The document discusses the importance of health education, environmental sanitation, and community participation in managing communicable diseases. It emphasizes the systematic planning and implementation of health programs, utilizing various educational methods to improve community health and empower individuals to take responsibility for their own health. It also outlines the role of health surveillance in monitoring disease outbreaks and ensuring effective response strategies, highlighting the need for community involvement and cooperation with governmental health efforts.

1.  
THE COMMUNITY
BY
NDUBUISI, I.C.

2.  THE ROLE OF HEALTH EDUCATION,
ENVIRONMENTAL SANITATION AND
MAINTENANCE OF ENVIRONMENTAL HEALTH.
 HEALTH SUVEILLANCE, MOTIVATION AND
COMMUNITY PARTICIPATION IN CONTROL OF
COMMUNICABLE DISEASES.

3.  It is an integral part of PHC
 Health education is any combination of learning
experiences designed to help individuals and
communities improve their health, by increasing
their knowledge or influencing their attitudes.
 It can also be defined as a carefully planned
method to influence and or change the attitude or
behaviour of individual or communities by
increasing their knowledge and understanding of
health and diseases.

4.  It is the totality of educational efforts aimed at
helping, motivating and encouraging people to:
 Want to be healthy
 Know how to stay healthy
 Do what they can to maintain health
 Seek help as when needed

5.  It involves the use of multiple strategies and methods
 It is a systematically planned activity or process
 It is a health intervention which is devoid of coercion
 It is done with the full understanding and free acceptance by
the target audience
 It focuses on the human health related behaviour or action:
o Healthy
o unhealthy

6.  The objectives of health education include:
o Improvement in health e.g. diarrhoea incidence
o Change in behaviour, for instance hand-washing
o Change knowledge, beliefs and attitudes
o Enlist community support for health programmes
o Inform the community about medical advances
and their limitation

7. There three types of health education
Individual health education
Group health education
Mass media health education

8.  It is usually the best and most
effective- this is because it allows
for close interaction
 It only involves the client and the
health educator
 The close relationship often
gives the client confidence in the
health educator and it may
increase compliance

9.  This the most approach type for
community health education
 It involves health educating a group of
people with related health issue(s).
 The group should not be more than 5
to 8 to an health educator.
 Members of the group must be
motivated to participate in the
discussion.
 Teaching aids like audio-visuals could
be used.

10.  This form of health education is done for a large
group of people
 It involve the use of radio, television, internet,
bill boards etc.
 Some of the disadvantages of this method
include:
o It consume a lot of money and time
o There may be no personal interraction

11.  Lecture
 Group discussion
 Demonstration
 Role play
 Film show/drama
 Workshop and seminars
 Health talk

12. Performing health education involves the following steps
 STEP I: Assessing the situation
 STEP II: Diagnosing the problem
 STEP III: Programme planning or planning the
programme
 STEP IV: Implementation
 STEP V: Evaluation (assess programme success)

13.  Establishing relationship between individuals, groups and
institutions
 Increasing awareness and upgrading knowledge
 Persuading people to change
 Influencing attitude
 Facilitating the adoption of innovations and creating
sustained demand for health innovations

14.  Encouraging individuals, groups and
communities to take responsibilities for their health
 Motivating people to make informed decision
 Empowering people with skills
 Advocating for the recognition of the health
promotion preventing activities or practices as a
major investment

15.  The World Health Organisation (WHO) defines
‘Environmental Sanitation’ as “the control of all those factors
in man’s physical environment which exercise or may
exercise a deleterious effect on his physical development,
health and survival.”
 This involves keeping the environment free from things that
can cause accident or endanger the life of the populace
 For example: uncompleted or dilapidated latrines, open
trenches, uncontrolled tipping methods of refuse disposal
 There is also need for good drainage system

16.  This is designed to emphasize adequate supply
of safe water and basic sanitation
 To achieve this, the health worker needs to
ensure community participation and the
involvement of the Government effort at
providing water and ensuring clean environment
 The technology adopted for providing water in
the community should be appropriate (it must be
cheap, simple, easy to maintain and reliable)

17.  Health surveillance is a system of ongoing health checks.
 These health checks may be required by law for community
members who are exposed to noise or vibration, ionising
radiation, solvents, fumes, dusts, biological agents and
other substances hazardous to health.
 Public health surveillance is the On-going, systematic
collection, analysis, and interpretation of health-related data
and dissemination for use in the planning, implementation,
and evaluation of public health practice on a specific
disease or other health-related event.

18.  Such surveillance can:
 serve as an early warning system for impending public
health emergencies
 document the impact of an intervention, or track progress
towards specified goals
 monitor and clarify the epidemiology of health problems, to
allow priorities to be set and to inform public health policy
and strategies

19. Public Health Surveillance has many uses:
 Monitoring trends in health events.
 Guiding decision making and action to reduce morbidity and
mortality
 Detecting cases for intervention, evaluate control and
prevention measures.
 Guiding planning, implementation and evaluation of public
health programs, providing a basis for epidemiological
research.

20.  Estimate magnitude of the problem.
 Portray the natural history of a disease.
 Determine distribution and spread of illness.
 Detecting potential outbreaks and threats to public health.
 Monitor changes in infectious agents.
 Directing public health interventions
 Generate hypotheses, stimulate research.

21.  There is an identifiable disease or other identifiable
adverse health outcome
 The disease or health effect may be related to
exposure
 There is a likelihood that the disease or health
effect may occur
 There are valid techniques for detecting indications
of the disease or health effects

22.  Health Surveillance Techniques should be:
 Sensitive
 Specific
 Easy to perform and interpret
 Safe
 Non-invasive
 Acceptable

24.  A Community is a set of people living
together with common interest
There are different things that bind
people together. Such as: Territory ,
Sharing resources, Administrative
unit, Language, Religion, Culture,
Occupation

25.  Community Mobilization refers to the process of building
social relationships in pursuit of common community
interests.
 It is a capacity building process through which
community members, groups, and organizations plan,
implement, and evaluate sustainable programs and
activities in a participatory manner to achieve an agreed
upon goal.
 Community Mobilization is seen as being the foundation
of the community development process.
 Community development seeks to empower individuals
and groups of people by providing these groups with the
skills they need to affect change in their own

26.  Engage the whole community
 Facilitate a process of social change thru:
o Awareness
o Support and
o action
 Provide repeated exposure to idea
 Promote community ownership

27.  Identify the problem(s)
 Select a strategy to solve the problem
 Community mobilization process
 Implementation through the people’s
participation

28.  Identify core areas of community development such as
Health (Maternal and child mortality, HIV/AIDs, Malaria),
women empowerment, Water and Sanitation, etc.
 Prepare to mobilize
 Identify a common issue that the whole community can get
involved
 Gather information about the issue and the community
 Identify resources and constraints

29.  This depends on the identified problem and it is likened to
the planning phase
 Plan for community dialogue and select a strategy
 Some problems –
o require sensitization on the issue.
o call for mobilization of community
o need interaction with individual family members.

30.  A process whereby a group of people become aware
of a shared concern or common need and decide to
take Mobilization in order to create shared benefits.
 A continual and cumulative process that involves
communication, education, and organization, which
together lead to community Mobilization and
development.
 Community Mobilization linkages Capacity building
Outside Community Group resources Participation
Mobilization Empowerment

31.  Developing an on-going dialogue between
community members
 Creating or strengthening community
organizations (Committees etc.)
 Creating an environment in which individuals
can empower themselves to address their own
and their community’s needs
 Promoting community members’ participation

32. Some of the actions undertaken by the people to promote
health and prevent diseases include:
 Co-operative farming to ensure that the community have
sufficient food of the right kind
 They can get together to make the most of whatever
source of water they have ensuring that it is protected from
pollution
 They can insist on acceptable standard of hygiene in and
around the homes, in the market places, shops, schools,
etc.
 They can ensure that every child in the community are
immunized against the childhood killer diseases
 They can fight certain diseases like malaria, and other

33. Evaluation should be carried out
while all these are on,
intermittently to ensure that the
set goals are being met
Revise the strategy wherever
necessary

34.  Increase community, individual, and group
capacity to identify and satisfy their needs
 Improve program design, quality, results and
evaluation
 Cost effective way to achieve sustainable results
 Increase community ownership of the program

35.  Bringing People Together
 Building Trust
 Encouraging Participation
 Facilitating Discussion and Decision-making
 Helping Things to Run Smoothly .
 Facilitation in community mobilization process

36.  Good communication skills
 Good facilitation skills
 Good listener
 Committed
 Decision maker
 Active
 Negotiation skills
 Honest
 Known to culture and values of society
 Well dress
 Catalyst
 Management skills

37.  This is the most essential and sensitive part of the
principles of primary health care.
 Enables them to become agents for their own development
instead of being passive beneficiaries of development aid.
 This is the process by which individuals, families and
communities assume the responsibility in promoting their
own health and welfare.
 Community involvement is a process in which partnership is
established between government and the local communities
in planning and implementation of health care activities.

38.  The purpose of this is to help in building local self
reliance and gaining social control over PHC
infrastructure and technology for example: training of
village health workers and aids.
 It is important to note that community participation
can not occur without prior mobilization
 Individual in the community know their own situation
better and they are motivated to solve common
problems.

39.  An illness due to a specific infectious agent or its toxic
products capable of being directly or indirectly transmitted
from man to man, animal to animal or from the environment
(air, dust, soil, water, food) to man or animal.

40.  Epidemic: occurrence, in a community or region, of a group of
illnesses of a similar nature in excess of normal expectancy
 Endemic: habitual presence of a disease or agent within a
geographic area based on the usual prevalence of a given
disease within such an area
 Pandemic: an epidemic which is worldwide in distribution
Antigenicity: Ability of agent to induce antibody production in the
host (e.g. re-infection with measles virus is very rare).
 Carrier: person/animal that harbors a specific infectious agent in
the absence of discernible clinical disease and serves as a
potential source of infection

41. Infectivity: Capacity of agent to enter and multiply in a
susceptible host (hence produce infection/disease) (polio and
measles have high infectivity)
Pathogenicity: Capacity of agent to cause clinical disease in the
infected host (measles has high pathogenicity)
Virulence: The degree of pathogenicity of an infectious agent. i.e.
the ability of the agent to invade and damage tissues of the host
causing severe manifestations or death.
 Toxigenicity: The ability of a microbe to produce bio chemicals,
known as toxins that disrupt the normal functions of cells or are
generally destructive to human cells and tissues

42. A process that begins when an agent leaves its
reservoir or host through a portal of exit, and is
transported by some mode of transmission, then
enters through an appropriate portal of entry to infect a
susceptible host.

43. Chain (Cycle) of infection
Susceptible Host
Agent
Reservoir
Mode of transmission
Portal of ExitPortal of Entry

44. • Microorganisms are responsible for disease production
(viruses, bacteria, protozoa, parasites, fungi, etc.
• Agent factors that affect disease transmission:
o Infectivity
o Pathogenicity
o Virulence
o Antigenicity

45.  The reservoir of an agent is the habitat in which
an infectious agent normally lives, grows, and
multiplies.
 “any person, animal, arthropod, plant, soil, or
substance, or a combination of these, in which
an infectious agent normally lives and multiplies,
on which it depends primarily for survival, and
where it reproduces itself in such a manner that
it can be transmitted to a susceptible host.
 It is the natural habitat of the infectious agent.”

46.  Portal of exit is the path by which an agent
leaves the source host.
 Examples:
• Respiratory tract
• GIT
• Skin and mucous membrane

47. Mode of transmission
Direct transmission Indirect transmission
Direct contact
Droplet infection
Contact with soil
Inoculation into skin or mucosa
Trans-placental (vertical)
Vehicle-borne
•Vector-borne:
•Mechanical
•biological
Air-borne
Fomite-born
Unclean hands and
fingers

48.  An agent enters a susceptible host through a portal of
entry.
 The portal of entry must provide access to tissues in
which the agent can multiply or a toxin can act.
 Often, organisms use the same portal to enter a new
host that they use to exit the source host.

49. A susceptible host is the final link in the chain of infection.
The host is a person or other living organism that can be
infected by an infectious agent under normal conditions.
An infectious agent seeks a susceptible host aiming
“successful parasitism”.
Four stages are required for successful parasitism:
1. Portal of entry
2. Site of election inside the body
3. Portal of exit
4. Survival in external environment

50. Rapid Assessment
Prevention
Surveillance
Outbreak Control
Disease Management

51.  The objectives should be :
 To assess the extent of the emergency and the threat of
communicable diseases in the population
 To define the type and size of interventions and priority
activities
 To plan the implementation of these activities
 To provide information to international community, donors
and the media to mobilize resources both human

52. Communicable diseases can be
prevented by appropriate preventive
measures which include:
Good site planning
Provision of basic clinical services
Provision of appropriate shelter
Clean water supply
Sanitation
Mass vaccination against specific
diseases
Regular and sufficient food supply

53.  Increasing the resistance of the host
 Inactivating the agent
 Interrupt the chain of infection
 Restricting spread of infection
o isolation
o quarantine
o segregation
o personal surveillance

54. Activities targeted at detecting disease at
earliest possible time to:
o begin treatment
o stop progression
o protect others in the community
Examples of activities: case finding,
health screening, health education

55. Limits the progression of disability
Treatment of symptoms and
rehabilitation vary with each specific
disease

56.  Surveillance of disease means the exercise of continuous
scrutiny and watchfulness over the distribution and spread
of infections and the related factors, with sufficient
accuracy and completeness to provide the basis for
effective control
 The surveillance of communicable diseases has 2 main
objectives:
o Recognition of acute problems that demand immediate
action
o Provide a broad assessment of specific problems in
order to discern long-term trends and epidemiological
patterns, to guide and monitor intervention and to

57.  An outbreak is occurrence of a number of cases of a
disease that is unusually large or unexpected for a given
place and time.
 Outbreaks and epidemics refer to the one and same
thing.
 Outbreaks in emergency situations can spread rapidly
giving rise to high morbidity and mortality rates.
 Aim should be to detect and control the outbreak as
early as possible.

58.  Preparation
 Detection
 Response
 Evaluation

59.  Health coordination meetings
 Strong surveillance system
 Outbreak response plan for each disease
 Stocks of iv fluids, antibiotics and vaccines
 Plans for isolation wards
 Laboratory support

60.  Surveillance system with early warning system
for epidemic prone diseases.
 Inform ministry of health and WHO in case of
outbreaks of specific diseases.
 Take appropriate specimens (stool, CSF or
serum) for laboratory confirmation.
 Include case in the weekly report.

61. Confirm the outbreak
Activate the outbreak control team
Investigate the outbreak
Control the outbreak

62. Assess appropriateness and effectiveness
of containment measures.
Assess timelines of outbreak detection
and response.
Change public health policy if indicated.
Write and disseminate outbreak report.

63.  Funso, T.A. (2013). A Guide to Primary
Health Care Practice in Developing Countries. 5th
ed. Akure: Rotimi Excel Production
 Basavanthappa, B.T. (2008). Community Health Nursing.
2nd ed. New Delhi: Jaypee Brothers Medical
Publishers (P) Limited
 Adesokan, F.O.O. (2011). Reproductive HealthFor All
Ages; 2nd edition, Akure. Bosem Publishers Nigeria
Limited
 Sagun P. (2014).
. www.slideshare.net
 http://www.agius.com/hew/resource/surv.htm

64.  Kulkarni, R. (2014). Control of Communicable Diseases
in Emergencies. Article from: Provincial
Epidemiology and Disease Control Officer, Ministry
of Health and Child Welfare, Zimbabwe.
www.scribd.com/doc/922132/Control-of-Communicable-
Diseases

65.  There is an outbreak of cholera in Alkamawa community,
discuss how health surveillance, community motivation
and participation can be used to control the disease.