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Curriculum Public Health Technician
4. Learning Objectives
After completing this Unit students will be able to:
i. Define and describe conservancy system and disadvantages of disposal of waste by this
system
ii. Describe the various phases of construction of sewage system and the sanitary fixtures for
underground sewage system
iii. Describe the physical, chemical and biological characteristics of sewage and demonstrate
skills in obtaining sewage samples and observing the precautions that need to be taken
during sampling
iv. Define the term house drainage system and describe its characteristics, principles and
components
v. Describe the characteristics of surface drainage system and various shapes of surface drains
vi. Describe the characteristics of drains and various ways of constructing drains
vii. Describe the need for paving lanes and markets in rural areas.
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Curriculum Public Health Technician
Section 3
Practical Training Component
Practical training will form an important part of pre-service education for PHTs. Practical training will
comprise of field learning attachments, demonstrations and visits to sites of public health
significance. Students will also receive practical training in the form of apprenticeship to acquire
demonstrable skills which would help them in the execution of their duties once being employed. It is
this aspect of the course that will determine the level of professionalism PHTs will display after
employment.
During the two years of this program the students will be placed in different sections depicted below
on a roster basis to gain practical experience in relevant areas under supervision of tutors and field
officers.
Students will maintain a record of their attachment in the ‘Practical Note Books’ (one for each
section), the last portion of which would be designed as a ‘Log Book’ which shall be a work diary and
record. Special mention shall be made of the procedures, if any, conducted by the candidate. This
diary shall be scrutinized and certified by the Head of the Department and Head of the Institution,
and presented in the practical /viva examination.
Duration of this component would be 900 hours (nine months). The subject-wise details of this
component are:
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Curriculum Public Health Technician
Visits
Students will be taken for day trips to the following food-related businesses
o Ice cream factories
o Beverage manufacturing factories
o Milk packing factories
o Bakeries
o Meat/fish/poultry/vegetable markets
o S slaughter houses, butcheries
o Food selling stores
o Hotels/restaurants.
Demonstrations
o Sanitary requirements in respect of slaughter houses and animal handlers
o Inspection slaughtered meat at slaughter houses
o Birth and death registration at office of Union Council
o DHIS section of EDO(H) office
C: Hygiene
Duration: three months
Field Attachments: District Officer (Health) and Tehsil/Town Municipal Administration
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Curriculum Public Health Technician
Visits
Students will be taken for day trips to the following:
o Water/sewage sanitation-related sites
Water supply sources
Water supply
Water supply in villages via sanitary wells, hand pumps and ponds, and
catchment areas of drinking water
Sewage treatment plants
Sewage disposal plant and broad irrigation system of sewage disposal
Septic tank
Swimming pools
Slow sand filter
Collection and disposal of refuse and human excreta (dumping, trenching,
water carriage system, septic tanks, activated sludge plants).
o Rural Areas
Dwellings built in sandy areas
Sheds, fodder and water storage areas and watering places for cattle, places
for storage of grains and other food items for human consumption
Safe disposal of waste water, manure and dead animals
Conservancy system, house drains, surface drainage system, and pavements.
o Transportation
Airport, Railway Station, Bus Stand
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Curriculum Public Health Technician
Municipal hygiene
o Points to be noted and action to be taken while making a sanitary round of
residential areas, shopping areas and residential cum shopping areas including
practical application of health laws, by-laws, regulations.
Environmental Hygiene
o Examine ventilation of different types of buildings
o Collect water sample from taps, wells and canals
Occupational Hygiene
o Examine temperature (heat and cold), noise, indoor air quality and lighting at
workplaces.
Rural Hygiene
o Inspect and chlorinate wells
o Conduct rat proofing.
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2. Essentials of Anatomy and Physiology by Seely, Stephens, and Tate (4th ed)
5. Practical Sanitation: A Handbook for Sanitary Inspectors and Others;With Apx. On Sanitary
Law, by Herbert Manley by George Reid
8. Sanitary Inspector's Handbook;: A manual for sanitary inspectors and other executive
public health officers, by Henry Hurrell Clay
9. Elementary Sanitary Engineering in India;: A text-book for Indian sanitary inspectors and
others interested in the application of the science of sanitary engineering to tropical
conditions, by George Bransby Williams
10. The Australian sanitary inspector's text book / by John L. Bruce and Theodore Mailler
Kendall
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Curriculum Public Health Technician
Acknowledgments
Grateful acknowledgement is hereby made to Dr Simon Azariah and Dr Nighat Farooqi from
CIDA funded System Oriented Health Investment Project (SOHIP) for their initial work on this
topic.
I am also indebted to Dr Ahsan Mahmood Gondal, Registrar PMF for providing assistance in
completion of this task.
Above all, my gratitude goes to Dr Mohammad Anwar Janjua, Additional Secretary (Technical),
Health Department for his valuable co-operation and contribution in completing this difficult
task.
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