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thiru murugan
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2nd Year B.Sc Nursing Community Health Nursing – I Determinants of health By, M. Thiru Murugan Community health nursing – I ( II Bsc.N.)Unit- 2: Determinants of health: Eugenics Environment : Physical : Air, light, Ventilation, Water, Housing, Sanitation; disposal of waste, disposal of dead bodies, Forestation, Noise, Climate, Communication: infrastructure facilities and Linkages Acts regulating the environment: National Pollution control board Bacterial & viral: Agents, host carriers and immunity Arthropods and Rodents ( II Bsc.N.)Unit- 2 Food hygiene: Production, Preservation, Purchase, Preparation, Consumption Acts regulating food hygiene- Prevention of food adulteration act, drugs and cosmetic act Socio-cultural Customs, taboos Marriage system Family structure Status of special groups; Females, Children, Elderly, challenged groups and Sick persons Life Style Hygiene Physical activity Recreation and sleep Sexual life Spiritual life philosophy Self reliance Dietary pattern Education Occupation Financial Management Income Budget Purchasing power Security Eugenics Eugenics: humanity can be improved by altering human genotypes or their frequencies i.e.. evolution of human traits by natural selection could be substituted by evolution through social selection Positive eugenics - increase frequency of beneficial genes Negative eugenics - decrease frequency of deleterious genes Positive eugenics Positive eugenics - increase frequency of beneficial genes Measures: Sperm banks Genetic engineering Parthenogenesis Cloning Negative eugenics Negative eugenics - decrease frequency of deleterious genes 2 - 2.5% of children born in defective - mentally or physically Two reasons for prevalence of deleterious genes although deleterious in homozygous condition, may produce hybrid vigor in heterozygous frequency of deleterious genes is now high because natural selection has been artificially reduced New Eugenics methods: Artificial insemination by donor Egg donation Prenatal diagnosis of genetic disorders and pregnancy terminations of defective fetuses Embryo selection Genetic engineering Gene therapy Cloning Eugenics policies and programs Genetic screening Birth control Promoting differential birth rates Marriage restrictions Immigration control Segregation (both racial segregation as well as segregation of the mentally ill from the normal) Compulsory sterilization Forced abortions Genocide (efforts to destroy a national, ethnic, racial, or religious group of people either entirely or a substantial portion) Environment Definition: The surroundings or conditions in which a person, animal, or plant lives or operates. Types of Environment: There are mainly three types of environment- The Physical environment: Biotic environment Social or cultural environment 1.The Physical environment: It is also known as a-biotic environment and natural environment. The meaning of ‘a-biotic’ or ‘physical’ is non living like land water air conditions atmosp

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2nd Year B.Sc Nursing Community Health Nursing – I Determinants of health By, M. Thiru Murugan
Community health nursing – I ( II Bsc.N.)Unit- 2: Determinants of health: • Eugenics • Environment : • Physical : Air, light, Ventilation, Water, Housing, Sanitation; disposal of waste, disposal of dead bodies, Forestation, Noise, Climate, Communication: infrastructure facilities and Linkages • Acts regulating the environment: National Pollution control board • Bacterial & viral: Agents, host carriers and immunity • Arthropods and Rodents
( II Bsc.N.)Unit- 2 • Food hygiene: Production, Preservation, Purchase, Preparation, Consumption • Acts regulating food hygiene- Prevention of food adulteration act, drugs and cosmetic act • Socio-cultural • Customs, taboos • Marriage system • Family structure • Status of special groups; Females, Children, Elderly, challenged groups and Sick persons • Life Style • Hygiene • Physical activity
• Recreation and sleep • Sexual life • Spiritual life philosophy • Self reliance • Dietary pattern • Education • Occupation • Financial Management • Income • Budget • Purchasing power • Security
Eugenics • Eugenics: humanity can be improved by altering human genotypes or their frequencies • i.e.. evolution of human traits by natural selection could be substituted by evolution through social selection • Positive eugenics - increase frequency of beneficial genes • Negative eugenics - decrease frequency of deleterious genes
Positive eugenics • Positive eugenics - increase frequency of beneficial genes Measures: • Sperm banks • Genetic engineering • Parthenogenesis • Cloning
Negative eugenics • Negative eugenics - decrease frequency of deleterious genes • 2 - 2.5% of children born in defective - mentally or physically • Two reasons for prevalence of deleterious genes 1. although deleterious in homozygous condition, may produce hybrid vigor in heterozygous 2. frequency of deleterious genes is now high because natural selection has been artificially reduced
New Eugenics methods: 1. Artificial insemination by donor 2. Egg donation 3. Prenatal diagnosis of genetic disorders and pregnancy terminations of defective fetuses 4. Embryo selection 5. Genetic engineering 6. Gene therapy 7. Cloning
Eugenics policies and programs  Genetic screening  Birth control  Promoting differential birth rates  Marriage restrictions  Immigration control  Segregation (both racial segregation as well as segregation of the mentally ill from the normal)  Compulsory sterilization  Forced abortions  Genocide (efforts to destroy a national, ethnic, racial, or religious group of people either entirely or a substantial portion)
Environment • Definition: The surroundings or conditions in which a person, animal, or plant lives or operates. • Types of Environment: There are mainly three types of environment- 1. The Physical environment: 2. Biotic environment 3. Social or cultural environment
1.The Physical environment: • It is also known as a-biotic environment and natural environment. • The meaning of ‘a-biotic’ or ‘physical’ is non living like land water air conditions atmosphere which constitutes of soil. So we can say that physical or a-biotic environment is the environment which includes non living or physical things which are constitutes of soil and affect the living things.
2. Biotic environment • It is also known as biological environment and organic environment. • In the opposite side of the physical environment, the biotic or biological environment is responsible for the living beings. • You have already understood that the meaning of ‘biological’ is living things. So, the biological environment is the environment which involves the living part of the earth.
3. Social or cultural environment • This type of environment involves the culture and life style of the human beings. • The social or cultural environment means the environment which is created by the man through his different social and cultural activities and thinking. • The historical, cultural, political, moral, economic aspects of human life constitute to the social or cultural environment
Air • Air is a mixture of different gases • Including nitrogen, oxygen, carbon dioxide, water vapour • There are other gases that are useful but come in very small quantities
Air is a mixture of GASES. • Atmosphere Every living thing needs air to breathe. We breathe in Oxygen present in the air. The layer of air that surrounds the earth is called an Atmosphere. Atmospheric layer is thick near the ground and gets thinner as we go up. It is difficult to breathe in thinner air and hence the mountaineers carry oxygen cylinders while climbing high mountains like Everest.
Composition of Air  By volume, dry air contains  78.09% nitrogen,  20.95% oxygen,  0.93% argon (chemical element),  0.04%carbon dioxide, and  Small amounts of other gases.  Air also contains a variable amount of water vapor
Properties of Air Air occupies Space. Air has weight. Air exerts pressure. Air is needed for burning. Air is odorless, tasteless and colorless
Air Pollution Definition: • Any visible or invisible particle or gas found in the air that is not part of the original, normal composition. Causes of Air Pollution: • Natural: forest fires, pollen, dust storm • Unnatural: man-made; coal, wood and other fuels used in cars, homes, and factories for energy
TYPES OF AIR POLLUTION Outdoor Air Pollution: • Smog • Particulates • Acid Rain • Greenhouse Gases Indoor Air Pollution:
Air Pollutants 5 Major Air Pollutants: 1. Carbon Monoxide 2. Sulfur Dioxide 3. Nitrogen Dioxide 4. Particulate Matter 5. Ground Level Ozone
EFFECTS & IMPACTS EFFECTS: Human Effects: • e.g. diseases Environmental Effects: • Acid rain • Eutrophication • Haze • Wildlife • Ozone Depletion • Crop and forest damage • Global Climate Change IMPACTS: • Climate System • Health • Economy • Environment • Ecosystem • Forestry • Agriculture
Effects of Air Pollution • Asthma and other respiratory diseases. • Lung function decreased and they suffered from respiratory inflammation. • Cancer. • Coughing and wheezing • Damages the immune system, endocrine and reproductive systems. • Higher incidents of heart problems. • Effects of Global Warming • The toxic chemicals released into the air settle into plants and water sources. Animals eat the contaminated plants and drink the water. The poison then travels up the food chain – to us.
Light • Light is electromagnetic radiation of a specific wavelength and frequency that is detectable by the human eye.
Sources of light 1.Natural light and 2. artificial light Natural: • Sunlight, • Improving sun light; 1. Orientation 2. Removal Of Obstructions 3. Windows 4. Interior Of The Rooms
Sources of light Artificial Lighting: There are five systems of artificial lighting 1. Direct 2. Semi-direct 3. Indirect 4. Semi –Indirect 5. Direct- Indirect
Sources of light 1.Direct: In direct lighting 90 to 100 per cent of the Light is projected directly towards the working area. 2.Semi Direct: Here 10 to 40 % of the light is projected upwards so that it is reflected back on the object by the ceiling. 3.Indirect: light does not strike a surface directly. because 90 to 100 per cent of the light is projected towards the ceiling and walls. 4.Semi Indirect: Here , 60 to 90% of the light is directed upwards, and the rest downwards. 5.Direct Indirect: Here , light is distributed equally
Methods of artificial lighting: Filaments Lamp Fluorescent Lamp Halogen Lamp Arc Lamps Mercury LED light Laser light
Properties of light 1. Reflection 2. Refraction 3. Diffraction 4. Interference
Properties of light • Reflection: incident ray reflected ray Normal Surface • Refraction: bending of waves when passing from one medium to another. (Under water) • Diffraction: bending of waves around a barrier, depends on the wavelength and size of the opening barrier. (CD surfaces Diffraction) • Interference: When two waves meets, they have an effect with each other. destructive when the crest of one wave meet the trough of the other wave (Thin Films - Bubbles & Oil Slicks)
Criteria for good light Good Lighting is essential for effective vision and puts lesser strain increasing working efficiency. Light Factors: • Sufficiency • Distribution • Absence of Glare • Absence of Sharp Shadows • Steadiness • Color Of Light • Surroundings.
Problems of poor lighting • The main causes of lighting problems are: • Insufficient light - not enough light for the need • Glare - too much light for the need • Improper contrast • Poor distribution, and • Flicker
Effect of poor light on health • Headache • Eyestrain • Neck, back, and shoulder strain • Falling, • Slipping • Dropping materials or tools • Depression • Accidents • Inefficient work
Ventilation DEFINITION: • It is the process of exchange or circulation of fresh air into room and removal of stale air inside room TYPES OF VENTILATION: 1. Natural Ventilation 2. Mechanical Ventilation
Natural Ventilation • Definition: the process of supplying and removing air through an indoor space without using mechanical systems. • Benefits: Improved Indoor air quality (IAQ) Energy savings Reduction of greenhouse gas emissions Occupant control Reduction in occupant illness associated with Sick Building Syndrome Increased worker productivity
Criteria for good Natural Ventilation 1. Building orientation and location. 2. Building form and dimensions. 3. Window typologies and operations 4. Types, shape and size of openings 5. Construction methods and detailing; 6. Urban planning consideration
Mechanical Ventilation • Definition: mechanical ventilation systems circulate fresh air using ducts and fans rather than relying on airflow through small holes or roof or windows. • Benefits: Better indoor air quality –can remove pollutants, allergens, and moisture that can cause mold problems More control – provide proper fresh air flow along with appropriate locations for intake and exhaust Improved comfort – allow a constant flow of outside air into the home provide filtration, dehumidification, and conditioning of the incoming outside air
Mechanical Ventilation • CEILING FANS, TABLE OR FLOOR FANS: Used to circulate air within a room for the purpose of reducing the perceived temperature, because of evaporation of perspiration from the skin of occupants. • EXHAUSTS: The indoor air is extracted out with the help of mechanically driven fans • PLENUM VENTILATION: Comprise air filter, heating and cooling system. Ex: hospital and lab
Mechanical Ventilation • AIR CONDITIONING: A system which provides a combination of cooling, ventilation and control of humidity. • DEMAND CONTROLLED VENTILATION: Reduces the energy consumption in a building, while maintaining adequate air quality. • HVAC: stands for ‘Heating, Ventilation and Air- Conditioning’. Important in those places where humidity and temperature must be closely regulated while maintaining healthy and safe conditions inside buildings.
Comparison of Mechanical & Natural Ventilation Mechanical Ventilation:  Use fan  Need to be install  Allow warmer air escape faster  High cost  High maintenance  Create air all time  Noise  High electricity bill Natural Ventilation: -- Not use any fan -- Ready fix to building -- Depend on weather -- More economic -- No maintenance -- Same in temperature -- Silent -- No electricity bill
VENTILATION STANDARDS • To achieve a sense of freshness in a room and remove body odours. a) Floor space : the product of the length and breadth optimum floor space requirements per person - 50 to 100 feet. b) Cubic space of area : Earlier prescriptions - fresh air supply of 3000 cu feet of air per person per hour. beyond 12 feet, not taken into account Current standards - 1000 to 1200 cu feet per person per hour c) Air change: The recommended number of air changes living room - 2 to 3 in an hour, Work rooms and assemblies - 4 to 6 per hour.
VENTILATION REQUIREMENTS Type of buildings Size of the buildings and the floor areas. Type of roof Local wind directions Number of persons occupying the room Proximity to commercial or industrial areas Sanitation of the surrounding area Nature of work being carried out inside the buildings Geographical locations such as closeness to sea, large water bodies, hilly areas
Poor Ventilation effect on health • High levels of CO2 and low levels of O2 • Poor indoor air quality can lead to suffering from different health problems • Headaches, fatigue, hypersensitivity and allergies, sinus congestion dizziness, shortness of breath, coughing and nausea • Increase accidents in the workplace as a result of poor ventilation • Low humidity can cause a dry throat, dry skin • High humidity contributes to bacterial and mould growth • Excessive and irritating odors cause discomfort
Water Water is a essential basic need of human and all living things Water is made of tiny molecules of hydrogen and oxygen. Each one is so small that you can’t see it even with the most powerful microscope The water is very important for life, because it is vital. The animals or humans drink water because the body needs 75% water Pure water has no colour, no taste and doesn’t smell of anything and absence of micro organism
Safe and wholesome 1. Safe and wholesome water is defined as that which is 2. free from pathogenic agents 3. free from harmful chemical substances 4. pleasant to taste, colourless and odourless 5. usable for domestic purposes
Sources of Water Rain water Surface water • Lakes • Ponds • Streams • Rivers • Storage reservoir Ground water: • Open wells • Tube wells • Artesian wells • Springs • Infiltration
Uses of water • Household or domestic(drinking, preparing food, bathing, washing clothes and dishes, brushing your teeth, watering the yard and garden) • Agricultural (farming gardening fisheries) • Industrial (manufacturing) • Recreational (swimming water shows boating) • Environmental activities (park, street cleaning) • Fire extinction • Hydro power generation.
Water purification • Water purification is the removal of contaminants from raw water to produce drinking water that is pure enough for human consumption or for industrial use. • The goal is to produce water fit for a specific purpose.
Water Purification Commonly 2 methods  Natural- Sunlight  Artificial: large scale methods Small scale methods
Large scale methods • Definition: large amount of water • Methods: I. Storage II. Filtration III. Disinfection
Large scale methods I. Storage: Physical, chemical and biological. II. Filtration: 1. Slow sand filters 2. Rapid sand filters
1. Slow sand filters Base materials
1. Slow sand filters 1.Inlet chamber: open tank to receive raw water, Sedimentation & oxidation (3-12 hrs) 2.Filter media: Consist fine & coarse sand layers 3. Base materials: Consist of fine gravel & coarse gravel 4. Under drainage system: 1 central drain & 2 lateral drains Lateral drain collect filtered water supply through central drain to outlet 5. Filter control devices: control flow of filtration and provide filtered water
2. Rapid sand filtration Rapid Sand filter Bed
2. Rapid sand filtration 1. Chemical coagulant( aluminium sulphate, ferrous sulphate, lime, chlorine) added Raw water 2. Coagulant mixed with water with mixing device 3. Stirring (30 min) the water at slow motion by mechanical flocculators 4. Sedimentation – 2 to 6 hrs 5. Rapid sand filtration bed consist of sand & gravel filter the water
III. Disinfection 1. Killing pathogenic organisms in water 2. After filtration – disinfection is important 3. By using disinfectants Ex: chlorine, KMNO4, iodine, lime 4. Chlorination of water: add chlorine 5. Super chlorination: adding large amount of chlorine in water for heavily polluted water, later excess chlorine removed. 6. Disinfection by UV radiations 7. Natural disinfection by sunlight 8. Disinfection by using ozone gas
Small scale • Water on small scale such as for domestic purposes can be purified as follows: 1. Disinfection of wells 2. Boiling 3. Filtration through muslin cloth. 4. Three pitcher system. 5. Chemicals. 6. Domestic filters e.g. Berkefeld filter and Pasteur’s Chamber- land filter.
Small scale (i) Disinfection of wells: 1. Main source of water – villages 2. Amount of bleaching powder needed 3. Diameter and depth of well 4. Prepare solution in bucket 5. Place in well by mix bleaching powder (1hr) 6. Disinfect the well by repeating this method
Small scale (ii) Boiling: 1. Boiling is the oldest and satisfactory method 2. Boiling for 5 to 10 minutes kills bacteria, spores. 3. It also removes hardness of water and soft water is produced. 4. Boiling is an excellent method of purification of water provided boiling is done in a neat and clean vessel and after boiling it is stored in clean covered container. 5. Preferably water should be boiled in the same container in which it is to be stored. 6. Only that much amount of water should be boiled which can be used within a few hours
Small scale (iii) Filtration through Muslin Cloth: • Muslin cloth acts as a coarse filter which can remove the suspended materials. • So water filtered through muslin is not fit for drinking purposes though it can be used for other household purposes like bathing, washing the clothes etc.
Small scale (iv) Three Pitcher System: • This is very old system of purification of water. • In this system three pitchers are used which are kept one above the other on a wooden stand. • The top Picher contains sand, second charcoal and sand; and the lowest collects the purified water. • The raw water is filled in the first pitcher from where it percolates through a hole into the 2nd pitcher. • From here the water further percolates through the hole to the third pitcher.
Small scale • (v) Chemicals: (a) Bleaching Powder (Chlorinated Lime): 2.5 gm of a good quality of bleaching powder could be required to disinfect 1000 liters of water. b) Chlorine tablets: One tablet of 500 mg is sufficient for disinfecting 20 liters of water. (c) Quick Lime (Calcium Oxide): 360 mg of slaked lime will disinfect 4.5 liters of water. It is cheap, easily available and quite effective. (d) High Test Hypochlorite (HTH): (e) Alum: • Alum is not a germicidal. It is used to purify muddy water and to remove turbidity. (f) Potassium Permanganate: It is a strong oxidizing agent and can kill cholera vibrios. It is used for disinfecting wells.
Small scale (vi) Domestic Filters: Berkefeld Filters and Pasteur’s Chamber- land filter.
Major Categories of Water Pollutants • Infectious Agents – Bacteria, Viruses, Protozoa, Parasitic Worms – Source: Human and animal waste • Oxygen-Demanding Waste – Organic debris & waste + aerobic bacteria – Source: Sewage, feedlots, paper- mills, food processing • Inorganic Chemicals – Acids, Metals, Salts – Sources: Surface runoff, Industrial effluent, household cleansers • Radioactive Materials – Iodine, radon, uranium, cesium, thorium, Source: Coal & Nuclear Power plants, mining, weapons production, natural • Plant Nutrients – Nitrates, Phosphates, Source: Sewage, manure, agricultural and landscaping runoff • Organic Chemicals – Oil, Gasoline, Plastics, Pesticides, Solvents, detergents, Sources: Industrial effluent, Household cleansers, runoff from farms and yards • Eroded Sediment: Soil, Silt • Heat/Thermal Pollution – Source: Power plants, Industrial
Effects of water pollution • Will cause – Soil contamination. – Air contamination. – Food chain contamination. – Esthetic. • Lack of clean water supply for – Domestic demand. – Industry use. – Agriculture use. • Will also cause – Breeding of diseases vector. – Spreading of water borne diseases. – Food poisoning. – Skin problem.
Housing
Sanitation
Disposal of Waste • Waste (also known as rubbish, trash, refuse, garbage, junk, litter, and ort) is unwanted or useless materials. Disposal means “any operation which may lead to resource recovery, recycling, reclamation, direct re-use or alternative uses
Types of waste Solid wastes: wastes in solid forms, domestic, commercial and industrial wastes. Examples: plastics, styrofoam containers, bottles, cans, papers, scrap iron, and other trash Liquid Wastes: wastes in liquid form, Examples: domestic washings, chemicals, oils, waste water from ponds, manufacturing industries and other sources
Classification of Wastes according to their Properties Bio-degradable: can be degraded (paper, wood, fruits and others) Non-biodegradable: cannot be degraded (plastics, bottles, old machines, cans, styrofoam containers and others)
Classification of Wastes according to their Effects on Human Health and the Environment • Hazardous wastes • Substances unsafe to use commercially, industrially, agriculturally, or economically and reactivity & toxicity. • Non-hazardous • Substances safe to use commercially, industrially, agriculturally, or economically and do not have any of those properties mentioned above. These substances usually create disposal problems.
Classification of wastes according to their origin and type Domestic wastes: Bio-medical wastes: Industrial wastes: Agricultural wastes: Fishery wastes: Radioactive wastes: E-wastes:
IMPACTS OF WASTE Affects our health Affects our socio-economic conditions Affects our coastal and marine environment Affects our climate
DISPOSAL OF DEAD BODIES • Death is the cessation of all biological functions that sustain a living organism. • Phenomena which commonly bring about death include aging, predation,malnutrition, disease, suicide, homicide, starvation, dehydra tion, and accidents or trauma resulting in terminal injury. • In most cases, bodies of living organisms begin to decompose shortly after death.
Need for disposal of dead bodies • All dead bodies are potentially infectious and “STANDARD PRECAUTIONS” should be implemented for every case. • Although most organisms in the dead body are unlikely to infect healthy persons, • To minimize the risks of transmission of known and also unsuspected infectious diseases, dead bodies should be handled and disposed properly. • A rational approach should include staff training and education, safe working environment, appropriate safe work practices, the use of recommended safety devices and vaccination.
Categorization of Dead Body • Based on the mode of transmission and the risk of infection of different diseases, the following categories of precautions for handling and disposal of dead bodies are advised: • Cat. 1： • Signified by a BLUE label • Standard precautions are recommended for all dead bodies other than those with infectious diseases as listed under Categories 2 & 3.
Categorization of Dead Body • Cat. 2: • Signified by a YELLOW label • In addition to standard precautions, additional precautions are recommended for dead bodies with known: Human Immunodeficiency Virus infection (HIV) Hepatitis C Creutzfeldt-Jacob disease (CJD) without necropsy Severe Acute Respiratory Syndrome (SARS) Avian influenza, Middle East Respiratory Syndrome (MERS), and Other infectious diseases as advised by the physician i/c, the infection control officer or microbiologist.
Categorization of Dead Body • Cat. 3: • Signified by a RED label • In addition to standard precautions, stringent precautions are recommended for dead bodies with known: Anthrax Plague Rabies Viral hemorrhagic fevers Creutzfeldt-Jacob disease (CJD) with necropsy, and Other infectious diseases as advised by the physician i/c, the infection control officer or microbiologist.
General Recommendations Vaccination (Hepatitis B vaccination ) Personal hygienic measures and protective equipment Prevent the Accidental exposure to blood or body fluids Clinical waste management Environmental control Precautions for Specific Risk
Precautionary Measures for Handling and Disposal of Dead Bodies Risk category Bagging Viewing in funeral process Embalming Hygienic preparation in funeral Disposal of dead body Cat. 1 NOT necessary Allowed Allowed with PPE Allowed with PPE Coffin burial or cremation is optional Cat. 2 must Allowed NOT allowed Allowed with PPE Cremation is advisable Cat. 3 must Not Allowed NOT allowed NOT allowed Cremation is strongly advisable
Forestation
Noise
Accepted Noise Level
Climate • Definition: • Climate is commonly defined as the weather averaged over a long period
Elements of climate 1. Temperature 2. Air pressure 3. Winds 4. Humidity 5. Cloud 6. Rainfall
Factors influencing on Indian climate Latitude Altitude Wind Air pressure Ocean Distance from sea Distribution of land and water Air circulation Cyclones
Climate Seasons 1.Winter: • December to March. • The year's coldest months are December and January • when temperatures average around 10–15 °C 2.Summer: or pre-monsoon: • April to June • In western and southern regions, the hottest month is April; for northern regions of India, May is the hottest month. • Temperatures average around 32–40 °C
Climate Seasons 3. Monsoon or rainy season: • July to September. • It may begin in late May or early June. • South India typically receives more rainfall. 4. Post-monsoon or autumn season: • October to November. • In the northwest of India, October and November are usually cloudless. • Tamil Nadu receives most of its annual precipitation in the northeast monsoon season.
Extreme climate conditions 1. Global warming 2. Droughts 3. Floods 4. Cyclones 5. Landslides 6. Snowstorms 7. Summer dust storms 8. Heat waves
Climate change • Climate change is a change in the statistical distribution of weather patterns when that change lasts for an extended period of time • Climate change may refer to a change in average weather conditions, or in the time variation of weather within the context of longer-term average conditions.
Causes of climate changes • Natural Disasters • Human activity • Deforestation • Ozone depletion • Global warming
Health impact of climate changes Malnutrition Injury/death Water borne diseases Vector borne diseases Food borne diseases Lung diseases Skin diseases Cancer Poor environmental sanitation Social disruption
Types of Communication • Verbal (oral & written) .Mass • Non verbal • Intra personal • Interpersonal • One way • Two way • Mass • Meta • Formal • Informal
Barriers
Infrastructure Facilities and Linkages Introduction: • There are many infrastructure facilities for health • Maximum health services provided by public sectors • Private sectors also providing quality of health care services to the community • It is essential to understand by the peoples for availability of health care in selected area.
Infrastructure Facilities and Linkages • Public sector: • Health centres (SC, PHC, CHC) • Rural hospital • District hospital • Specialized hospital • Teaching hospital • Health insurance( ESI & CGHS) • Defense hospital • Railway hospital
Infrastructure Facilities and Linkages • Private Sector: • Private hospital • Poly Clinics • Nursing home • Dispensaries • General practitioner and clinic
Infrastructure Facilities and Linkages • ISM: • Ayurveda • Yoga and Naturopathy • Unani • Siddha • Homeopathy • VHA: • (WHO, UNICEF, CARE and Red Cross)
Linkages • Definition: • It means referral services • It is a process of sending the patient from one place to another place where they will get better treatment or diagnostic facilities.
Level of Linkage village SC PHC CHC Secondary or tertiary level hospital District hospital Multi specialty hospital
PURPOSES • To provide need based comprehensive care within the technical competencies & resources at each level • To help people avail specialized services. • To provide accurate diagnosis • To provide first aid services • To save the life of patient in emergency
SELECTION OF REFERRAL CASES Category – I: • Fatal patient Category – II: • Serious patient Category – III: • For diagnosis.
CASES REQUIRE IMMEDIATE REFERRAL • Cases presenting any problem which cannot be handled during pregnancy, labor and post natal period. • Severe diarrhea with dehydration • Pain in abdomen and vomiting • Heart burn, dyspepsia, dysphagia, haemetemesis and maleana etc. • Continuous cough with or without sputum, haemoptysis.
CASES REQUIRE IMMEDIATE REFERRAL • Fever with stiff neck. Fever with severe joints pain, rashes, bleeding under the skin. • Breathing difficulty while walking, sleeping, doing physical work. • Chest pain with/without pain in the left arm, restlessness and vomiting. • Jaundice, loss of appetite. • Convulsions with fever. • Coma, paralysis, fracture, severe injury, hemorrhage, poison etc.
REFERRAL FORM • Patient details • Date, place and time of referral • Conditions of patient at the time of referral • Reason for referral • Previous history • Treatment provided • Clinical records if any • Name and detail of M.O
NURSE’S ROLE IN REFERRAL  Observe and collect information about the illness, trauma, related situation, factors etc.  Identifies the nature of illness/emergency and its seriousness.  Provides immediate treatment care within her competence, standing orders and resources available.  Assures the casualty/family members/ any other person accompanying.  Explains about the seriousness of the problem situation and need for reference to the casualty.
NURSE’S ROLE IN REFERRAL  Fills up the referral form as desired and hands over the same with related documents to be given to health professionals in referred health center.  Arranges for transport of the patient according to feasibility as soon as possible.  May do the telephonic consultation or provide information to referred health center.  May accompany the casualty/patient if required and feasible.  Maintains the records and reports.  Provides follow up care as per treatment and instructions prescribed by the referral unit.
Acts regulating the environment: (National Pollution control board) Introduction: • The ministry of environment & forest – formulate • Protect the environment • Maintain nature and prevent hazards • Control human activities from destroy
Acts Related to environmental protection 1. EPA (1986) 2. Indian forest act 1927 3. The wild life protection act 1972 4. Indian fisheries act 1897 5. River board act 1956 6. Water (prevention and control of pollution) act 1974 7. Air (prevention and control of pollution) act 1981 8. The atomic energy act 1982 9. The motor vehicles act 1988 10.Bio medical waste act 1988 11.Noise pollution control act 2002
EPA (1986): • Protect and improve environment quality, control and reduce pollution from all sources Indian forest act 1927: • Protection and conservation of forest The wild life protection act 1972: • Provides for the protection of birds, animals and plants and all resources in forest
Indian fisheries act 1897: • Maintain coastal or inland with intend to prevent destroy of fish River board act 1956: • Maintain cleanliness and prevention of river pollution Water (prevention and control of pollution) act 1974: • Prevention and control of Water pollution Air (prevention and control of pollution) act 1981: • Prevention and control of Air pollution
The atomic energy act 1982: • Control of radio active substances in environment The motor vehicles act 1988: • Control of motor vehicles related pollution in environment Bio medical waste act 1988: • Proper waste disposal from health care settings Noise pollution control act 2002: • Prevention and control of noise due to all sources
National Pollution Control Board Introduction: • 1974 • Also known – central pollution control board (CPCB) • Under water act, ministry of environment and forest • Prevent and control of water pollution
Objectives- NPCB To Advice central govt prevent & control of water pollution To Guide all the state board To Organize raining programme To Collect and publish data To Organize mass media programme To Set standard for water quality To provide Lab analysis for water quality
Functions - NPCB 1. Surveillance of water and air quality 2. Monitor and guide state board 3. Inspection of industries 4. Interstate river monitoring 5. Organizing mass awareness 6. Inspection of pollutions 7. Lab services for water quality 8. Prevention and control of pollution 9. Publishing data
Bacterial & viral: Agents, host carriers and immunity • Introduction: • The diseases are caused by micro organism • It may be bacteria or virus or fungus or other organisms • It is necessary to understand about the causative agents for easy diagnosis and treatment • Immunity is the essential power of the body to prevent the occurrence of the disease • The study of distribution and determinants of the disease is called Epidemiology
Agents Agent: • The causative factor for disease Types: • Biological: (micro-organisms) • Physical: (temperature, radiation, trauma, others) • Chemical: (acids, alkalis, poisons, tobacco, medications / drugs, others) • Environmental: (nutrients in diet, allergens, others) • Nutritional: (under- or over-nutrition) • Psychological: experiences
Host who is vulnerable to suffering from disease. Its depends upon • Genetic • Immunologic state • Personal behavior: (life-style factors): diet, tobacco use, exercise, etc • Personal characteristics: Age, gender, socio- economic status, etc.
Carriers • A carrier is defined as an infected person or animal that harbors' a specific infectious agent and serves as a potential source of infection for others. • Classification of carriers: A. Type: i)Incubatory ii)Convalescent iii)Healthy B. Duration: i)Temporary ii)Chronic C. Portal Of Exit: i)Urinary ii)Intestinal iii)Respiratory iv)Others
Immunity • It is a resistance power of host to fight against micro organism • It may be Natural • From birth onwards Acquired • During life time
Arthropods and Rodents Arthropods: • It is a type of living thins with no spine, having an exoskeleton, legs joined together and body divided into different parts and causes many diseases in human beings Types: Insecta (hexapoda): • Mosquitoes, flies, bugs, fleas Arachnida (octopodsa): • Scorpion, spiders, ticks and mites Crustacea: Cyclops:
Characteristics of arthropods Exoskeleton: • No internal bones and strong outer skin Segmental bodies: • Bodies separated into different parts, the number segments depends on the species Jointed appendages: • All the limbs attached to their exoskeleton Bilateral symmetry: • Arthropod body can be divided vertically into two mirror image Open circulatory system: Circulatory system is open without any blood vessels
Arthropods borne diseases Bacterial: • Plague Viral: • Yellow fever • Encephalitis • Dengue fever Parasitic: • Malaria • Filaira Others: • Typhus • Q fever • Relapsing fever
Prevention and control of arthropods Early diagnosis and treatment: Environmental measures: : • Control of breeding place • Sanitation • Proper waste disposal Personal protection measures: • Mosquito net, coils, body lotion and bat • Repellants • Blue light fly killer • Clothing • hygiene
Prevention and control of arthropods Chemical measures: • Insecticides (DDT) • Biological measures: • Growing of larva fishes Health education: Vaccines:
Rodents Definition: • Rodents are small mammals with large, sharp front teeth which may causes some of the disease in human Example: • Rats, mice and squirrels Types: • Wild rodents • Domestic rodents
Characteristics • The majority of rodents have tails, which can be of many shapes and sizes, The tail is sometimes used for communication, • Rodents generally have well-developed senses of smell, hearing, and vision. • Rodents have efficient digestive systems
Types 1. Domestic rodents 2. Wild rodents Domestic rodents: Living in houses Wild rodents: Living forests
Food hygiene: Production, Preservation, Purchase, Preparation, Consumption • Food hygiene are the conditions and measures necessary to ensure the safety of food from production to consumption • Food can be contaminated at any point during harvesting, processing, storage, distribution, transportation and preparation • Lack of food hygiene can leads to food borne diseases.
Food hygiene • Milk hygiene • Meat hygiene • Fish hygiene • Egg hygiene • Vegetables and fruits hygiene • Food handler hygiene • Sanitation of eating places
Food hygiene-Production • Proper harvesting and cultivation • Minimal use of fertilizer and insecticides • Registered food business • Correct label and description • Regular inspection on food manufacturer and retailers • Strict hygiene in restaurant and food premises • Food is safe to eat • Prevent the source of food contamination
Food preservation • Proper storage • Prevent contamination • Avoid the growth of micro organism • Proper and minimal handling • Maintain proper temperature • Ventilation • Avoid vectors and rodents • Personal hygiene • Close the food container • Kitchen hygiene
Food preservation Methods: • Drying • Refrigerator • Freezing • Vaccum packing • Salt • Sugaring • Smoking • Artificial food additives • Pickling • Canning • Jellying • Irradiation
Food Purchase • Production cost • The season • Market supply • Demands • Advertisement • Amount of processing
Guidelines for purchase Make shopping list Type and location of market Compare prices Assess the quality Buy foods in bulk Check expiry Check crack or open Check freshness (vegetable and fruits) Properly store Prevent contamination
Food Preparation • It means cooking • Cook thoroughly • Eat cooked food immediately • Avoid contact – raw food & cooked food • Choose food processed for safety • Hand hygiene • Dry and clean kitchen • Use safe water
Food Preparation methods • Boiling • Steaming • Grilling • Baking • Dry frying • Shallow frying • Stir frying • Deep frying • Roasting • Simmering • Broiling • Braising • Stewing
Boiling: • Transfer heat from liquid to the food Steaming: • Convection for transferring heat from the steam to the food Grilling: • Cooking by using the heat from below sources Roasting and baking: • Process of surrounding a food with dry heated air in an enclosed area.
Dry frying: • Does not require oil Shallow frying: • Uses very little oil Stir frying: • Does not require more oil & involve stirring of small pieces of food Deep frying: • Food is submerged in oil Simmering: • Cooked in hot liquid just below boiling point
Broiling: • Cooking by using the heat from above sources Poaching: Uses convection of transfer heat to cook food that no need of high temperature Braising: • Uses dry and moist heat Stewing: • Similar to braising but used on smaller cuts of meat& cooking time is shorter
Food Consumption  Consume Properly cooked food  Cover the food properly  Hand hygiene  Do not sneeze or cough  Kitchen hygiene  Hygienic eating place  Use clean utensils  Do Not eat stored food for long time
Food Consumption  Do not waste the food  Easily digestible  Eat the food immediately after cooking  Protect from vectors and flies  Avoid food contamination  Prevent food poisoning and food borne diseases  Proper disposal of waste food  Appropriate washing and cleaning
Acts regulating food hygiene- Prevention of food adulteration act, drugs and cosmetic act • The food safety and standards act 2006 is regulating the food hygiene • It regulate food manufacture, storage, distribution, sale, import, export and quality of food items • It is also helps to control the food adulteration process. • Any food products fails to follow these regulation liable to punishments
Act related to food hygiene 1. Prevention of food adulteration act – 1954 2. Fruits products order – 1955 3. Meat food products order – 1973 4. Vegetables oil products (control) order – 1947 5. Edible oil packaging (regulation) order – 1988 6. Milk and milk products order – 1992 7. Any order under essential commodities act- 1955 relating to food
Prevention of food adulteration act • Food Adulteration: • Any unwanted materials or substances that added to food items which affect the quality of food and causes serious health consequences. • Administrative bodies: 1. Central committee for food standards 2. Central food laboratory 3. Public analyst 4. Food inspector
Prevention of food adulteration act • It was formulated in 1954 and implemented in 1955 • Objectives: • To make provision for the prevention of adulteration of food • To prevent import, manufacture, sale or distribution of adulterated and misbranded food • To prevent all types of food adulterations
Sample and analysis • Any food inspector can check the quality of food items • A sample will be collected and send to lab for quality checking • If the food item not met the criteria for quality that manufacture will get the notification • Failure in improving the quality of food items after notice will be punished according to PFAA
Common food adulterants Food items Adulterants Milk water & starch Edible oil Argemone oil, mineral & castor oil Sugar chalk powder Tea Exhausted tea leaves, black gram dhal Pulses Khesari dhal, clay, stone, gravel Ghee vanaspati, sweet potato, Chilli powder red brick powder, artificial color Coffee powder Tamarind seed, date seed powder Black powder Papaya seeds and light berries
Common food adulterants Food items Adulterants Turmeric powder Yellow aniline dyes Sweets, juices, jam (metanil yellow) Jaggery Washing soda, chalk powder Honey (sugar plus water) Butter and Cream Beef fat Ice cream Washing powder i Paneer Starch and washing powder i Wheat Flour: Chalk powder, barn dust and sand Vegetables: Copper salts are added to color the vegetables with green.
Punishment under PFAA • a penalty up to 10 lakh would be imposed for sale or distributed unhygienic and adulterated food • The accused will get minimum 6 months or life imprisonment depends upon the nature of consequences • Fine between 500 to 5000 or depends upon the nature of consequences
Drugs and Cosmetic act The Drugs and Cosmetics Act, 1940 is an Act of the Parliament of India which regulates the import, manufacture and distribution of drugs in India
Amendments • The Drugs (Amendment) Act, 1955 • The Drugs (Amendment) Act, 1960 • The Drugs (Amendment) Act, 1962 • The Drugs and Cosmetics (Amendment) Act, 1964 • The Drugs and Cosmetics (Amendment) Act, 1972 • The Drugs and Cosmetics (Amendment) Act, 1982 • The Drugs and Cosmetics (Amendment) Act, 1986 • The Drugs and Cosmetics (Amendment) Act, 1995
Objectives • To regulate the import, manufacture, distribution and sale of drugs & cosmetics through licensing. • To prevent substandard in drugs. • To regulate the manufacture and sale of Ayurvedic, Siddha and Unani drugs. • To establish Drugs Technical Advisory Board(DTAB) and Drugs Consultative Committees(DCC) for Allopathic and allied drugs and cosmetics. • To maintain quality of drugs and cosmetics
Drugs and Cosmetic Drugs : All medicines for internal or external use of human beings or animals and all substances intended to be used for or in the diagnosis, treatment, or prevention of any disease or disorder in human beings or animals. Cosmetic : Any article intended to be rubbed, poured, sprinkled or sprayed on, or introduced into, or otherwise applied to, the human body or any part thereof for cleansing, beautifying, promoting attractiveness, or altering the appearance.
Alteration of Drugs and Cosmetic Misbranded drugs : • (a) if it is so coloured, coated, powdered or polished that damage or • (b) if it is not labeled in the prescribed manner. Adulterated drug : • (a) if it consists, in whole or in part, of any filthy, putrid or decomposed substance; or • (b) if it has been prepared, packed or stored under insanitary conditions or • (c) if its container is composed in whole or in part, of any poisonous or deleterious substance
Alteration of Drugs and Cosmetic Spurious drugs : (a) if it is imported under a name which belongs to another drug; or (b) if it is an imitation of, or a substitute for, another drug or resembles another drug in a manner Manufacture : In relation to any drug or cosmetic, it includes any process or part of a process for making, altering, ornamenting, finishing, packing, labeling, breaking up or otherwise treating or adopting any drug or cosmetic with a view to its sale or distribution but does not include the compounding or dispensing of any drug Patent or Proprietary medicine : any drug not included in the edition of the Indian Pharmacopoeia for the time being or any other Pharmacopoeia authorized in this behalf by the Central Government.
Administration of the act and rules I. Advisory : 1. Drugs Technical Advisory Board-DTAB 2. Drugs Consultative Committee-D.C.C.B) II. Analytical : 1. Central Drugs Laboratory - CDL 2. Drug Control Laboratory in states 3. Government Analysts III. Executives : 1. Licensing authorities 2. Controlling authorities 3. Drug Inspectors
Penalties-Drugs and Cosmetic act • Penalties related to Import of spurious drug: 3 years imprisonment and 5000 Rs. fine on first involves risk to human beings or conviction animals • 5 years imprisonment OR therapeutic values 1000 Rs. fine OR both for serious consequences • 1 year imprisonment OR 1000 Rs. fine for subsequent offence
Penalties-Drugs and Cosmetic act • Penalties related to Manufacture:1-3 years imprisonment and Rs.5000 fine for first time • 2-6 years imprisonment & Rs.10000 fine on subsequent conviction Manufacture of adulterated drugs.
Drugs and Cosmetics (Amendment)Act, 2008Salient features of the Act • Substantial enhancement in punishment • Life imprisonment for offenders involved in manufacture, sale and distribution of spurious and adulterated drug likely to cause grievous hurt • Minimum punishment of seven years which may extend to life imprisonment • Provision for compensation to affected person
Socio-cultural Aspects: • Customs: • It means practices or behaviors which is accepted by the society as per social norms, it may transmitted from one generation to next generation • Customs in society: Customs related to hygiene Customs related to religion Customs related to nutrition Customs related to festivals Customs related to marriage Customs related to cloth Customs related to sex Customs related to language Customs related to child birth Customs related to life style
Taboos Definition: • The behaviors or action of the peoples which are not accepted or restricted by the society Examples: • Social taboos • Religious taboos • Nutritional taboos • Ritual taboos • Sexual taboos • Educational taboos • Marital taboos
Marriage System • Marriage is one of the universal social institution. • It is established by the human society to control and regulate the sex life of human. • It is closely connected with the institution of family. • Definition: Marriage is a physical, legal and moral union between man and woman in complete community life for the establishment of a family.
Characteristics of marriage Marriage is a universal social institution Marriage is a permanent bond between husband and wife. It fulfill the social, psychological, biological and religious aims. Marriage is a specific relationship between two individuals of opposite sex Marriage requires social approval.
Characteristics of marriage Marriage establishes family. Marriage creates mutual obligations between husband and wife. Marriage is always associated with some civil and religious ceremony Marriage regulates sex relationship according to prescribed customs and laws. Marriage has certain symbols like ring, special cloths, special sign before the house etc
Types of Marriage • Monogamy • Serial Monogamy • Bigamy • Polygamy: (Polygyny, Polyandry, Group Marriage) • Exogamy • Endogamy • Marriage by mutual understanding • Contractual marriage • Arranged marriage
Types of Marriage • Monogamy: Marriage between one man and one woman. • Serial Monogamy: Having several marriage partners one after the other - not at the same time • Bigamy: having more than one marriage partner at a time. This is illegal • Polygamy or plural : marriage of more than one mate at a given time. It has three forms. 1. Polygyny- one husband and two more wives. 2. Polyandry- one wife and two or more husbands. 3. Group Marriage- marriage of several man to several women
Types of Marriage • Exogamy-marrying outside a community • Endogamy- marrying only within the limits of a local community, • Marriage by mutual understanding: Love marriage • Contractual marriage: marriage for particular period of time • Arranged marriage: Marriage partners selected by parents.
Functions of Marriage 1. Regulation of sex life 2. Marriage leads establishment of family 3. Provides economic cooperation 4. Marriage contributes to emotional and intellectual inter stimulation of the partners 5. Marriage aims at social solidarity Functions of marriage
Problems of Marriage 1. Understanding problems 2. In law misunderstanding 3. Divorce 4. Dowry 5. Family conflict 6. Inter caste marriage 7. Inter state marriage 8. Inter country marriage 9. Unsatisfied family life
Family It is basic unit of community characterized by common residence, economic co-operation and reproduction and socially approved relationship with one or more own or adopted children,
Types • On the basis of family size: 1. Nuclear family 2. Joint family 3. Extended family 4. Single parent family
Family cycle Formation (Marriage) Dissolve (Death of parents) Development (Child birth) Maturity (Growth of children)
Structure of age group in family • Newborn • Infant • Toddler • Preschool • School going • Adolescent • Adult • Old age
Relationship in a family • Father • Mother • Husband • wife • Son • Daughter • Sister • Brother • Grand father • Grand mother • Uncle • Aunt • In laws
Status of special groups • Some of peoples are need to provide special attention in society • They are called vulnerable group or risk group • These group are having the high risk of health and other problems • There are so many welfare services and agencies are available for special group • This group may include Females, Children, Elderly, challenged groups and Sick persons
Status of females • Females are important peoples in our country as they have many roles • They are facing many problems in their daily life • The status of women in India has been subject to many great changes over the past few years • In modern India, women have adorned high offices in India including that of the President, Prime Minister, Speaker of the Lok Sabha and Leader of the Opposition etc • Women in India generally are still exposed to numerous social issues, so need to address and solve them
Problems faced by Indian females and women: • Illiteracy • Poverty • Sexual harassment • Dowry • Child marriage • Female infanticides and sex selective abortions • Domestic violence • Violence at work place • Trafficking • Health problems • Eve teasing • Restriction on widow remarriage • Gender bias • Neglect during childhood
Female and women welfare services • Rajiv Gandhi Scheme for Empowerment of Adolescent Girls (Sabla) • Indira Gandhi Matritva Sahyog Yojana (IGMSY) • Support to Training & Employment Programme for Women (STEP) • Hostel for Working Women (WWH) • Women Empowerment and Livelihood Programme in Mid-Gangetic Plains (Priyadarshini) • Swadhar (Scheme for Women in Difficult Circumstances)
Female and women welfare services • Scheme for Combating Trafficking • Family Counseling Centers (FCCs) • Short Stay Home Programme • Awareness Generation Programme (AGP) • Condensed Courses of Education for Adult Women (CCE) • Integrated Scheme for Women’s Empowerment (ISWE) • Gender Budgeting Scheme (GBS)
Status of children • India has the largest child population in the world. • Children’s Development is as important component and the best way to develop national human resources is to take care of children. • Services and institutions concerned with the physical, social, and psychological well-being of children, particularly children suffering from the effects of poverty or lacking normal parental care and supervision. • The general standard of living, the level of education, and the financial resources of the country are among the factors that determine child welfare standards.
Problems faced by children 1. Child marriage 2. Illiteracy 3. Female feticide 4. Juvenile delinquency 5. Child labour 6. Child abuse 7. Sexual harassments 8. Nutritional problems 9. Developmental problems 10.Poverty 11.Child Trafficking 12.Gender inequality
Child welfare services 1. Indian council for child welfare (ICCW) 2. Central Social Welfare Board. 3. Kasturba Gandhi Memorial Trust 4. Indian Red Cross Society 5. All these agencies get financial aid from government to organize child welfare services in the country. 6. Day Care services by setting Balwadies 7. Holiday home 8. Recreation facilities 9. WHO department of child and Adolescent health and development 10.WHO School Initiative
Child welfare services 1. IMNCI 2. Diarrheal disease control programme (DDCP) 3. Acute respiratory infection control programme 4. National Programme for control of Blindness 5. CSSM 6. Iodine deficiency disorders( IDDs) Programme 7. Family Welfare 8. Child Welfare programme for disabled children 9. Maternal child health and family planning integrated 10.Sarva Shiksha Abhiyan (SSA) 11.District rehabilitation centers
Care of elderly • The care of aged is called geriatrics • Ageing a progressive and generalized impairment of body functions. • People more than 60 yrs are considered elderly. Old age is not a disease but a normal and inevitable biological phenomenon. • Elderly services integrates health care and psychological care with other needed services such as: housing, home care services, nutritional services, assistance with activities of daily living.
Problems during old age • Prone for infections • Prone for injuries • Prone for psychological • Problems prone for degenerative disorders • Increased risk for disease • Increased risk of disability • Increased risk of death • Old age abuse • Neglected by children • Nutritional problems • Economical problems
Services for old age • National policy on older persons policy on older persons January, 1999. • Financial security, • healthcare and nutrition, shelter, education and welfare • protection of life and property etc. • National Council for Older Persons ◦ Constituted by the Ministry of Social Justice and Empowerment • Promotion of public private partnerships in Geriatric Health Care.
Services for old age • Mainstreaming AYUSH Empowerment in the field of geriatrics. • Reorienting medical education to support geriatric issues. • Regional Geriatric Centers (RGC) • Regional Medical Institutions • Post-graduates in Geriatric Medicine • District Geriatric Units • Geriatric Clinics/Rehabilitation units/Sub centers • Old age homes • Pension and many scheme from government
Status of Challenged peoples • A disability is a condition or function of body impaired relative to the usual standard of an individual or their group. • The term is often used to refer to individual functioning, including physical impairment, sensory impairment, cognitive impairment, intellectual impairment or mental health issue
Status of Challenged peoples • Blindness • Low vision • Leprosy-cured • Hearing impairment • Locomotors disability • Mental retardation • Mental illness
Services for disabled • Early Intervention • Counseling & Medical Rehabilitation • Increasing the independence of the disables • Suitable Education (Integrated, Special) • Vocational training • Vocational rehabilitation of the Disables: Sheltered employment, Open Employment, Self-Employment • Appropriate leisure time activities. a) Sports, Recreation and Cultural life • Care Group, Old Age Homes. • Community Based Rehabilitation
Government scheme and benefits • Disability certificate and identity card concessions/benefits. • Education programmes for children with concessions • Children's Education Allowance and Scholarships • Assistance for purchase/fitting of aids and appliances • Preference in allotment • Employment • National awards for people with disabilities • Incentives to private sector employers for handicaps; • Reservation of jobs and other facilities for medicine and rehabilitation • Economic assistance • Grant-in-aid schemes of the Ministry of Social
Care of Sick persons • Sickness weakens the body. • To gain strength and get well quickly, special care is needed. • The care a sick person receives is frequently the most important part of his treatment. • Medicines are often not necessary. But good care is always important
Need of caring for sick people • A sick person needs love and constant encouragement. • A person who is sick should rest in a quiet, comfortable place with plenty of fresh air and light. • Need divertional therapy • prevent from getting too hot or cold. • If the air is cold or the person is chilled, cover them with a sheet or blanket. • If the room is hot, or the person has a fever, they may need only a light sheet over them. • Need fluid and electrolyte balance
Need of caring for sick people • Sleeping • Nutritional • elimination • Caring for a sick person at home is less costly and one can focus on the patient more. • At home, patients are more comfortable and are able to regain good health. • Everyone just needs to learn the basics of home care
Care of sick person Rest and sleep Liquids Proper diet Elimination Ventilation  Personal Cleanliness Airway Circulation Monitor vital signs Treatment of symptoms Health education Medical advice if necessary
Life Style • Lifestyle means the way in which a person lives. • Lifestyle includes the behavior and activities that make up your daily life. This includes: 1. The work you do, 2. Your leisure activities 3. The food you eat 4. your interaction with family, friends, neighbours, co workers and strangers.
Life Style • Lifestyle changes are defined as changes that alter various lifestyle-related behaviors such as diet, physical activity, smoking, alcohol consumption and other behaviors. • Lifestyle changes may often relate to physical and health mental conditions such as various disorders, obesity, asthma, sexually transmitted diseases, depression, and anxiety.
Healthy life style 1. Diet 2. Physical activity 3. Control obesity 4. Habits 5. Hygiene 6. Avoidance of Pollution 7. Mental health 8. Sleeping pattern 9. Recreation 10.Frequent health check up
Healthy life style • Diet: balanced diet, nutritional requirements, food hygiene and avoid food poisoning • Physical activity: Active exercise • Control obesity: controlling obesity helps to prevent many health problems • Habits: good habits – health: bad habits- smoking, alcoholism and drug addiction • Hygiene: Personal, environmental, food hygiene
Healthy life style • Avoidance of Pollution: helps to prevent many diseases, ex- water pollution ( water borne disease) air pollution ( air borne disease) • Mental health: healthy mind helps to relax and reduce stress and mental illness • Sleeping pattern: promote relaxation and rest • Recreation: Promote mental health and happy life • Frequent health check up: helps to identify physiological and psychological abnormalities.
Hygiene • It is Cleanliness or the practice of keeping yourself and your surroundings clean, especially in order to prevent illness or the spread of diseases. • Types: 1. Personal hygiene 2. Environmental hygiene 3. Food hygiene
Personal hygiene Definition: Personal hygiene may be described as the principle of maintaining cleanliness and grooming of the external body. It includes the Regular Routine of Personal Care of following things: 1. Washing and Grooming of Hair 2. Face and Skin 3. Teeth 4. Ears 5. Hands 6. Nails 7. Feet
Hair Care Wash regularly with shampoo. Rinse hair thoroughly with clear water after shampooing to remove all the soap Don't scrub or rub too hard . It may irritate your scalp or damage your hair. Massage your scalp well. It will remove dead skin cells, excess oil and dirt Brush hair daily, Wash combs and brushes frequently, Don’t share combs, brushes etc. Brushing helps keep the scalp clean by loosening and removing dust and dead cells. It also adds shine
Skin care • Daily baths or showers using soap and scrubbing the entire body with a washcloth • Wash the face two times a day with a mild soap or gentle cleanser. It is best to Use lotions only if needed • Try to stay out of the sun, and use a sunscreen every day during summer and winter. • Wear clean clothes & Maintain a healthy diet • Don’t squeeze or pick the pimples, Try to avoid touching the face & Keep hands clean by washing them often • Drink plenty of fluids. • Protect yourself from UV Rays
Care of teeth • Daily dental hygiene routine that consist of brushing for 2-4 minutes and flossing • If possible, brush after every meal or rinse your mouth with warm water. Use a soft-bristled brush. • Replace your toothbrush every 2-3 months or after an illness. • Use toothpaste that contains fluoride. Flossing removes food trapped between your teeth and gum lines that rinsing and brushing miss. • Eat at least 5 servings of fruits and vegetables each day. • Include foods that contain calcium, such as milk and yogurt, Limit intake of sugar. • See a dentist every 6 months
Care of Ears • Wash ears daily with a wash cloth don’t forget behind the ears • Remove ear plug • Avoid foreign bodies in the ear • Avoid infection in the in the middle ear • Consult doctor if severe pain or abnormalities
Care of Hands • First, wet hands and apply liquid or clean bar of soap. • Next, rub your hands together and scrub all surfaces (palms, fingers, and in between). • Continue for 10-15 seconds. Soap combined with the scrubbing action that helps remove germs. • Rinse well and dry your hands.
Nail Care • Without proper care they can become weak, ingrown or infected. • Keep nails trim but do not cut nails shorter than skin level. • Keep nails clean. • Round your fingernails slightly when trimming them. • Cut toe nails straight across. • Smooth rough nail edges with a file or emery board.
Feet Care • Large collection of sweat glands live in our feet • Wash your feet well at least once a day. • Dry them carefully, especially between the toes. • Keep feet and skin clean and dry • Change socks daily • Avoid walking barefoot in public areas
Environmental hygiene • It is that branch of public health that is concerned with the control of all those factors in man’s surroundings or physical environment which may have deleterious effect on human health and wellbeing
Environmental hygiene Safe Water supply Waste management pollution control Vector control Occupational health Standard Housing Urban planning Accident prevention Public recreation and tourism Sanitation measures during epidemics, emergencies, disaster and population migration Wildlife and forest conservation.
Food hygiene • Protecting food from risk of contamination, including harmful bacteria, poison and other foreign bodies • Milk hygiene • Meat hygiene • Egg hygiene • Fish hygiene • Vegetables and fruits hygiene • Hygienic practices during production, transportation, distribution, purchasing, sale, preparation, storage and consumption
Physical activity Any form of exercise or movement. Physical activity may include planned activity such as walking, running, basketball, or other sports. Physical activity may also include other daily activities such as household chores, yard work, walking the dog, etc.
Types of physical activity • Physical activity are generally grouped into three types 1. Flexibility exercises: such as stretching, improve the range of motion of muscles and joints. 2. Aerobic exercises: such as cycling, swimming, walking, skipping rope, rowing, running, hiking or playing tennis, focus on increasing cardiovascular endurance. 3. Anaerobic exercises: such as weight training, functional training, eccentric training or sprinting, increase short-term muscle strength.
Opportunities for Physical Activity • At work • For transport • In domestic duties • In leisure time
Benefits of Physical Activity Promotes health and fitness Builds healthy bones and muscles1 Reduces the risk of developing obesity and risk factors for diseases Reduces the symptoms of anxiety and depression Can positively affect concentration, memory, and classroom behavior Helps control weight. Helps reduce blood pressure in people who already have high blood pressure. Causes the development of new blood vessels in the heart and other muscles. Enlarges the arteries that supply blood to the heart.
Problems due to inactive 1. Coronary Heart Disease (CHD) 2. Stroke 3. Obesity 4. Type II Diabetes 5. Hypertension 6. Colorectal cancer 7. Stress and Anxiety 8. Osteo-arthritis 9. Osteoporosis 10.Low back pain
Recreation and sleep • Recreation is the expenditure of time with an intent to gain some refreshment. • It is a break from monotony and a diversion from the daily routine. • It is a positive change from the stereotypical lifestyle and involves an active participation in some entertaining activity.
Uses • Broader understanding experiences • learn more functional responses • Creative thinking • Mental Health • Physical Health and Growth • Emotional Stability • Social Fitness • Psychological Awareness
Types of Recreational Activities 1. Physical 2. Social 3. Cultural 4. Intellectual
Types of Recreational Activities • Physical: Minor Sports, Group Games, Camping and Outing • Social : Social dancing , Attending parties , Joining Parlor Games and the likes • Cultural : Arts and crafts, Joining Glee Club or Music Ministries and Choirs, Dramatic guilds, Dance Troupes • Intellectual: Song, Poetry , Jingle, Short Story Writing , Internet Surfing, Answering Puzzle, Playing Scrabble, Bowling, Chess, Dart, etc.
Benefits for students • Everyone needs to plan and best utilize daily free time for recreation. • Recreate the body, mind, and spirit through and through Bring forth renewed vigor, spirit, and creative effort • Recreational activities gives you opportunity to be creative, to express your basic needs, and to be your real self. • All work and no play makes a person not only dull but a sick, unbalanced, and unhappy individual according to medical authorities. • Students who correctly balance work and play are more productive and tend to be in better physical, mental, social, and emotional health. • Better chances of being successful.
Benefits • These will help them build a lifelong habit. • Recreational activities like sports will develop muscular strength, agility, power, flexibility, and improve one’s health. • Engaging in group activities develops social skills that will lead to the development of proper conduct and behavior and social graces. • Worthwhile recreational activities give students or youth opportunities to be busy with meaningful activities instead of roaming around and doing harmful vices like abusing dangerous drugs. • Other Values that you can derive from engaging in worthwhile recreational activities.
SLEEP • DEFINITION OF SLEEP: Sleep is a naturally occurring altered state of consciousness characterized by decreases in awareness and responsiveness to stimuli.
PHYSIOLOGY OF SLEEP • Controlled by reticular-activating system and bulbar synchronizing system. • Wakefulness occurs when the reticular system is activated. • The hypothalamus has control centers sleeping and waking. • Injury to the hypothalamus may cause a person to sleep for abnormally long periods.
CIRCADIAN RHYTHMS: • Biological rhythms that follow a cycle of about 24 hours are termed circadian rhythms • Circa means ―about and dies means ―day • Circadian synchronization exists when an individual sleep-wake pattern follows an inner biological clock. • When physiologic and psychological rhythms are high or most active, the person is awake and when these rhythms are low, the person will sleep
Average amount of sleep per day  Newborn – up to 18 hours  1–12 months – 14 to18 hours  1–3 years – 2 to15 hours  3–5 years – 11to13 hours  5–12 years – 9 to11 hours  Adolescents – 9 to10 hours  Adults, elder – 7 to 8 (+) hours  Pregnant women – 8 (+) hours
SLEEP HYGEINE • Avoid napping during the day. • Avoid stimulants. • Exercise. • Food. • Ensure adequate exposure to natural light. • Establish a regular bedtime routine. • Try to avoid emotionally upsets before sleep. • Associate your bed with sleep. • Sleep environment is pleasant and relaxing.
FACTORS AFFECTING SLEEP Physical activity Psychological stress Motivation Diet Alcohol Intake Smoking Environmental Factors Lifestyle Illness Medications
SLEEP DISORDERS • Insomnia: it is troubling or difficulty in falling asleep • Narcolepsy: Narcolepsy is a condition characterized by an uncontrollable desire to sleep features • Hypersomnia: Hypersomnia is a condition characterized by excessive sleep, particularly during the day. • Sleep apnea syndrome: Sleep apnea refers to periods of no breathing between snoring intervals. • Periodic limb movement disorder: it is also called nocturnal myoclonus. In this syndrome, sleep is disturbed by repetitive jerky flexion movements of the limbs which occurs in the early stages of sleep • Restless leg syndrome: Unpleasant sensations in the legs that are ameliorated by moving the legs occur when patient tired in the evenings and at the onset of sleep
Sexual life • Sexuality is more than genital physical activity. Sexuality encompasses our whole being. • It includes our sense of femaleness and maleness. • Sexuality includes biological, sociological, psychological, spiritual, and cultural dimensions of each person’s being. • In addition, sexuality influenced by values, attitudes, behaviors, relationships with others and the need to establish emotional closeness with others.
Sexual Rights 1. The right to sexual freedom. 2. The right to sexual privacy 3. The right to sexual equity 4. The right to sexual pleasure 5. The right to emotional sexual expression 6. The right to sexually associate freely and safely 7. The right to make free & responsible reproductive choices 8. The right to sexual information based upon scientific enquiry 9. The right to comprehensive sexuality education 10.The right to sexual health care
Sexual health • Sexual health as the state complete well being related to sexuality • Sexual health requires a positive, respectful approach to the sexuality • Sexual relationships, • Safe sexual experiences, discrimination & violence.
Responsible sexual behavior • Responsible sexual behaviors is expressed at individual, interpersonal & community levels. • It is characterized by: Autonomy Mutuality Honesty Respectfulness Consent Protection Pursuit of pleasure Wellness
Sexual development • At birth: gender assigned. • It is common for 18 month old to play with genitals • 3years: gender identification. • School age: gender role behavior is learned • 6-12years: identification with gender parent, both parents • Adolescence: primary & secondary sexual characteristic develop. • Young adulthood (20-40yrs): sexually active. • Adulthood 40-65yrs: Less hormone production, sexually active and less active after 60 years
Sexual orientation • Sexual orientation refers to a person’s sense of personal & social identity based on those attractions, behaviors expressing them, & membership in a community of others who share them • Types: 1. Heterosexual 2. Homosexual 3. Bisexual
Contraceptive • There are numerous contraceptive options available to prevent the pregnancy and STD • Examples: 1. Barrier methods 2. Hormonal methods 3. Intrauterine methods 4. Behavioral methods 5. Sterilization
Factors influencing on sexual life • Culture: dress, rule of marriage, role of behavior, religious values & guidelines • Personal ethics: unwritten code of conduct based upon ethical principles • Health status: Pregnancy - Menstruation • Problems that interfere with sexuality: medication side effects, MI, STD, Chronic pain, Joint diseases, Surgery.Sexual dysfunctions
Sexual disorders • Sexual desire disorders: Hypoactive sexual desire disorder and Sexual aversion disorder • Sexual arousal disorders: Female sexual arousal disorder • Male erectile disorder • Orgasmic disorders: Female orgasmic disorder and Male orgasmic disorder • Premature ejaculation • Sexual pain disorders
Spiritual life philosophy • Spirituality refers to a belief in a higher power, an awareness of life and its meaning, the centering of a person with purpose in life. • It involves relationships with a higher being, with self, and with the world around the individual. • Spirituality implies living with moral standards.
Five basic spiritual needs of every person: 1. A meaningful philosophy of life (values, and moral sense). 2. A sense of the transcendent (outside of self, view of God and something beyond the immediate life, having hope.) 3. A trusting relationship with God (faith). 4. A relatedness to nature and people (friendship). Experiencing love and forgiveness. 5. A sense of life meaning.
Spiritual philosophy concept • Healthy relationships, treating ourselves and others with respect, honesty, integrity, and love, are a sign of spiritual well-being. • Values are our principles—not only the things we say we care about, but also the things that cause us to behave the way we do. • People who are spiritually healthy are able to articulate their purpose in life, and make choices that manifest that purpose.
Spiritual Health Contributes to Physical Health  Can improve immune function, cardiovascular function, and/or other physiological changes.  Americans who attend religious services regularly live many years longer, on average, than those who do not.  People who are more spiritually healthy exhibit greater self-control.  Those who are spiritually healthy may also be more disciplined about getting adequate exercise and sleep.
Spiritual or Religious Well-Being Improves Quality of Life By decreasing anxiety, depression, anger, discomfort, and feelings of isolation By decreasing alcohol and drug abuse By decreasing blood pressure and the risk of heart disease By increasing the ability to cope with the effects of illness and with medical treatments By increasing feelings of hope, optimism, freedom from regret, satisfaction with life, and inner peace
Spiritual Health Contributes to Psychosocial Health Current research suggests spiritual health reduces levels of anxiety and depression. Yoga, deep meditation, and prayer can positively affect brain chemistry. Charitable organizations and social gatherings can help members avoid isolation and find support in a spiritual community.
Spiritual Health Contributes to Reduced Stress Stress reduction is one probable mechanism among spiritually healthy people for improved health and longevity, and for coping more effectively with illness. Positive religious coping supports effective stress management. Increasing mindfulness through meditation reduces stress levels not only in people with physical and mental disorders, but in healthy people as well.
Self reliance • Reliance on one's own efforts and abilities. • It means ability to reliant of an individual on his own without depend on anyone • Self-reliance is defined by independence. It is the ability to think and act without the help or influence of others, the ability to decide what you should be or do. • Dependency is the act of relying on others to make decisions for an individual.
Factors influencing on self reliance 1. Educational 2. Employment 3. Socio economic status 4. Nutrition 5. Personality 6. Human value 7. Human relationship 8. Hygiene 9. Health status 10.Spiritual and religion
Dietary pattern
Importance
Diet therapy • Diet therapy is modification or alteration in diet according to disease condition of patient. • Example: diet for Dm, Diet for HT, Diet for GIT problems, Diet for kidney disease, Diet for liver disease • Diet for Dm – sugar restricted and Diet for HT – Salt restricted diet..
Education • Education is the process of acquiring knowledge through different sources • The sources may be teacher, text books, articles, internet etc..
Importance of education 1. Behavior modification 2. Learning 3. Improving knowledge 4. Not restricted only in school 5. Life long process 6. Employment 7. Improving socio economic status 8. Helps to meet basic needs 9. Develop personality 10.Maintain health 11.Creativity
Level of education Pre primary ( Pre KG, LKG, UKG) Primary level (1to 5th) Middle level (6 to 8) High school (9 & 10) Higher ( 11 & 12) UG PG M.phil PhD Vocational education and training
Educational methods • The method of teaching is called pedagogy • Story telling • Discussion • Teaching • Training • Research • Field trips
Formal and informal education 1. Formal education occurs in a structured environment (class room) 2. Informal education: occurs in home or work place 3. Special education: for disabled children 4. Open education: learn by own effort without guidance
Challenges of Present Education System Lack of will to learn Quality of teaching Infra structure Reservation Distance of educational facility Socio economical status Educational policy
Government schemes • Free Education • Sarva Shiksha Abhiyan ( Education for all) • Mid day meal programme • Right to education (RTE) • National policy on education • Free uniforms, books, notes and other materials • Adult education • Established so many institute for education (IIT,AIIMS)
Occupation •It means involving in any job or work to earn money in order to meet all basic needs of human life •Job or profession or career or work
Classification of occupation I: 1. Professional 2. Employment 3. Business II: 1. Full time 2. Part time 3. Day job III: 1. Temporary 2. Permanent 3. Seasonal 4. Self employment 5. Consultation 6. Contract
Examples for jobs  Teacher  Doctor  Nurse  Policeman  Farmer  Fireman  Tailor  Painter  Mechanic  Electrician  Postman  Gardner  Officials  fisherman  Driver  Photographer  Pilot  Dentist  Cook  Musician  Journalist  Lawyer
Requirement for Good Occupation 1. Education 2. Knowledge 3. Skills 4. Service motive 5. Creative thinking 6. Leadership 7. Human relation 8. Discipline 9. Personality
Need for occupation Meet basic needs Earn money Improve socio economic status Maintain social status Gain experiences Socialization Personality development
Income • Income is money or a benefit in kind you receive. • It means Money earned by a person, company or government over particular period of time. • Earn/have/receive (an) income Your hobby could become a part-time way of earning income.
Types- I • Family/household income • Annual/monthly/quarterly income • A high/low income • Additional/extra income • Current/future income • A regular/steady income • Pension/retirement income • Rental income
Types- II 1. Regular 2. Irregular (additional) 3. Benefit-in-Kind 1. Regular Income: Is what you are sure of receiving- You can plan to spend it- E.G. Wages/ Salary/Child Benefit 2. Irregular Income: Is what you are not sure of receiving- You cannot plan to spend it- E.G. Bonus 3. Benefit- in –Kind: Non money income received for work done- Incentive to work hard-
Sources of Income • Wages and Salaries/Allowances • Investment Income • Self-employment • Inheritance • Gifts • Awards • Lottery
National income & Per Capita Income • National Income: National income measures the total value of goods and services produced within the economy over a period of time. • Per Capita Income (PCI): Per Capita Income of a country is derived by dividing the national income of the country by the total population of a country.
Common Employee Benefits Paid Vacation Holidays Paid Sick Days Health Insurance Disability Income Insurance Life Insurance Dental/Vision Insurance Profit Sharing
Factors the Affect Income • Education • training • Experience • Skill • Knowledge • Level of demand • Job opportunities • Seniority • Work habits, • Reliability • Accountability • Performance • Status of employer
Budget • It is a financial plan that shows expected income and expenditure over a certain time period
Aims 1. To ensure money is available to cover costs 2. To Reduce risk of impulse buying 3. To Avoid build up of debt 4. To manage expenses
IMPORTANCE OF BUDGET 1. It sets a frame work for policy formulation 2. Budgeting is a means of policy implementation 3. A budget is a means of legal control 4. It is a tool of accountability 5. It is a tool of management 6. It is an instrument of economic policy
Characteristics 1. Should be flexible. 2. Should be synthesis of past ,present and future. 3. Should be product of joint venture and cooperation at different level 4. Should be in the form of statistical standard laid down in the specific numerical terms. 5. Should have support of top management throughout the period of its planning and implementation.
Types  OPERATING BUDGET(Revenues and Expenses): Provides an overview of planned operation for upcoming year. Deals with salaries, medical-surgical supplies, office supplies, laundry services, books periodicals, recreation and contractual services.  CAPITAL EXPENDITURE BUDGET: Related to long range planning. They are major investment and reduces flexibility in budgeting.  CASH BUDGET: Planned to make adequate funds available and to use extra funds profitably. Should not have too much cash on hand during budgetary period.
Types  LABOR OR PERSONNEL BUDGET: Estimate cost of direct labor necessary to meet agency objectives. Determine the recruitment, hiring, assignment, layoff, discharge of personnel.  FLEXIBLE BUDGET: Some expenses are unpredictable and can be determined only after change has begun. Periodic reviews required to compensate for changes.  STRATEGIC PLANNING BUDGET: Long range budget for long range planning. Projected for 3-5 years. Programme budget is a part of this budget.
STEPS • STEP 1: Establishment of goals and objectives • STEP 2: Goals must be translated into quantifiable management • STEP 3: Formal plan for budget preparation and review • STEP 4: Departmental budget are revised and master budget is prepared. • STEP5: Financial feasibility of master budget is tested • STEP 6: Every head of the office required to prepare budget estimate in respect of salaries of establishment, contingent expenditure and others.eg. Telephone, office expenses, rent of building etc.
Model S. N INCOME EXPENDITURE % Source Amount Expenses Amount 1. Salary 10000 Rent 3000 20% 2. Part time 2000 Food 4000 26% 3. Allowances - Electricity 500 3% 4. Incentives 3000 Medical 2500 16% 5. Others - Saving and others 5000 33%
Purchasing power • The financial ability to buy products and services. • It means available funds to make purchases. • Purchasing power is important because, it is essential to fulfill all the basic needs of individual, family and community
Factors affecting Purchasing Power Education Employment Income Status Tax Socio economic background Cost of goods and services Economical crisis Supply and demand
Purchasing Power Loss/Gain: • Purchasing power loss is an decrease in how much consumers can buy with a given amount of money. • Consumers lose purchasing power when prices increase • Causes of purchasing power loss include government regulations, inflation and natural and manmade disasters. • Purchasing power gain is an increase in how much consumers can buy with a given amount of money. • Consumers gain purchasing power when prices decrease. • Causes of purchasing power gain include deflation and technological innovation.
Security • The financial security is a contract between the provider of funds and the user of funds. • It means maintain or saving money for future utilization in order to avoid economical crisis
Purposes 1. To mange economical condition 2. To solve economical problems 3. To reduce economical burden 4. To save the money for future 5. To maintain economical stability
Types 1. Insurance 2. Health policies 3. Debt Security 4. Equity Security 5. Security bond 6. Bank loan

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  • 1. 2nd Year B.Sc Nursing Community Health Nursing – I Determinants of health By, M. Thiru Murugan
  • 2. Community health nursing – I ( II Bsc.N.)Unit- 2: Determinants of health: • Eugenics • Environment : • Physical : Air, light, Ventilation, Water, Housing, Sanitation; disposal of waste, disposal of dead bodies, Forestation, Noise, Climate, Communication: infrastructure facilities and Linkages • Acts regulating the environment: National Pollution control board • Bacterial & viral: Agents, host carriers and immunity • Arthropods and Rodents
  • 3. ( II Bsc.N.)Unit- 2 • Food hygiene: Production, Preservation, Purchase, Preparation, Consumption • Acts regulating food hygiene- Prevention of food adulteration act, drugs and cosmetic act • Socio-cultural • Customs, taboos • Marriage system • Family structure • Status of special groups; Females, Children, Elderly, challenged groups and Sick persons • Life Style • Hygiene • Physical activity
  • 4. • Recreation and sleep • Sexual life • Spiritual life philosophy • Self reliance • Dietary pattern • Education • Occupation • Financial Management • Income • Budget • Purchasing power • Security
  • 5. Eugenics • Eugenics: humanity can be improved by altering human genotypes or their frequencies • i.e.. evolution of human traits by natural selection could be substituted by evolution through social selection • Positive eugenics - increase frequency of beneficial genes • Negative eugenics - decrease frequency of deleterious genes
  • 6. Positive eugenics • Positive eugenics - increase frequency of beneficial genes Measures: • Sperm banks • Genetic engineering • Parthenogenesis • Cloning
  • 7. Negative eugenics • Negative eugenics - decrease frequency of deleterious genes • 2 - 2.5% of children born in defective - mentally or physically • Two reasons for prevalence of deleterious genes 1. although deleterious in homozygous condition, may produce hybrid vigor in heterozygous 2. frequency of deleterious genes is now high because natural selection has been artificially reduced
  • 8. New Eugenics methods: 1. Artificial insemination by donor 2. Egg donation 3. Prenatal diagnosis of genetic disorders and pregnancy terminations of defective fetuses 4. Embryo selection 5. Genetic engineering 6. Gene therapy 7. Cloning
  • 9. Eugenics policies and programs  Genetic screening  Birth control  Promoting differential birth rates  Marriage restrictions  Immigration control  Segregation (both racial segregation as well as segregation of the mentally ill from the normal)  Compulsory sterilization  Forced abortions  Genocide (efforts to destroy a national, ethnic, racial, or religious group of people either entirely or a substantial portion)
  • 10. Environment • Definition: The surroundings or conditions in which a person, animal, or plant lives or operates. • Types of Environment: There are mainly three types of environment- 1. The Physical environment: 2. Biotic environment 3. Social or cultural environment
  • 11. 1.The Physical environment: • It is also known as a-biotic environment and natural environment. • The meaning of ‘a-biotic’ or ‘physical’ is non living like land water air conditions atmosphere which constitutes of soil. So we can say that physical or a-biotic environment is the environment which includes non living or physical things which are constitutes of soil and affect the living things.
  • 12. 2. Biotic environment • It is also known as biological environment and organic environment. • In the opposite side of the physical environment, the biotic or biological environment is responsible for the living beings. • You have already understood that the meaning of ‘biological’ is living things. So, the biological environment is the environment which involves the living part of the earth.
  • 13. 3. Social or cultural environment • This type of environment involves the culture and life style of the human beings. • The social or cultural environment means the environment which is created by the man through his different social and cultural activities and thinking. • The historical, cultural, political, moral, economic aspects of human life constitute to the social or cultural environment
  • 14. Air • Air is a mixture of different gases • Including nitrogen, oxygen, carbon dioxide, water vapour • There are other gases that are useful but come in very small quantities
  • 15. Air is a mixture of GASES. • Atmosphere Every living thing needs air to breathe. We breathe in Oxygen present in the air. The layer of air that surrounds the earth is called an Atmosphere. Atmospheric layer is thick near the ground and gets thinner as we go up. It is difficult to breathe in thinner air and hence the mountaineers carry oxygen cylinders while climbing high mountains like Everest.
  • 16. Composition of Air  By volume, dry air contains  78.09% nitrogen,  20.95% oxygen,  0.93% argon (chemical element),  0.04%carbon dioxide, and  Small amounts of other gases.  Air also contains a variable amount of water vapor
  • 17. Properties of Air Air occupies Space. Air has weight. Air exerts pressure. Air is needed for burning. Air is odorless, tasteless and colorless
  • 18. Air Pollution Definition: • Any visible or invisible particle or gas found in the air that is not part of the original, normal composition. Causes of Air Pollution: • Natural: forest fires, pollen, dust storm • Unnatural: man-made; coal, wood and other fuels used in cars, homes, and factories for energy
  • 19. TYPES OF AIR POLLUTION Outdoor Air Pollution: • Smog • Particulates • Acid Rain • Greenhouse Gases Indoor Air Pollution:
  • 20. Air Pollutants 5 Major Air Pollutants: 1. Carbon Monoxide 2. Sulfur Dioxide 3. Nitrogen Dioxide 4. Particulate Matter 5. Ground Level Ozone
  • 21. EFFECTS & IMPACTS EFFECTS: Human Effects: • e.g. diseases Environmental Effects: • Acid rain • Eutrophication • Haze • Wildlife • Ozone Depletion • Crop and forest damage • Global Climate Change IMPACTS: • Climate System • Health • Economy • Environment • Ecosystem • Forestry • Agriculture
  • 22. Effects of Air Pollution • Asthma and other respiratory diseases. • Lung function decreased and they suffered from respiratory inflammation. • Cancer. • Coughing and wheezing • Damages the immune system, endocrine and reproductive systems. • Higher incidents of heart problems. • Effects of Global Warming • The toxic chemicals released into the air settle into plants and water sources. Animals eat the contaminated plants and drink the water. The poison then travels up the food chain – to us.
  • 23. Light • Light is electromagnetic radiation of a specific wavelength and frequency that is detectable by the human eye.
  • 24. Sources of light 1.Natural light and 2. artificial light Natural: • Sunlight, • Improving sun light; 1. Orientation 2. Removal Of Obstructions 3. Windows 4. Interior Of The Rooms
  • 25. Sources of light Artificial Lighting: There are five systems of artificial lighting 1. Direct 2. Semi-direct 3. Indirect 4. Semi –Indirect 5. Direct- Indirect
  • 26. Sources of light 1.Direct: In direct lighting 90 to 100 per cent of the Light is projected directly towards the working area. 2.Semi Direct: Here 10 to 40 % of the light is projected upwards so that it is reflected back on the object by the ceiling. 3.Indirect: light does not strike a surface directly. because 90 to 100 per cent of the light is projected towards the ceiling and walls. 4.Semi Indirect: Here , 60 to 90% of the light is directed upwards, and the rest downwards. 5.Direct Indirect: Here , light is distributed equally
  • 27. Methods of artificial lighting: Filaments Lamp Fluorescent Lamp Halogen Lamp Arc Lamps Mercury LED light Laser light
  • 28. Properties of light 1. Reflection 2. Refraction 3. Diffraction 4. Interference
  • 29. Properties of light • Reflection: incident ray reflected ray Normal Surface • Refraction: bending of waves when passing from one medium to another. (Under water) • Diffraction: bending of waves around a barrier, depends on the wavelength and size of the opening barrier. (CD surfaces Diffraction) • Interference: When two waves meets, they have an effect with each other. destructive when the crest of one wave meet the trough of the other wave (Thin Films - Bubbles & Oil Slicks)
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  • 31. Criteria for good light Good Lighting is essential for effective vision and puts lesser strain increasing working efficiency. Light Factors: • Sufficiency • Distribution • Absence of Glare • Absence of Sharp Shadows • Steadiness • Color Of Light • Surroundings.
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  • 33. Problems of poor lighting • The main causes of lighting problems are: • Insufficient light - not enough light for the need • Glare - too much light for the need • Improper contrast • Poor distribution, and • Flicker
  • 34. Effect of poor light on health • Headache • Eyestrain • Neck, back, and shoulder strain • Falling, • Slipping • Dropping materials or tools • Depression • Accidents • Inefficient work
  • 35. Ventilation DEFINITION: • It is the process of exchange or circulation of fresh air into room and removal of stale air inside room TYPES OF VENTILATION: 1. Natural Ventilation 2. Mechanical Ventilation
  • 36. Natural Ventilation • Definition: the process of supplying and removing air through an indoor space without using mechanical systems. • Benefits: Improved Indoor air quality (IAQ) Energy savings Reduction of greenhouse gas emissions Occupant control Reduction in occupant illness associated with Sick Building Syndrome Increased worker productivity
  • 37. Criteria for good Natural Ventilation 1. Building orientation and location. 2. Building form and dimensions. 3. Window typologies and operations 4. Types, shape and size of openings 5. Construction methods and detailing; 6. Urban planning consideration
  • 38. Mechanical Ventilation • Definition: mechanical ventilation systems circulate fresh air using ducts and fans rather than relying on airflow through small holes or roof or windows. • Benefits: Better indoor air quality –can remove pollutants, allergens, and moisture that can cause mold problems More control – provide proper fresh air flow along with appropriate locations for intake and exhaust Improved comfort – allow a constant flow of outside air into the home provide filtration, dehumidification, and conditioning of the incoming outside air
  • 39. Mechanical Ventilation • CEILING FANS, TABLE OR FLOOR FANS: Used to circulate air within a room for the purpose of reducing the perceived temperature, because of evaporation of perspiration from the skin of occupants. • EXHAUSTS: The indoor air is extracted out with the help of mechanically driven fans • PLENUM VENTILATION: Comprise air filter, heating and cooling system. Ex: hospital and lab
  • 40. Mechanical Ventilation • AIR CONDITIONING: A system which provides a combination of cooling, ventilation and control of humidity. • DEMAND CONTROLLED VENTILATION: Reduces the energy consumption in a building, while maintaining adequate air quality. • HVAC: stands for ‘Heating, Ventilation and Air- Conditioning’. Important in those places where humidity and temperature must be closely regulated while maintaining healthy and safe conditions inside buildings.
  • 41. Comparison of Mechanical & Natural Ventilation Mechanical Ventilation:  Use fan  Need to be install  Allow warmer air escape faster  High cost  High maintenance  Create air all time  Noise  High electricity bill Natural Ventilation: -- Not use any fan -- Ready fix to building -- Depend on weather -- More economic -- No maintenance -- Same in temperature -- Silent -- No electricity bill
  • 42. VENTILATION STANDARDS • To achieve a sense of freshness in a room and remove body odours. a) Floor space : the product of the length and breadth optimum floor space requirements per person - 50 to 100 feet. b) Cubic space of area : Earlier prescriptions - fresh air supply of 3000 cu feet of air per person per hour. beyond 12 feet, not taken into account Current standards - 1000 to 1200 cu feet per person per hour c) Air change: The recommended number of air changes living room - 2 to 3 in an hour, Work rooms and assemblies - 4 to 6 per hour.
  • 43. VENTILATION REQUIREMENTS Type of buildings Size of the buildings and the floor areas. Type of roof Local wind directions Number of persons occupying the room Proximity to commercial or industrial areas Sanitation of the surrounding area Nature of work being carried out inside the buildings Geographical locations such as closeness to sea, large water bodies, hilly areas
  • 44. Poor Ventilation effect on health • High levels of CO2 and low levels of O2 • Poor indoor air quality can lead to suffering from different health problems • Headaches, fatigue, hypersensitivity and allergies, sinus congestion dizziness, shortness of breath, coughing and nausea • Increase accidents in the workplace as a result of poor ventilation • Low humidity can cause a dry throat, dry skin • High humidity contributes to bacterial and mould growth • Excessive and irritating odors cause discomfort
  • 45. Water Water is a essential basic need of human and all living things Water is made of tiny molecules of hydrogen and oxygen. Each one is so small that you can’t see it even with the most powerful microscope The water is very important for life, because it is vital. The animals or humans drink water because the body needs 75% water Pure water has no colour, no taste and doesn’t smell of anything and absence of micro organism
  • 46. Safe and wholesome 1. Safe and wholesome water is defined as that which is 2. free from pathogenic agents 3. free from harmful chemical substances 4. pleasant to taste, colourless and odourless 5. usable for domestic purposes
  • 47. Sources of Water Rain water Surface water • Lakes • Ponds • Streams • Rivers • Storage reservoir Ground water: • Open wells • Tube wells • Artesian wells • Springs • Infiltration
  • 48. Uses of water • Household or domestic(drinking, preparing food, bathing, washing clothes and dishes, brushing your teeth, watering the yard and garden) • Agricultural (farming gardening fisheries) • Industrial (manufacturing) • Recreational (swimming water shows boating) • Environmental activities (park, street cleaning) • Fire extinction • Hydro power generation.
  • 49. Water purification • Water purification is the removal of contaminants from raw water to produce drinking water that is pure enough for human consumption or for industrial use. • The goal is to produce water fit for a specific purpose.
  • 50. Water Purification Commonly 2 methods  Natural- Sunlight  Artificial: large scale methods Small scale methods
  • 51. Large scale methods • Definition: large amount of water • Methods: I. Storage II. Filtration III. Disinfection
  • 52. Large scale methods I. Storage: Physical, chemical and biological. II. Filtration: 1. Slow sand filters 2. Rapid sand filters
  • 53. 1. Slow sand filters Base materials
  • 54. 1. Slow sand filters 1.Inlet chamber: open tank to receive raw water, Sedimentation & oxidation (3-12 hrs) 2.Filter media: Consist fine & coarse sand layers 3. Base materials: Consist of fine gravel & coarse gravel 4. Under drainage system: 1 central drain & 2 lateral drains Lateral drain collect filtered water supply through central drain to outlet 5. Filter control devices: control flow of filtration and provide filtered water
  • 55. 2. Rapid sand filtration Rapid Sand filter Bed
  • 56. 2. Rapid sand filtration 1. Chemical coagulant( aluminium sulphate, ferrous sulphate, lime, chlorine) added Raw water 2. Coagulant mixed with water with mixing device 3. Stirring (30 min) the water at slow motion by mechanical flocculators 4. Sedimentation – 2 to 6 hrs 5. Rapid sand filtration bed consist of sand & gravel filter the water
  • 57. III. Disinfection 1. Killing pathogenic organisms in water 2. After filtration – disinfection is important 3. By using disinfectants Ex: chlorine, KMNO4, iodine, lime 4. Chlorination of water: add chlorine 5. Super chlorination: adding large amount of chlorine in water for heavily polluted water, later excess chlorine removed. 6. Disinfection by UV radiations 7. Natural disinfection by sunlight 8. Disinfection by using ozone gas
  • 58. Small scale • Water on small scale such as for domestic purposes can be purified as follows: 1. Disinfection of wells 2. Boiling 3. Filtration through muslin cloth. 4. Three pitcher system. 5. Chemicals. 6. Domestic filters e.g. Berkefeld filter and Pasteur’s Chamber- land filter.
  • 59. Small scale (i) Disinfection of wells: 1. Main source of water – villages 2. Amount of bleaching powder needed 3. Diameter and depth of well 4. Prepare solution in bucket 5. Place in well by mix bleaching powder (1hr) 6. Disinfect the well by repeating this method
  • 60. Small scale (ii) Boiling: 1. Boiling is the oldest and satisfactory method 2. Boiling for 5 to 10 minutes kills bacteria, spores. 3. It also removes hardness of water and soft water is produced. 4. Boiling is an excellent method of purification of water provided boiling is done in a neat and clean vessel and after boiling it is stored in clean covered container. 5. Preferably water should be boiled in the same container in which it is to be stored. 6. Only that much amount of water should be boiled which can be used within a few hours
  • 61. Small scale (iii) Filtration through Muslin Cloth: • Muslin cloth acts as a coarse filter which can remove the suspended materials. • So water filtered through muslin is not fit for drinking purposes though it can be used for other household purposes like bathing, washing the clothes etc.
  • 62. Small scale (iv) Three Pitcher System: • This is very old system of purification of water. • In this system three pitchers are used which are kept one above the other on a wooden stand. • The top Picher contains sand, second charcoal and sand; and the lowest collects the purified water. • The raw water is filled in the first pitcher from where it percolates through a hole into the 2nd pitcher. • From here the water further percolates through the hole to the third pitcher.
  • 63. Small scale • (v) Chemicals: (a) Bleaching Powder (Chlorinated Lime): 2.5 gm of a good quality of bleaching powder could be required to disinfect 1000 liters of water. b) Chlorine tablets: One tablet of 500 mg is sufficient for disinfecting 20 liters of water. (c) Quick Lime (Calcium Oxide): 360 mg of slaked lime will disinfect 4.5 liters of water. It is cheap, easily available and quite effective. (d) High Test Hypochlorite (HTH): (e) Alum: • Alum is not a germicidal. It is used to purify muddy water and to remove turbidity. (f) Potassium Permanganate: It is a strong oxidizing agent and can kill cholera vibrios. It is used for disinfecting wells.
  • 64. Small scale (vi) Domestic Filters: Berkefeld Filters and Pasteur’s Chamber- land filter.
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  • 66. Major Categories of Water Pollutants • Infectious Agents – Bacteria, Viruses, Protozoa, Parasitic Worms – Source: Human and animal waste • Oxygen-Demanding Waste – Organic debris & waste + aerobic bacteria – Source: Sewage, feedlots, paper- mills, food processing • Inorganic Chemicals – Acids, Metals, Salts – Sources: Surface runoff, Industrial effluent, household cleansers • Radioactive Materials – Iodine, radon, uranium, cesium, thorium, Source: Coal & Nuclear Power plants, mining, weapons production, natural • Plant Nutrients – Nitrates, Phosphates, Source: Sewage, manure, agricultural and landscaping runoff • Organic Chemicals – Oil, Gasoline, Plastics, Pesticides, Solvents, detergents, Sources: Industrial effluent, Household cleansers, runoff from farms and yards • Eroded Sediment: Soil, Silt • Heat/Thermal Pollution – Source: Power plants, Industrial
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  • 71. Effects of water pollution • Will cause – Soil contamination. – Air contamination. – Food chain contamination. – Esthetic. • Lack of clean water supply for – Domestic demand. – Industry use. – Agriculture use. • Will also cause – Breeding of diseases vector. – Spreading of water borne diseases. – Food poisoning. – Skin problem.
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  • 116. Disposal of Waste • Waste (also known as rubbish, trash, refuse, garbage, junk, litter, and ort) is unwanted or useless materials. Disposal means “any operation which may lead to resource recovery, recycling, reclamation, direct re-use or alternative uses
  • 117. Types of waste Solid wastes: wastes in solid forms, domestic, commercial and industrial wastes. Examples: plastics, styrofoam containers, bottles, cans, papers, scrap iron, and other trash Liquid Wastes: wastes in liquid form, Examples: domestic washings, chemicals, oils, waste water from ponds, manufacturing industries and other sources
  • 118. Classification of Wastes according to their Properties Bio-degradable: can be degraded (paper, wood, fruits and others) Non-biodegradable: cannot be degraded (plastics, bottles, old machines, cans, styrofoam containers and others)
  • 119. Classification of Wastes according to their Effects on Human Health and the Environment • Hazardous wastes • Substances unsafe to use commercially, industrially, agriculturally, or economically and reactivity & toxicity. • Non-hazardous • Substances safe to use commercially, industrially, agriculturally, or economically and do not have any of those properties mentioned above. These substances usually create disposal problems.
  • 120. Classification of wastes according to their origin and type Domestic wastes: Bio-medical wastes: Industrial wastes: Agricultural wastes: Fishery wastes: Radioactive wastes: E-wastes:
  • 121. IMPACTS OF WASTE Affects our health Affects our socio-economic conditions Affects our coastal and marine environment Affects our climate
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  • 147. DISPOSAL OF DEAD BODIES • Death is the cessation of all biological functions that sustain a living organism. • Phenomena which commonly bring about death include aging, predation,malnutrition, disease, suicide, homicide, starvation, dehydra tion, and accidents or trauma resulting in terminal injury. • In most cases, bodies of living organisms begin to decompose shortly after death.
  • 148. Need for disposal of dead bodies • All dead bodies are potentially infectious and “STANDARD PRECAUTIONS” should be implemented for every case. • Although most organisms in the dead body are unlikely to infect healthy persons, • To minimize the risks of transmission of known and also unsuspected infectious diseases, dead bodies should be handled and disposed properly. • A rational approach should include staff training and education, safe working environment, appropriate safe work practices, the use of recommended safety devices and vaccination.
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  • 159. Categorization of Dead Body • Based on the mode of transmission and the risk of infection of different diseases, the following categories of precautions for handling and disposal of dead bodies are advised: • Cat. 1： • Signified by a BLUE label • Standard precautions are recommended for all dead bodies other than those with infectious diseases as listed under Categories 2 & 3.
  • 160. Categorization of Dead Body • Cat. 2: • Signified by a YELLOW label • In addition to standard precautions, additional precautions are recommended for dead bodies with known: Human Immunodeficiency Virus infection (HIV) Hepatitis C Creutzfeldt-Jacob disease (CJD) without necropsy Severe Acute Respiratory Syndrome (SARS) Avian influenza, Middle East Respiratory Syndrome (MERS), and Other infectious diseases as advised by the physician i/c, the infection control officer or microbiologist.
  • 161. Categorization of Dead Body • Cat. 3: • Signified by a RED label • In addition to standard precautions, stringent precautions are recommended for dead bodies with known: Anthrax Plague Rabies Viral hemorrhagic fevers Creutzfeldt-Jacob disease (CJD) with necropsy, and Other infectious diseases as advised by the physician i/c, the infection control officer or microbiologist.
  • 162. General Recommendations Vaccination (Hepatitis B vaccination ) Personal hygienic measures and protective equipment Prevent the Accidental exposure to blood or body fluids Clinical waste management Environmental control Precautions for Specific Risk
  • 163. Precautionary Measures for Handling and Disposal of Dead Bodies Risk category Bagging Viewing in funeral process Embalming Hygienic preparation in funeral Disposal of dead body Cat. 1 NOT necessary Allowed Allowed with PPE Allowed with PPE Coffin burial or cremation is optional Cat. 2 must Allowed NOT allowed Allowed with PPE Cremation is advisable Cat. 3 must Not Allowed NOT allowed NOT allowed Cremation is strongly advisable
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  • 198. Climate • Definition: • Climate is commonly defined as the weather averaged over a long period
  • 199. Elements of climate 1. Temperature 2. Air pressure 3. Winds 4. Humidity 5. Cloud 6. Rainfall
  • 200. Factors influencing on Indian climate Latitude Altitude Wind Air pressure Ocean Distance from sea Distribution of land and water Air circulation Cyclones
  • 201. Climate Seasons 1.Winter: • December to March. • The year's coldest months are December and January • when temperatures average around 10–15 °C 2.Summer: or pre-monsoon: • April to June • In western and southern regions, the hottest month is April; for northern regions of India, May is the hottest month. • Temperatures average around 32–40 °C
  • 202. Climate Seasons 3. Monsoon or rainy season: • July to September. • It may begin in late May or early June. • South India typically receives more rainfall. 4. Post-monsoon or autumn season: • October to November. • In the northwest of India, October and November are usually cloudless. • Tamil Nadu receives most of its annual precipitation in the northeast monsoon season.
  • 203. Extreme climate conditions 1. Global warming 2. Droughts 3. Floods 4. Cyclones 5. Landslides 6. Snowstorms 7. Summer dust storms 8. Heat waves
  • 204. Climate change • Climate change is a change in the statistical distribution of weather patterns when that change lasts for an extended period of time • Climate change may refer to a change in average weather conditions, or in the time variation of weather within the context of longer-term average conditions.
  • 205. Causes of climate changes • Natural Disasters • Human activity • Deforestation • Ozone depletion • Global warming
  • 206. Health impact of climate changes Malnutrition Injury/death Water borne diseases Vector borne diseases Food borne diseases Lung diseases Skin diseases Cancer Poor environmental sanitation Social disruption
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  • 209. Types of Communication • Verbal (oral & written) .Mass • Non verbal • Intra personal • Interpersonal • One way • Two way • Mass • Meta • Formal • Informal
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  • 215. Infrastructure Facilities and Linkages Introduction: • There are many infrastructure facilities for health • Maximum health services provided by public sectors • Private sectors also providing quality of health care services to the community • It is essential to understand by the peoples for availability of health care in selected area.
  • 216. Infrastructure Facilities and Linkages • Public sector: • Health centres (SC, PHC, CHC) • Rural hospital • District hospital • Specialized hospital • Teaching hospital • Health insurance( ESI & CGHS) • Defense hospital • Railway hospital
  • 217. Infrastructure Facilities and Linkages • Private Sector: • Private hospital • Poly Clinics • Nursing home • Dispensaries • General practitioner and clinic
  • 218. Infrastructure Facilities and Linkages • ISM: • Ayurveda • Yoga and Naturopathy • Unani • Siddha • Homeopathy • VHA: • (WHO, UNICEF, CARE and Red Cross)
  • 219. Linkages • Definition: • It means referral services • It is a process of sending the patient from one place to another place where they will get better treatment or diagnostic facilities.
  • 220. Level of Linkage village SC PHC CHC Secondary or tertiary level hospital District hospital Multi specialty hospital
  • 221. PURPOSES • To provide need based comprehensive care within the technical competencies & resources at each level • To help people avail specialized services. • To provide accurate diagnosis • To provide first aid services • To save the life of patient in emergency
  • 222. SELECTION OF REFERRAL CASES Category – I: • Fatal patient Category – II: • Serious patient Category – III: • For diagnosis.
  • 223. CASES REQUIRE IMMEDIATE REFERRAL • Cases presenting any problem which cannot be handled during pregnancy, labor and post natal period. • Severe diarrhea with dehydration • Pain in abdomen and vomiting • Heart burn, dyspepsia, dysphagia, haemetemesis and maleana etc. • Continuous cough with or without sputum, haemoptysis.
  • 224. CASES REQUIRE IMMEDIATE REFERRAL • Fever with stiff neck. Fever with severe joints pain, rashes, bleeding under the skin. • Breathing difficulty while walking, sleeping, doing physical work. • Chest pain with/without pain in the left arm, restlessness and vomiting. • Jaundice, loss of appetite. • Convulsions with fever. • Coma, paralysis, fracture, severe injury, hemorrhage, poison etc.
  • 225. REFERRAL FORM • Patient details • Date, place and time of referral • Conditions of patient at the time of referral • Reason for referral • Previous history • Treatment provided • Clinical records if any • Name and detail of M.O
  • 226. NURSE’S ROLE IN REFERRAL  Observe and collect information about the illness, trauma, related situation, factors etc.  Identifies the nature of illness/emergency and its seriousness.  Provides immediate treatment care within her competence, standing orders and resources available.  Assures the casualty/family members/ any other person accompanying.  Explains about the seriousness of the problem situation and need for reference to the casualty.
  • 227. NURSE’S ROLE IN REFERRAL  Fills up the referral form as desired and hands over the same with related documents to be given to health professionals in referred health center.  Arranges for transport of the patient according to feasibility as soon as possible.  May do the telephonic consultation or provide information to referred health center.  May accompany the casualty/patient if required and feasible.  Maintains the records and reports.  Provides follow up care as per treatment and instructions prescribed by the referral unit.
  • 228. Acts regulating the environment: (National Pollution control board) Introduction: • The ministry of environment & forest – formulate • Protect the environment • Maintain nature and prevent hazards • Control human activities from destroy
  • 229. Acts Related to environmental protection 1. EPA (1986) 2. Indian forest act 1927 3. The wild life protection act 1972 4. Indian fisheries act 1897 5. River board act 1956 6. Water (prevention and control of pollution) act 1974 7. Air (prevention and control of pollution) act 1981 8. The atomic energy act 1982 9. The motor vehicles act 1988 10.Bio medical waste act 1988 11.Noise pollution control act 2002
  • 230. EPA (1986): • Protect and improve environment quality, control and reduce pollution from all sources Indian forest act 1927: • Protection and conservation of forest The wild life protection act 1972: • Provides for the protection of birds, animals and plants and all resources in forest
  • 231. Indian fisheries act 1897: • Maintain coastal or inland with intend to prevent destroy of fish River board act 1956: • Maintain cleanliness and prevention of river pollution Water (prevention and control of pollution) act 1974: • Prevention and control of Water pollution Air (prevention and control of pollution) act 1981: • Prevention and control of Air pollution
  • 232. The atomic energy act 1982: • Control of radio active substances in environment The motor vehicles act 1988: • Control of motor vehicles related pollution in environment Bio medical waste act 1988: • Proper waste disposal from health care settings Noise pollution control act 2002: • Prevention and control of noise due to all sources
  • 233. National Pollution Control Board Introduction: • 1974 • Also known – central pollution control board (CPCB) • Under water act, ministry of environment and forest • Prevent and control of water pollution
  • 234. Objectives- NPCB To Advice central govt prevent & control of water pollution To Guide all the state board To Organize raining programme To Collect and publish data To Organize mass media programme To Set standard for water quality To provide Lab analysis for water quality
  • 235. Functions - NPCB 1. Surveillance of water and air quality 2. Monitor and guide state board 3. Inspection of industries 4. Interstate river monitoring 5. Organizing mass awareness 6. Inspection of pollutions 7. Lab services for water quality 8. Prevention and control of pollution 9. Publishing data
  • 236. Bacterial & viral: Agents, host carriers and immunity • Introduction: • The diseases are caused by micro organism • It may be bacteria or virus or fungus or other organisms • It is necessary to understand about the causative agents for easy diagnosis and treatment • Immunity is the essential power of the body to prevent the occurrence of the disease • The study of distribution and determinants of the disease is called Epidemiology
  • 237. Agents Agent: • The causative factor for disease Types: • Biological: (micro-organisms) • Physical: (temperature, radiation, trauma, others) • Chemical: (acids, alkalis, poisons, tobacco, medications / drugs, others) • Environmental: (nutrients in diet, allergens, others) • Nutritional: (under- or over-nutrition) • Psychological: experiences
  • 238. Host who is vulnerable to suffering from disease. Its depends upon • Genetic • Immunologic state • Personal behavior: (life-style factors): diet, tobacco use, exercise, etc • Personal characteristics: Age, gender, socio- economic status, etc.
  • 239. Carriers • A carrier is defined as an infected person or animal that harbors' a specific infectious agent and serves as a potential source of infection for others. • Classification of carriers: A. Type: i)Incubatory ii)Convalescent iii)Healthy B. Duration: i)Temporary ii)Chronic C. Portal Of Exit: i)Urinary ii)Intestinal iii)Respiratory iv)Others
  • 240. Immunity • It is a resistance power of host to fight against micro organism • It may be Natural • From birth onwards Acquired • During life time
  • 241. Arthropods and Rodents Arthropods: • It is a type of living thins with no spine, having an exoskeleton, legs joined together and body divided into different parts and causes many diseases in human beings Types: Insecta (hexapoda): • Mosquitoes, flies, bugs, fleas Arachnida (octopodsa): • Scorpion, spiders, ticks and mites Crustacea: Cyclops:
  • 242. Characteristics of arthropods Exoskeleton: • No internal bones and strong outer skin Segmental bodies: • Bodies separated into different parts, the number segments depends on the species Jointed appendages: • All the limbs attached to their exoskeleton Bilateral symmetry: • Arthropod body can be divided vertically into two mirror image Open circulatory system: Circulatory system is open without any blood vessels
  • 243. Arthropods borne diseases Bacterial: • Plague Viral: • Yellow fever • Encephalitis • Dengue fever Parasitic: • Malaria • Filaira Others: • Typhus • Q fever • Relapsing fever
  • 244. Prevention and control of arthropods Early diagnosis and treatment: Environmental measures: : • Control of breeding place • Sanitation • Proper waste disposal Personal protection measures: • Mosquito net, coils, body lotion and bat • Repellants • Blue light fly killer • Clothing • hygiene
  • 245. Prevention and control of arthropods Chemical measures: • Insecticides (DDT) • Biological measures: • Growing of larva fishes Health education: Vaccines:
  • 246. Rodents Definition: • Rodents are small mammals with large, sharp front teeth which may causes some of the disease in human Example: • Rats, mice and squirrels Types: • Wild rodents • Domestic rodents
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  • 249. Characteristics • The majority of rodents have tails, which can be of many shapes and sizes, The tail is sometimes used for communication, • Rodents generally have well-developed senses of smell, hearing, and vision. • Rodents have efficient digestive systems
  • 250. Types 1. Domestic rodents 2. Wild rodents Domestic rodents: Living in houses Wild rodents: Living forests
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  • 256. Food hygiene: Production, Preservation, Purchase, Preparation, Consumption • Food hygiene are the conditions and measures necessary to ensure the safety of food from production to consumption • Food can be contaminated at any point during harvesting, processing, storage, distribution, transportation and preparation • Lack of food hygiene can leads to food borne diseases.
  • 257. Food hygiene • Milk hygiene • Meat hygiene • Fish hygiene • Egg hygiene • Vegetables and fruits hygiene • Food handler hygiene • Sanitation of eating places
  • 258. Food hygiene-Production • Proper harvesting and cultivation • Minimal use of fertilizer and insecticides • Registered food business • Correct label and description • Regular inspection on food manufacturer and retailers • Strict hygiene in restaurant and food premises • Food is safe to eat • Prevent the source of food contamination
  • 259. Food preservation • Proper storage • Prevent contamination • Avoid the growth of micro organism • Proper and minimal handling • Maintain proper temperature • Ventilation • Avoid vectors and rodents • Personal hygiene • Close the food container • Kitchen hygiene
  • 260. Food preservation Methods: • Drying • Refrigerator • Freezing • Vaccum packing • Salt • Sugaring • Smoking • Artificial food additives • Pickling • Canning • Jellying • Irradiation
  • 261. Food Purchase • Production cost • The season • Market supply • Demands • Advertisement • Amount of processing
  • 262. Guidelines for purchase Make shopping list Type and location of market Compare prices Assess the quality Buy foods in bulk Check expiry Check crack or open Check freshness (vegetable and fruits) Properly store Prevent contamination
  • 263. Food Preparation • It means cooking • Cook thoroughly • Eat cooked food immediately • Avoid contact – raw food & cooked food • Choose food processed for safety • Hand hygiene • Dry and clean kitchen • Use safe water
  • 264. Food Preparation methods • Boiling • Steaming • Grilling • Baking • Dry frying • Shallow frying • Stir frying • Deep frying • Roasting • Simmering • Broiling • Braising • Stewing
  • 265. Boiling: • Transfer heat from liquid to the food Steaming: • Convection for transferring heat from the steam to the food Grilling: • Cooking by using the heat from below sources Roasting and baking: • Process of surrounding a food with dry heated air in an enclosed area.
  • 266. Dry frying: • Does not require oil Shallow frying: • Uses very little oil Stir frying: • Does not require more oil & involve stirring of small pieces of food Deep frying: • Food is submerged in oil Simmering: • Cooked in hot liquid just below boiling point
  • 267. Broiling: • Cooking by using the heat from above sources Poaching: Uses convection of transfer heat to cook food that no need of high temperature Braising: • Uses dry and moist heat Stewing: • Similar to braising but used on smaller cuts of meat& cooking time is shorter
  • 268. Food Consumption  Consume Properly cooked food  Cover the food properly  Hand hygiene  Do not sneeze or cough  Kitchen hygiene  Hygienic eating place  Use clean utensils  Do Not eat stored food for long time
  • 269. Food Consumption  Do not waste the food  Easily digestible  Eat the food immediately after cooking  Protect from vectors and flies  Avoid food contamination  Prevent food poisoning and food borne diseases  Proper disposal of waste food  Appropriate washing and cleaning
  • 270. Acts regulating food hygiene- Prevention of food adulteration act, drugs and cosmetic act • The food safety and standards act 2006 is regulating the food hygiene • It regulate food manufacture, storage, distribution, sale, import, export and quality of food items • It is also helps to control the food adulteration process. • Any food products fails to follow these regulation liable to punishments
  • 271. Act related to food hygiene 1. Prevention of food adulteration act – 1954 2. Fruits products order – 1955 3. Meat food products order – 1973 4. Vegetables oil products (control) order – 1947 5. Edible oil packaging (regulation) order – 1988 6. Milk and milk products order – 1992 7. Any order under essential commodities act- 1955 relating to food
  • 272. Prevention of food adulteration act • Food Adulteration: • Any unwanted materials or substances that added to food items which affect the quality of food and causes serious health consequences. • Administrative bodies: 1. Central committee for food standards 2. Central food laboratory 3. Public analyst 4. Food inspector
  • 273. Prevention of food adulteration act • It was formulated in 1954 and implemented in 1955 • Objectives: • To make provision for the prevention of adulteration of food • To prevent import, manufacture, sale or distribution of adulterated and misbranded food • To prevent all types of food adulterations
  • 274. Sample and analysis • Any food inspector can check the quality of food items • A sample will be collected and send to lab for quality checking • If the food item not met the criteria for quality that manufacture will get the notification • Failure in improving the quality of food items after notice will be punished according to PFAA
  • 275. Common food adulterants Food items Adulterants Milk water & starch Edible oil Argemone oil, mineral & castor oil Sugar chalk powder Tea Exhausted tea leaves, black gram dhal Pulses Khesari dhal, clay, stone, gravel Ghee vanaspati, sweet potato, Chilli powder red brick powder, artificial color Coffee powder Tamarind seed, date seed powder Black powder Papaya seeds and light berries
  • 276. Common food adulterants Food items Adulterants Turmeric powder Yellow aniline dyes Sweets, juices, jam (metanil yellow) Jaggery Washing soda, chalk powder Honey (sugar plus water) Butter and Cream Beef fat Ice cream Washing powder i Paneer Starch and washing powder i Wheat Flour: Chalk powder, barn dust and sand Vegetables: Copper salts are added to color the vegetables with green.
  • 277. Punishment under PFAA • a penalty up to 10 lakh would be imposed for sale or distributed unhygienic and adulterated food • The accused will get minimum 6 months or life imprisonment depends upon the nature of consequences • Fine between 500 to 5000 or depends upon the nature of consequences
  • 278. Drugs and Cosmetic act The Drugs and Cosmetics Act, 1940 is an Act of the Parliament of India which regulates the import, manufacture and distribution of drugs in India
  • 279. Amendments • The Drugs (Amendment) Act, 1955 • The Drugs (Amendment) Act, 1960 • The Drugs (Amendment) Act, 1962 • The Drugs and Cosmetics (Amendment) Act, 1964 • The Drugs and Cosmetics (Amendment) Act, 1972 • The Drugs and Cosmetics (Amendment) Act, 1982 • The Drugs and Cosmetics (Amendment) Act, 1986 • The Drugs and Cosmetics (Amendment) Act, 1995
  • 280. Objectives • To regulate the import, manufacture, distribution and sale of drugs & cosmetics through licensing. • To prevent substandard in drugs. • To regulate the manufacture and sale of Ayurvedic, Siddha and Unani drugs. • To establish Drugs Technical Advisory Board(DTAB) and Drugs Consultative Committees(DCC) for Allopathic and allied drugs and cosmetics. • To maintain quality of drugs and cosmetics
  • 281. Drugs and Cosmetic Drugs : All medicines for internal or external use of human beings or animals and all substances intended to be used for or in the diagnosis, treatment, or prevention of any disease or disorder in human beings or animals. Cosmetic : Any article intended to be rubbed, poured, sprinkled or sprayed on, or introduced into, or otherwise applied to, the human body or any part thereof for cleansing, beautifying, promoting attractiveness, or altering the appearance.
  • 282. Alteration of Drugs and Cosmetic Misbranded drugs : • (a) if it is so coloured, coated, powdered or polished that damage or • (b) if it is not labeled in the prescribed manner. Adulterated drug : • (a) if it consists, in whole or in part, of any filthy, putrid or decomposed substance; or • (b) if it has been prepared, packed or stored under insanitary conditions or • (c) if its container is composed in whole or in part, of any poisonous or deleterious substance
  • 283. Alteration of Drugs and Cosmetic Spurious drugs : (a) if it is imported under a name which belongs to another drug; or (b) if it is an imitation of, or a substitute for, another drug or resembles another drug in a manner Manufacture : In relation to any drug or cosmetic, it includes any process or part of a process for making, altering, ornamenting, finishing, packing, labeling, breaking up or otherwise treating or adopting any drug or cosmetic with a view to its sale or distribution but does not include the compounding or dispensing of any drug Patent or Proprietary medicine : any drug not included in the edition of the Indian Pharmacopoeia for the time being or any other Pharmacopoeia authorized in this behalf by the Central Government.
  • 284. Administration of the act and rules I. Advisory : 1. Drugs Technical Advisory Board-DTAB 2. Drugs Consultative Committee-D.C.C.B) II. Analytical : 1. Central Drugs Laboratory - CDL 2. Drug Control Laboratory in states 3. Government Analysts III. Executives : 1. Licensing authorities 2. Controlling authorities 3. Drug Inspectors
  • 285. Penalties-Drugs and Cosmetic act • Penalties related to Import of spurious drug: 3 years imprisonment and 5000 Rs. fine on first involves risk to human beings or conviction animals • 5 years imprisonment OR therapeutic values 1000 Rs. fine OR both for serious consequences • 1 year imprisonment OR 1000 Rs. fine for subsequent offence
  • 286. Penalties-Drugs and Cosmetic act • Penalties related to Manufacture:1-3 years imprisonment and Rs.5000 fine for first time • 2-6 years imprisonment & Rs.10000 fine on subsequent conviction Manufacture of adulterated drugs.
  • 287. Drugs and Cosmetics (Amendment)Act, 2008Salient features of the Act • Substantial enhancement in punishment • Life imprisonment for offenders involved in manufacture, sale and distribution of spurious and adulterated drug likely to cause grievous hurt • Minimum punishment of seven years which may extend to life imprisonment • Provision for compensation to affected person
  • 288. Socio-cultural Aspects: • Customs: • It means practices or behaviors which is accepted by the society as per social norms, it may transmitted from one generation to next generation • Customs in society: Customs related to hygiene Customs related to religion Customs related to nutrition Customs related to festivals Customs related to marriage Customs related to cloth Customs related to sex Customs related to language Customs related to child birth Customs related to life style
  • 289. Taboos Definition: • The behaviors or action of the peoples which are not accepted or restricted by the society Examples: • Social taboos • Religious taboos • Nutritional taboos • Ritual taboos • Sexual taboos • Educational taboos • Marital taboos
  • 290. Marriage System • Marriage is one of the universal social institution. • It is established by the human society to control and regulate the sex life of human. • It is closely connected with the institution of family. • Definition: Marriage is a physical, legal and moral union between man and woman in complete community life for the establishment of a family.
  • 291. Characteristics of marriage Marriage is a universal social institution Marriage is a permanent bond between husband and wife. It fulfill the social, psychological, biological and religious aims. Marriage is a specific relationship between two individuals of opposite sex Marriage requires social approval.
  • 292. Characteristics of marriage Marriage establishes family. Marriage creates mutual obligations between husband and wife. Marriage is always associated with some civil and religious ceremony Marriage regulates sex relationship according to prescribed customs and laws. Marriage has certain symbols like ring, special cloths, special sign before the house etc
  • 293. Types of Marriage • Monogamy • Serial Monogamy • Bigamy • Polygamy: (Polygyny, Polyandry, Group Marriage) • Exogamy • Endogamy • Marriage by mutual understanding • Contractual marriage • Arranged marriage
  • 294. Types of Marriage • Monogamy: Marriage between one man and one woman. • Serial Monogamy: Having several marriage partners one after the other - not at the same time • Bigamy: having more than one marriage partner at a time. This is illegal • Polygamy or plural : marriage of more than one mate at a given time. It has three forms. 1. Polygyny- one husband and two more wives. 2. Polyandry- one wife and two or more husbands. 3. Group Marriage- marriage of several man to several women
  • 295. Types of Marriage • Exogamy-marrying outside a community • Endogamy- marrying only within the limits of a local community, • Marriage by mutual understanding: Love marriage • Contractual marriage: marriage for particular period of time • Arranged marriage: Marriage partners selected by parents.
  • 296. Functions of Marriage 1. Regulation of sex life 2. Marriage leads establishment of family 3. Provides economic cooperation 4. Marriage contributes to emotional and intellectual inter stimulation of the partners 5. Marriage aims at social solidarity Functions of marriage
  • 297. Problems of Marriage 1. Understanding problems 2. In law misunderstanding 3. Divorce 4. Dowry 5. Family conflict 6. Inter caste marriage 7. Inter state marriage 8. Inter country marriage 9. Unsatisfied family life
  • 298. Family It is basic unit of community characterized by common residence, economic co-operation and reproduction and socially approved relationship with one or more own or adopted children,
  • 299. Types • On the basis of family size: 1. Nuclear family 2. Joint family 3. Extended family 4. Single parent family
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  • 306. Family cycle Formation (Marriage) Dissolve (Death of parents) Development (Child birth) Maturity (Growth of children)
  • 307. Structure of age group in family • Newborn • Infant • Toddler • Preschool • School going • Adolescent • Adult • Old age
  • 308. Relationship in a family • Father • Mother • Husband • wife • Son • Daughter • Sister • Brother • Grand father • Grand mother • Uncle • Aunt • In laws
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  • 312. Status of special groups • Some of peoples are need to provide special attention in society • They are called vulnerable group or risk group • These group are having the high risk of health and other problems • There are so many welfare services and agencies are available for special group • This group may include Females, Children, Elderly, challenged groups and Sick persons
  • 313. Status of females • Females are important peoples in our country as they have many roles • They are facing many problems in their daily life • The status of women in India has been subject to many great changes over the past few years • In modern India, women have adorned high offices in India including that of the President, Prime Minister, Speaker of the Lok Sabha and Leader of the Opposition etc • Women in India generally are still exposed to numerous social issues, so need to address and solve them
  • 314. Problems faced by Indian females and women: • Illiteracy • Poverty • Sexual harassment • Dowry • Child marriage • Female infanticides and sex selective abortions • Domestic violence • Violence at work place • Trafficking • Health problems • Eve teasing • Restriction on widow remarriage • Gender bias • Neglect during childhood
  • 315. Female and women welfare services • Rajiv Gandhi Scheme for Empowerment of Adolescent Girls (Sabla) • Indira Gandhi Matritva Sahyog Yojana (IGMSY) • Support to Training & Employment Programme for Women (STEP) • Hostel for Working Women (WWH) • Women Empowerment and Livelihood Programme in Mid-Gangetic Plains (Priyadarshini) • Swadhar (Scheme for Women in Difficult Circumstances)
  • 316. Female and women welfare services • Scheme for Combating Trafficking • Family Counseling Centers (FCCs) • Short Stay Home Programme • Awareness Generation Programme (AGP) • Condensed Courses of Education for Adult Women (CCE) • Integrated Scheme for Women’s Empowerment (ISWE) • Gender Budgeting Scheme (GBS)
  • 317. Status of children • India has the largest child population in the world. • Children’s Development is as important component and the best way to develop national human resources is to take care of children. • Services and institutions concerned with the physical, social, and psychological well-being of children, particularly children suffering from the effects of poverty or lacking normal parental care and supervision. • The general standard of living, the level of education, and the financial resources of the country are among the factors that determine child welfare standards.
  • 318. Problems faced by children 1. Child marriage 2. Illiteracy 3. Female feticide 4. Juvenile delinquency 5. Child labour 6. Child abuse 7. Sexual harassments 8. Nutritional problems 9. Developmental problems 10.Poverty 11.Child Trafficking 12.Gender inequality
  • 319. Child welfare services 1. Indian council for child welfare (ICCW) 2. Central Social Welfare Board. 3. Kasturba Gandhi Memorial Trust 4. Indian Red Cross Society 5. All these agencies get financial aid from government to organize child welfare services in the country. 6. Day Care services by setting Balwadies 7. Holiday home 8. Recreation facilities 9. WHO department of child and Adolescent health and development 10.WHO School Initiative
  • 320. Child welfare services 1. IMNCI 2. Diarrheal disease control programme (DDCP) 3. Acute respiratory infection control programme 4. National Programme for control of Blindness 5. CSSM 6. Iodine deficiency disorders( IDDs) Programme 7. Family Welfare 8. Child Welfare programme for disabled children 9. Maternal child health and family planning integrated 10.Sarva Shiksha Abhiyan (SSA) 11.District rehabilitation centers
  • 321. Care of elderly • The care of aged is called geriatrics • Ageing a progressive and generalized impairment of body functions. • People more than 60 yrs are considered elderly. Old age is not a disease but a normal and inevitable biological phenomenon. • Elderly services integrates health care and psychological care with other needed services such as: housing, home care services, nutritional services, assistance with activities of daily living.
  • 322. Problems during old age • Prone for infections • Prone for injuries • Prone for psychological • Problems prone for degenerative disorders • Increased risk for disease • Increased risk of disability • Increased risk of death • Old age abuse • Neglected by children • Nutritional problems • Economical problems
  • 323. Services for old age • National policy on older persons policy on older persons January, 1999. • Financial security, • healthcare and nutrition, shelter, education and welfare • protection of life and property etc. • National Council for Older Persons ◦ Constituted by the Ministry of Social Justice and Empowerment • Promotion of public private partnerships in Geriatric Health Care.
  • 324. Services for old age • Mainstreaming AYUSH Empowerment in the field of geriatrics. • Reorienting medical education to support geriatric issues. • Regional Geriatric Centers (RGC) • Regional Medical Institutions • Post-graduates in Geriatric Medicine • District Geriatric Units • Geriatric Clinics/Rehabilitation units/Sub centers • Old age homes • Pension and many scheme from government
  • 325. Status of Challenged peoples • A disability is a condition or function of body impaired relative to the usual standard of an individual or their group. • The term is often used to refer to individual functioning, including physical impairment, sensory impairment, cognitive impairment, intellectual impairment or mental health issue
  • 326. Status of Challenged peoples • Blindness • Low vision • Leprosy-cured • Hearing impairment • Locomotors disability • Mental retardation • Mental illness
  • 327. Services for disabled • Early Intervention • Counseling & Medical Rehabilitation • Increasing the independence of the disables • Suitable Education (Integrated, Special) • Vocational training • Vocational rehabilitation of the Disables: Sheltered employment, Open Employment, Self-Employment • Appropriate leisure time activities. a) Sports, Recreation and Cultural life • Care Group, Old Age Homes. • Community Based Rehabilitation
  • 328. Government scheme and benefits • Disability certificate and identity card concessions/benefits. • Education programmes for children with concessions • Children's Education Allowance and Scholarships • Assistance for purchase/fitting of aids and appliances • Preference in allotment • Employment • National awards for people with disabilities • Incentives to private sector employers for handicaps; • Reservation of jobs and other facilities for medicine and rehabilitation • Economic assistance • Grant-in-aid schemes of the Ministry of Social
  • 329. Care of Sick persons • Sickness weakens the body. • To gain strength and get well quickly, special care is needed. • The care a sick person receives is frequently the most important part of his treatment. • Medicines are often not necessary. But good care is always important
  • 330. Need of caring for sick people • A sick person needs love and constant encouragement. • A person who is sick should rest in a quiet, comfortable place with plenty of fresh air and light. • Need divertional therapy • prevent from getting too hot or cold. • If the air is cold or the person is chilled, cover them with a sheet or blanket. • If the room is hot, or the person has a fever, they may need only a light sheet over them. • Need fluid and electrolyte balance
  • 331. Need of caring for sick people • Sleeping • Nutritional • elimination • Caring for a sick person at home is less costly and one can focus on the patient more. • At home, patients are more comfortable and are able to regain good health. • Everyone just needs to learn the basics of home care
  • 332. Care of sick person Rest and sleep Liquids Proper diet Elimination Ventilation  Personal Cleanliness Airway Circulation Monitor vital signs Treatment of symptoms Health education Medical advice if necessary
  • 333. Life Style • Lifestyle means the way in which a person lives. • Lifestyle includes the behavior and activities that make up your daily life. This includes: 1. The work you do, 2. Your leisure activities 3. The food you eat 4. your interaction with family, friends, neighbours, co workers and strangers.
  • 334. Life Style • Lifestyle changes are defined as changes that alter various lifestyle-related behaviors such as diet, physical activity, smoking, alcohol consumption and other behaviors. • Lifestyle changes may often relate to physical and health mental conditions such as various disorders, obesity, asthma, sexually transmitted diseases, depression, and anxiety.
  • 335. Healthy life style 1. Diet 2. Physical activity 3. Control obesity 4. Habits 5. Hygiene 6. Avoidance of Pollution 7. Mental health 8. Sleeping pattern 9. Recreation 10.Frequent health check up
  • 336. Healthy life style • Diet: balanced diet, nutritional requirements, food hygiene and avoid food poisoning • Physical activity: Active exercise • Control obesity: controlling obesity helps to prevent many health problems • Habits: good habits – health: bad habits- smoking, alcoholism and drug addiction • Hygiene: Personal, environmental, food hygiene
  • 337. Healthy life style • Avoidance of Pollution: helps to prevent many diseases, ex- water pollution ( water borne disease) air pollution ( air borne disease) • Mental health: healthy mind helps to relax and reduce stress and mental illness • Sleeping pattern: promote relaxation and rest • Recreation: Promote mental health and happy life • Frequent health check up: helps to identify physiological and psychological abnormalities.
  • 338. Hygiene • It is Cleanliness or the practice of keeping yourself and your surroundings clean, especially in order to prevent illness or the spread of diseases. • Types: 1. Personal hygiene 2. Environmental hygiene 3. Food hygiene
  • 339. Personal hygiene Definition: Personal hygiene may be described as the principle of maintaining cleanliness and grooming of the external body. It includes the Regular Routine of Personal Care of following things: 1. Washing and Grooming of Hair 2. Face and Skin 3. Teeth 4. Ears 5. Hands 6. Nails 7. Feet
  • 340. Hair Care Wash regularly with shampoo. Rinse hair thoroughly with clear water after shampooing to remove all the soap Don't scrub or rub too hard . It may irritate your scalp or damage your hair. Massage your scalp well. It will remove dead skin cells, excess oil and dirt Brush hair daily, Wash combs and brushes frequently, Don’t share combs, brushes etc. Brushing helps keep the scalp clean by loosening and removing dust and dead cells. It also adds shine
  • 341. Skin care • Daily baths or showers using soap and scrubbing the entire body with a washcloth • Wash the face two times a day with a mild soap or gentle cleanser. It is best to Use lotions only if needed • Try to stay out of the sun, and use a sunscreen every day during summer and winter. • Wear clean clothes & Maintain a healthy diet • Don’t squeeze or pick the pimples, Try to avoid touching the face & Keep hands clean by washing them often • Drink plenty of fluids. • Protect yourself from UV Rays
  • 342. Care of teeth • Daily dental hygiene routine that consist of brushing for 2-4 minutes and flossing • If possible, brush after every meal or rinse your mouth with warm water. Use a soft-bristled brush. • Replace your toothbrush every 2-3 months or after an illness. • Use toothpaste that contains fluoride. Flossing removes food trapped between your teeth and gum lines that rinsing and brushing miss. • Eat at least 5 servings of fruits and vegetables each day. • Include foods that contain calcium, such as milk and yogurt, Limit intake of sugar. • See a dentist every 6 months
  • 343. Care of Ears • Wash ears daily with a wash cloth don’t forget behind the ears • Remove ear plug • Avoid foreign bodies in the ear • Avoid infection in the in the middle ear • Consult doctor if severe pain or abnormalities
  • 344. Care of Hands • First, wet hands and apply liquid or clean bar of soap. • Next, rub your hands together and scrub all surfaces (palms, fingers, and in between). • Continue for 10-15 seconds. Soap combined with the scrubbing action that helps remove germs. • Rinse well and dry your hands.
  • 345. Nail Care • Without proper care they can become weak, ingrown or infected. • Keep nails trim but do not cut nails shorter than skin level. • Keep nails clean. • Round your fingernails slightly when trimming them. • Cut toe nails straight across. • Smooth rough nail edges with a file or emery board.
  • 346. Feet Care • Large collection of sweat glands live in our feet • Wash your feet well at least once a day. • Dry them carefully, especially between the toes. • Keep feet and skin clean and dry • Change socks daily • Avoid walking barefoot in public areas
  • 347. Environmental hygiene • It is that branch of public health that is concerned with the control of all those factors in man’s surroundings or physical environment which may have deleterious effect on human health and wellbeing
  • 348. Environmental hygiene Safe Water supply Waste management pollution control Vector control Occupational health Standard Housing Urban planning Accident prevention Public recreation and tourism Sanitation measures during epidemics, emergencies, disaster and population migration Wildlife and forest conservation.
  • 349. Food hygiene • Protecting food from risk of contamination, including harmful bacteria, poison and other foreign bodies • Milk hygiene • Meat hygiene • Egg hygiene • Fish hygiene • Vegetables and fruits hygiene • Hygienic practices during production, transportation, distribution, purchasing, sale, preparation, storage and consumption
  • 350. Physical activity Any form of exercise or movement. Physical activity may include planned activity such as walking, running, basketball, or other sports. Physical activity may also include other daily activities such as household chores, yard work, walking the dog, etc.
  • 351. Types of physical activity • Physical activity are generally grouped into three types 1. Flexibility exercises: such as stretching, improve the range of motion of muscles and joints. 2. Aerobic exercises: such as cycling, swimming, walking, skipping rope, rowing, running, hiking or playing tennis, focus on increasing cardiovascular endurance. 3. Anaerobic exercises: such as weight training, functional training, eccentric training or sprinting, increase short-term muscle strength.
  • 352. Opportunities for Physical Activity • At work • For transport • In domestic duties • In leisure time
  • 353. Benefits of Physical Activity Promotes health and fitness Builds healthy bones and muscles1 Reduces the risk of developing obesity and risk factors for diseases Reduces the symptoms of anxiety and depression Can positively affect concentration, memory, and classroom behavior Helps control weight. Helps reduce blood pressure in people who already have high blood pressure. Causes the development of new blood vessels in the heart and other muscles. Enlarges the arteries that supply blood to the heart.
  • 354. Problems due to inactive 1. Coronary Heart Disease (CHD) 2. Stroke 3. Obesity 4. Type II Diabetes 5. Hypertension 6. Colorectal cancer 7. Stress and Anxiety 8. Osteo-arthritis 9. Osteoporosis 10.Low back pain
  • 355. Recreation and sleep • Recreation is the expenditure of time with an intent to gain some refreshment. • It is a break from monotony and a diversion from the daily routine. • It is a positive change from the stereotypical lifestyle and involves an active participation in some entertaining activity.
  • 356. Uses • Broader understanding experiences • learn more functional responses • Creative thinking • Mental Health • Physical Health and Growth • Emotional Stability • Social Fitness • Psychological Awareness
  • 357. Types of Recreational Activities 1. Physical 2. Social 3. Cultural 4. Intellectual
  • 358. Types of Recreational Activities • Physical: Minor Sports, Group Games, Camping and Outing • Social : Social dancing , Attending parties , Joining Parlor Games and the likes • Cultural : Arts and crafts, Joining Glee Club or Music Ministries and Choirs, Dramatic guilds, Dance Troupes • Intellectual: Song, Poetry , Jingle, Short Story Writing , Internet Surfing, Answering Puzzle, Playing Scrabble, Bowling, Chess, Dart, etc.
  • 359. Benefits for students • Everyone needs to plan and best utilize daily free time for recreation. • Recreate the body, mind, and spirit through and through Bring forth renewed vigor, spirit, and creative effort • Recreational activities gives you opportunity to be creative, to express your basic needs, and to be your real self. • All work and no play makes a person not only dull but a sick, unbalanced, and unhappy individual according to medical authorities. • Students who correctly balance work and play are more productive and tend to be in better physical, mental, social, and emotional health. • Better chances of being successful.
  • 360. Benefits • These will help them build a lifelong habit. • Recreational activities like sports will develop muscular strength, agility, power, flexibility, and improve one’s health. • Engaging in group activities develops social skills that will lead to the development of proper conduct and behavior and social graces. • Worthwhile recreational activities give students or youth opportunities to be busy with meaningful activities instead of roaming around and doing harmful vices like abusing dangerous drugs. • Other Values that you can derive from engaging in worthwhile recreational activities.
  • 361. SLEEP • DEFINITION OF SLEEP: Sleep is a naturally occurring altered state of consciousness characterized by decreases in awareness and responsiveness to stimuli.
  • 362. PHYSIOLOGY OF SLEEP • Controlled by reticular-activating system and bulbar synchronizing system. • Wakefulness occurs when the reticular system is activated. • The hypothalamus has control centers sleeping and waking. • Injury to the hypothalamus may cause a person to sleep for abnormally long periods.
  • 363. CIRCADIAN RHYTHMS: • Biological rhythms that follow a cycle of about 24 hours are termed circadian rhythms • Circa means ―about and dies means ―day • Circadian synchronization exists when an individual sleep-wake pattern follows an inner biological clock. • When physiologic and psychological rhythms are high or most active, the person is awake and when these rhythms are low, the person will sleep
  • 364. Average amount of sleep per day  Newborn – up to 18 hours  1–12 months – 14 to18 hours  1–3 years – 2 to15 hours  3–5 years – 11to13 hours  5–12 years – 9 to11 hours  Adolescents – 9 to10 hours  Adults, elder – 7 to 8 (+) hours  Pregnant women – 8 (+) hours
  • 365. SLEEP HYGEINE • Avoid napping during the day. • Avoid stimulants. • Exercise. • Food. • Ensure adequate exposure to natural light. • Establish a regular bedtime routine. • Try to avoid emotionally upsets before sleep. • Associate your bed with sleep. • Sleep environment is pleasant and relaxing.
  • 366. FACTORS AFFECTING SLEEP Physical activity Psychological stress Motivation Diet Alcohol Intake Smoking Environmental Factors Lifestyle Illness Medications
  • 367. SLEEP DISORDERS • Insomnia: it is troubling or difficulty in falling asleep • Narcolepsy: Narcolepsy is a condition characterized by an uncontrollable desire to sleep features • Hypersomnia: Hypersomnia is a condition characterized by excessive sleep, particularly during the day. • Sleep apnea syndrome: Sleep apnea refers to periods of no breathing between snoring intervals. • Periodic limb movement disorder: it is also called nocturnal myoclonus. In this syndrome, sleep is disturbed by repetitive jerky flexion movements of the limbs which occurs in the early stages of sleep • Restless leg syndrome: Unpleasant sensations in the legs that are ameliorated by moving the legs occur when patient tired in the evenings and at the onset of sleep
  • 368. Sexual life • Sexuality is more than genital physical activity. Sexuality encompasses our whole being. • It includes our sense of femaleness and maleness. • Sexuality includes biological, sociological, psychological, spiritual, and cultural dimensions of each person’s being. • In addition, sexuality influenced by values, attitudes, behaviors, relationships with others and the need to establish emotional closeness with others.
  • 369. Sexual Rights 1. The right to sexual freedom. 2. The right to sexual privacy 3. The right to sexual equity 4. The right to sexual pleasure 5. The right to emotional sexual expression 6. The right to sexually associate freely and safely 7. The right to make free & responsible reproductive choices 8. The right to sexual information based upon scientific enquiry 9. The right to comprehensive sexuality education 10.The right to sexual health care
  • 370. Sexual health • Sexual health as the state complete well being related to sexuality • Sexual health requires a positive, respectful approach to the sexuality • Sexual relationships, • Safe sexual experiences, discrimination & violence.
  • 371. Responsible sexual behavior • Responsible sexual behaviors is expressed at individual, interpersonal & community levels. • It is characterized by: Autonomy Mutuality Honesty Respectfulness Consent Protection Pursuit of pleasure Wellness
  • 372. Sexual development • At birth: gender assigned. • It is common for 18 month old to play with genitals • 3years: gender identification. • School age: gender role behavior is learned • 6-12years: identification with gender parent, both parents • Adolescence: primary & secondary sexual characteristic develop. • Young adulthood (20-40yrs): sexually active. • Adulthood 40-65yrs: Less hormone production, sexually active and less active after 60 years
  • 373. Sexual orientation • Sexual orientation refers to a person’s sense of personal & social identity based on those attractions, behaviors expressing them, & membership in a community of others who share them • Types: 1. Heterosexual 2. Homosexual 3. Bisexual
  • 374. Contraceptive • There are numerous contraceptive options available to prevent the pregnancy and STD • Examples: 1. Barrier methods 2. Hormonal methods 3. Intrauterine methods 4. Behavioral methods 5. Sterilization
  • 375. Factors influencing on sexual life • Culture: dress, rule of marriage, role of behavior, religious values & guidelines • Personal ethics: unwritten code of conduct based upon ethical principles • Health status: Pregnancy - Menstruation • Problems that interfere with sexuality: medication side effects, MI, STD, Chronic pain, Joint diseases, Surgery.Sexual dysfunctions
  • 376. Sexual disorders • Sexual desire disorders: Hypoactive sexual desire disorder and Sexual aversion disorder • Sexual arousal disorders: Female sexual arousal disorder • Male erectile disorder • Orgasmic disorders: Female orgasmic disorder and Male orgasmic disorder • Premature ejaculation • Sexual pain disorders
  • 377. Spiritual life philosophy • Spirituality refers to a belief in a higher power, an awareness of life and its meaning, the centering of a person with purpose in life. • It involves relationships with a higher being, with self, and with the world around the individual. • Spirituality implies living with moral standards.
  • 378. Five basic spiritual needs of every person: 1. A meaningful philosophy of life (values, and moral sense). 2. A sense of the transcendent (outside of self, view of God and something beyond the immediate life, having hope.) 3. A trusting relationship with God (faith). 4. A relatedness to nature and people (friendship). Experiencing love and forgiveness. 5. A sense of life meaning.
  • 379. Spiritual philosophy concept • Healthy relationships, treating ourselves and others with respect, honesty, integrity, and love, are a sign of spiritual well-being. • Values are our principles—not only the things we say we care about, but also the things that cause us to behave the way we do. • People who are spiritually healthy are able to articulate their purpose in life, and make choices that manifest that purpose.
  • 380. Spiritual Health Contributes to Physical Health  Can improve immune function, cardiovascular function, and/or other physiological changes.  Americans who attend religious services regularly live many years longer, on average, than those who do not.  People who are more spiritually healthy exhibit greater self-control.  Those who are spiritually healthy may also be more disciplined about getting adequate exercise and sleep.
  • 381. Spiritual or Religious Well-Being Improves Quality of Life By decreasing anxiety, depression, anger, discomfort, and feelings of isolation By decreasing alcohol and drug abuse By decreasing blood pressure and the risk of heart disease By increasing the ability to cope with the effects of illness and with medical treatments By increasing feelings of hope, optimism, freedom from regret, satisfaction with life, and inner peace
  • 382. Spiritual Health Contributes to Psychosocial Health Current research suggests spiritual health reduces levels of anxiety and depression. Yoga, deep meditation, and prayer can positively affect brain chemistry. Charitable organizations and social gatherings can help members avoid isolation and find support in a spiritual community.
  • 383. Spiritual Health Contributes to Reduced Stress Stress reduction is one probable mechanism among spiritually healthy people for improved health and longevity, and for coping more effectively with illness. Positive religious coping supports effective stress management. Increasing mindfulness through meditation reduces stress levels not only in people with physical and mental disorders, but in healthy people as well.
  • 384. Self reliance • Reliance on one's own efforts and abilities. • It means ability to reliant of an individual on his own without depend on anyone • Self-reliance is defined by independence. It is the ability to think and act without the help or influence of others, the ability to decide what you should be or do. • Dependency is the act of relying on others to make decisions for an individual.
  • 385. Factors influencing on self reliance 1. Educational 2. Employment 3. Socio economic status 4. Nutrition 5. Personality 6. Human value 7. Human relationship 8. Hygiene 9. Health status 10.Spiritual and religion
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  • 402. Diet therapy • Diet therapy is modification or alteration in diet according to disease condition of patient. • Example: diet for Dm, Diet for HT, Diet for GIT problems, Diet for kidney disease, Diet for liver disease • Diet for Dm – sugar restricted and Diet for HT – Salt restricted diet..
  • 403. Education • Education is the process of acquiring knowledge through different sources • The sources may be teacher, text books, articles, internet etc..
  • 404. Importance of education 1. Behavior modification 2. Learning 3. Improving knowledge 4. Not restricted only in school 5. Life long process 6. Employment 7. Improving socio economic status 8. Helps to meet basic needs 9. Develop personality 10.Maintain health 11.Creativity
  • 405. Level of education Pre primary ( Pre KG, LKG, UKG) Primary level (1to 5th) Middle level (6 to 8) High school (9 & 10) Higher ( 11 & 12) UG PG M.phil PhD Vocational education and training
  • 406. Educational methods • The method of teaching is called pedagogy • Story telling • Discussion • Teaching • Training • Research • Field trips
  • 407. Formal and informal education 1. Formal education occurs in a structured environment (class room) 2. Informal education: occurs in home or work place 3. Special education: for disabled children 4. Open education: learn by own effort without guidance
  • 408. Challenges of Present Education System Lack of will to learn Quality of teaching Infra structure Reservation Distance of educational facility Socio economical status Educational policy
  • 409. Government schemes • Free Education • Sarva Shiksha Abhiyan ( Education for all) • Mid day meal programme • Right to education (RTE) • National policy on education • Free uniforms, books, notes and other materials • Adult education • Established so many institute for education (IIT,AIIMS)
  • 410. Occupation •It means involving in any job or work to earn money in order to meet all basic needs of human life •Job or profession or career or work
  • 411. Classification of occupation I: 1. Professional 2. Employment 3. Business II: 1. Full time 2. Part time 3. Day job III: 1. Temporary 2. Permanent 3. Seasonal 4. Self employment 5. Consultation 6. Contract
  • 412. Examples for jobs  Teacher  Doctor  Nurse  Policeman  Farmer  Fireman  Tailor  Painter  Mechanic  Electrician  Postman  Gardner  Officials  fisherman  Driver  Photographer  Pilot  Dentist  Cook  Musician  Journalist  Lawyer
  • 413. Requirement for Good Occupation 1. Education 2. Knowledge 3. Skills 4. Service motive 5. Creative thinking 6. Leadership 7. Human relation 8. Discipline 9. Personality
  • 414. Need for occupation Meet basic needs Earn money Improve socio economic status Maintain social status Gain experiences Socialization Personality development
  • 415. Income • Income is money or a benefit in kind you receive. • It means Money earned by a person, company or government over particular period of time. • Earn/have/receive (an) income Your hobby could become a part-time way of earning income.
  • 416. Types- I • Family/household income • Annual/monthly/quarterly income • A high/low income • Additional/extra income • Current/future income • A regular/steady income • Pension/retirement income • Rental income
  • 417. Types- II 1. Regular 2. Irregular (additional) 3. Benefit-in-Kind 1. Regular Income: Is what you are sure of receiving- You can plan to spend it- E.G. Wages/ Salary/Child Benefit 2. Irregular Income: Is what you are not sure of receiving- You cannot plan to spend it- E.G. Bonus 3. Benefit- in –Kind: Non money income received for work done- Incentive to work hard-
  • 418. Sources of Income • Wages and Salaries/Allowances • Investment Income • Self-employment • Inheritance • Gifts • Awards • Lottery
  • 419. National income & Per Capita Income • National Income: National income measures the total value of goods and services produced within the economy over a period of time. • Per Capita Income (PCI): Per Capita Income of a country is derived by dividing the national income of the country by the total population of a country.
  • 420. Common Employee Benefits Paid Vacation Holidays Paid Sick Days Health Insurance Disability Income Insurance Life Insurance Dental/Vision Insurance Profit Sharing
  • 421. Factors the Affect Income • Education • training • Experience • Skill • Knowledge • Level of demand • Job opportunities • Seniority • Work habits, • Reliability • Accountability • Performance • Status of employer
  • 422. Budget • It is a financial plan that shows expected income and expenditure over a certain time period
  • 423. Aims 1. To ensure money is available to cover costs 2. To Reduce risk of impulse buying 3. To Avoid build up of debt 4. To manage expenses
  • 424. IMPORTANCE OF BUDGET 1. It sets a frame work for policy formulation 2. Budgeting is a means of policy implementation 3. A budget is a means of legal control 4. It is a tool of accountability 5. It is a tool of management 6. It is an instrument of economic policy
  • 425. Characteristics 1. Should be flexible. 2. Should be synthesis of past ,present and future. 3. Should be product of joint venture and cooperation at different level 4. Should be in the form of statistical standard laid down in the specific numerical terms. 5. Should have support of top management throughout the period of its planning and implementation.
  • 426. Types  OPERATING BUDGET(Revenues and Expenses): Provides an overview of planned operation for upcoming year. Deals with salaries, medical-surgical supplies, office supplies, laundry services, books periodicals, recreation and contractual services.  CAPITAL EXPENDITURE BUDGET: Related to long range planning. They are major investment and reduces flexibility in budgeting.  CASH BUDGET: Planned to make adequate funds available and to use extra funds profitably. Should not have too much cash on hand during budgetary period.
  • 427. Types  LABOR OR PERSONNEL BUDGET: Estimate cost of direct labor necessary to meet agency objectives. Determine the recruitment, hiring, assignment, layoff, discharge of personnel.  FLEXIBLE BUDGET: Some expenses are unpredictable and can be determined only after change has begun. Periodic reviews required to compensate for changes.  STRATEGIC PLANNING BUDGET: Long range budget for long range planning. Projected for 3-5 years. Programme budget is a part of this budget.
  • 428. STEPS • STEP 1: Establishment of goals and objectives • STEP 2: Goals must be translated into quantifiable management • STEP 3: Formal plan for budget preparation and review • STEP 4: Departmental budget are revised and master budget is prepared. • STEP5: Financial feasibility of master budget is tested • STEP 6: Every head of the office required to prepare budget estimate in respect of salaries of establishment, contingent expenditure and others.eg. Telephone, office expenses, rent of building etc.
  • 429. Model S. N INCOME EXPENDITURE % Source Amount Expenses Amount 1. Salary 10000 Rent 3000 20% 2. Part time 2000 Food 4000 26% 3. Allowances - Electricity 500 3% 4. Incentives 3000 Medical 2500 16% 5. Others - Saving and others 5000 33%
  • 430. Purchasing power • The financial ability to buy products and services. • It means available funds to make purchases. • Purchasing power is important because, it is essential to fulfill all the basic needs of individual, family and community
  • 431. Factors affecting Purchasing Power Education Employment Income Status Tax Socio economic background Cost of goods and services Economical crisis Supply and demand
  • 432. Purchasing Power Loss/Gain: • Purchasing power loss is an decrease in how much consumers can buy with a given amount of money. • Consumers lose purchasing power when prices increase • Causes of purchasing power loss include government regulations, inflation and natural and manmade disasters. • Purchasing power gain is an increase in how much consumers can buy with a given amount of money. • Consumers gain purchasing power when prices decrease. • Causes of purchasing power gain include deflation and technological innovation.
  • 433. Security • The financial security is a contract between the provider of funds and the user of funds. • It means maintain or saving money for future utilization in order to avoid economical crisis
  • 434. Purposes 1. To mange economical condition 2. To solve economical problems 3. To reduce economical burden 4. To save the money for future 5. To maintain economical stability
  • 435. Types 1. Insurance 2. Health policies 3. Debt Security 4. Equity Security 5. Security bond 6. Bank loan