The document discusses factors that impact family health in rural Indian communities. It notes that 80% of the Indian population lives in rural areas that often lack education, health services, adequate housing and infrastructure. As a result, many families suffer from malnutrition, poor socioeconomic status, and inability to meet basic needs. Common health issues include malnutrition, diseases from unsafe water/lack of sanitation, unhealthy living conditions, and substance abuse. Poverty is identified as a major underlying cause of illness, as the poor cannot afford adequate nutrition or medical care.

1. S.Jasmindebora,
Professor,
Dept of medical surgical nursing ,
NRI college of Nursing,
Chinakakani,
Guntur

2.  Indian population 80% live in rural areas
 Lack of education & primary health care
services
 Poor resources- Housing ,water , electricity
 Unable to meet basic needs
 Poor socio economic status
 Malnutrition
Volunteers play vital role

3.  Health Awareness Know about our self &
create awareness among others

4.  People usually associate health with illness,
doctor, and medicines.

5.  Actually good health does not simply mean
the absence of disease, but is related to
good physical, mental ,economical , social
and spiritual wellbeing
A Healthy Family

6.  Adequate food (nutrition)
 Safe drinking water, sanitation, and housing
 Clean environment, healthy living conditions and
health lifestyle
 Access to better health services
 Education
 Social security measures and proper and equal
wages
 Freedom from exploitation and discrimination
 Women’s rights
 Protected work environment
 Relaxation, recreation and healthy relationships

7.  Malnutrition
 Unsafe water and lack of sanitation
 Unhealthy living conditions
 Unhealthy habits-alcohol/drug abuse
 Hard labour and difficult work conditions
 Mental tension
 Patriarchy
 Lack of access to health services
 Lack of health education

8.  Malnourished people fall ill very easily because
they have reduced capacity to keep themselves
free from diseases. That’s why they fall ill very
easily and stay ill for a long time.
 Diseases like diarrhea, measles, malaria and
pneumonia are often the cause for death of
malnourished people.
 Around 50% of our population is very poor and
they have to deal with a lot of difficult
circumstances in their lives.
 Girls and women are often seen to be more
malnourished

9. Biggest reason for ill health is malnutrition
Hunger is the main cause of malnutrition (lack of
awareness is relatively a smaller problem)
Poverty is the reason for hunger (availability of food is not the
problem, the problem is that the poor do not have money to buy
enough food)
Malnutrition causes illness again and again
Falling ill repeatedly leads to malnutrition
Expenses on treatment further leads to poverty and more
malnutrition
Leading to more disease…more malnutrition
This continuous process leads to ill health

10. Monitoring growth by checking height ,weight and mid-arm
circumference with growth chart(below 50th%)are considered
sick or malnourished children, in need of prompt medical
attention, they are referred to the Primary Health Centre or
its sub-centre.
Supplementary nutrition
 Each child up to 6 years of age to get 300 calories and 8-10 grams of
protein
 Each malnourished child to get 600 calories and 16-20 grams of protein
 Each adolescent girl to get 500 calories and 20-25grams of protein
 Each pregnant women and lactating mother to get 500 calories and 20-
25 gms of protein

11.  Unsafe water is cause of many diseases.
 The lack of sanitation leads to contaminated and unsafe
drinking water
 In both villages and cities, the non-availability of safe
drinking water facilities for all residents also leads to more
diseases
 Diarrhea, cholera, jaundice, typhoid spread due to unsafe
drinking water
 Malaria, dengue Filaria, encephalitis
spread due to mosquitoes breeding in
stagnant water

12.  Provision of good water supply alone can not free the
community from water born diseases
 Recognize the need for Safe water by boiling water
 Storing of water safely is must for health
 Keep water supply clean and safe by practicing good health
habits
 Good health habits include cleaning hands while handling
water
 Do not contaminate public water supply by washing vessels
, clothes, bathing etc

13.  In home, water need to be handled carefully by using
utensils with handles to take water from pots or vessels
 Have a check on mixing of Drain water with drinking water
 Avoid open field defecation and use latrines
 Proper sewage disposal methods
 Hand washing with soap after defecation prevent gastro
intestinal disorders

14.  Crowded living spaces, damp rooms, smoke and dust filled
environment, all these give rise to respiratory problems
and lead to diseases like Tuberculosis.

15.  Two living rooms and veranda space should be provided for
a house
 Built up area should not exceed one third of the total area
 Separate kitchen with washing and storage facility
 Windows and doors should be provided
 A sanitary well should be accessible with in quarter of a
mile from the house
 Cattle shed should be at least 25 feet away from the house

16.  Facility for waste water and garbage disposal
 Avoid stagnation of water during rainy season in and
around the house
 Gambusia fish can be reared in the ditches to avoid growth
of insects
 Spray insecticides in the premises, rat holes, Godowns and
store houses
 Nets , mesh for doors and windows
 repellents can be used to control flies
 Good housing , good environment and good sanitation are
needed to have good health

17.  Unhealthy habits related to life style like alcoholism and
use of other intoxicants, drugs and norcotic substances are
also a major cause of bad health in many families. They
also lead to social problems at the family and community
level and health problems

18.  a lifestyle where a person engages in activities that are known to be
detrimental to one's health, such as smoking, not exercising regularly
or enough, eating unhealthy foods on a regular basis, and not
maintaining a healthy weight. An unhealthy lifestyle can vary by
degrees, and some may determine that being slightly unhealthy is
acceptable for the sake of quality of life
 Alzheimer's disease, Arthritis, atherosclerosis, asthma, cancer,
chronic liver disease or cirrhosis, chronic obstructive pulmonary
disease, Type 2 diabetes, heart disease, metabolic syndrome,
chronic renal failure, osteoporosis, stroke, depression and obesity
are the diseases caused out of un healthy life style

19.  Alcoholics ,drug abusers and smokers should admit they
are in problem
 Person should be honest with himself and with others
 Family friends and others need to support
 People who are previous victims are best helpers
 Parents ,teachers and health workers should set good
example
 Mass media should propagate the dangers caused by them
and their hazards

20. Dietary modifications
 Reduction of fat intake to 20-30% of total energy intake
 Consumption of saturated fats must be limited less than 10%
 Reduction of dietary cholesterol to below 100 mg per 1000kcal
per day
 An increase in complex carbohydrates consumption( vegetables
,fruits , whole grains and legumes)
 Avoid alcohol consumption , reduction of salt intake 5gm daily

21. Physical activity
 Regular physical activity should be part of normal daily life
 At least 30 minutes of moderate physical activity controls blood
pressure ,control glucose in blood , build and maintain healthy
bones ,muscles and joints , promote psychological wellbeing ,
controls weight
Health check ups
 Monitor blood glucose levels
 Monitor blood sugar levels
 Check weight regularly
 Regular follow ups
 Adherence to treatment
 Mammogram
 Pap smear test
 Breast self examination

22.  Having to do hard labour e.g. pulling cycle-rickshaws
 Working for long hours
 Conditions of work; increase the possibilities for disease and
illness. For example: working unprotected in stone quarries
leads to severe respiratory problems, spraying pesticides
without protection
 Unsafe equipment and work tools

23.  Regular health check ups – annually
 Immunizations during epidemics; Inj.TT for injury
 Provision of adequate self protecting devices and tools
 Leisure in between work periods -coffee break, lunch
break
 Educating on child rearing practices , provision of safe
environment
 Rehabilitation of the ill and injured
 Reduce absenteeism by providing adequate health as
priority

24.  When we compare men and women, we find that more
women fall ill than men.
 The core reason for this is patriarchy. It means that our
society is dominated by men and accords a lower status to
women. This causes ill-health for women in the following
ways:
-In the family, women eat last and also get lesser quantities
of food to eat
-Women have to bear the burden of work both
in the home and outside

25. -Women have lesser access to health services
-Women are giving lesser opportunities for education
-Women are taught to feel ashamed about their bodies
-Women are taught to tolerate everything in silence
-Women are made to give the least importance to their
health
-They are subjected to violence, abuse and harassment
-They also face the constant fear that men can leave them or
kick them out of the house
-Females are subjected to female feticide, girl infanticide,
and dowry death

26.  Enlighten on Gender equity
 Women empowerment
 Women education
 Women rights

27.  Many times the negative circumstances of life become too much
to bear and leads to mental stress which is an contributing factor
for most of non communicable diseases like cancer, stroke ,
cardio vascular diseases,Diabetes
 Breakdown of society or family, unemployment, social insecurity,
no relaxation, these all are causes of mental tension leading to
mental illness
 People fall ill due to mental tension.
Sometimes this also leads to the
extreme step of committing suicide.

28.  Live in Safe environment both physically and emotionally
 Improve socializing skills among family as well as individual
 One should Learn new things through out the life
 Having something that keeps you excited and enthusiastic
 Being creative in all areas- music, art, poetry, living,
movement etc
 Eat healthfully.
 Exercise adequately.
 Care for your health daily.
 Take time for yourself regularly.
 Sleep bountifully.

29.  Play -Learn to do something new and fun
 Know yourself-Be attuned to your thoughts and feelings.
 Keep a journal-Recognize when “this just doesn’t seem like I
usually think or act”.
 Say “no” sometimes- Don’t overbook your schedule or your life.
 Make time for quiet -Turn off the cell phone, TV…
 Coping skills to family and individual
 Balanced diet , recreation, rest and sleep and mental
happiness is needed for pregnant women to have mental
health
 Avoid drugs , alcoholism, toxins and infections during
pregnancy
 Recognize warning signs in
 How you think,
 How you feel,
 How you act.

30. – Practice stress management and other self care
strategies throughout life.
– Know when and where to get help.
 Get help as soon as you suspect you need it.
 Get help from a trained counselor or through a
medical referral.

31.  The government is responsible for providing healthcare services
to all people. However, many a time people are not able to
access these services. This may be due to many reasons, for
example:
 Health facilities like PHC are non- functional due to lack of
availability/vacant positions of ANMs, doctors, nurses and other
staff.
 Overburdening of health facility staff may also limit their
effectiveness in providing care to the patients.

32.  Provision of care is also adversely affected in cases where the
staff of health facility lacks initiative or is negligent.
 People are unable to avail adequate health services due to
limited availability of diagnostics and medicines in health
centers in some places.
 Block and district hospitals sometimes also lack adequate
services
 Lack of connectivity, unavailability of transport, geographic
barriers limits the reach of the people to avail health services.
 In many places, people have to spend some money from their
own pockets even if they go to Government hospitals

33. The cost of going to private hospitals is even higher. Therefore
many poor people are not able to take treatment from proper
hospitals

34. Health check-ups
 Record of weight and height of children at periodical intervals
 Watch over milestones
 Immunization
 General check up for detection of disease
 Treatment of diseases like diarrhea, ARI
 De worming
 Detection of Disability among Children
 Providing Treatment for Minor Ailments and first aid
 Prophylaxis against vitamin A deficiency and anemia
 Referral of serious cases

35. Referral Services
 During health check-ups and growth monitoring, sick or
malnourished children, in need of prompt medical attention,
are referred to the Primary Health Centre or its sub-centre.
 The anganwadi worker has also been oriented to detect
disabilities in young children. She enlists all such cases in a
special register and refers them to the medical officer of the
Primary Health Centre/ Sub-centre
 Mother and child health services
 Family planning services

36. Immunization
 Immunization of pregnant women and infants protects
children from six vaccine preventable diseases-
poliomyelitis, diphtheria, pertussis, tetanus, tuberculosis
and measles.
 These are major preventable causes of child mortality,
disability, morbidity and related malnutrition.
Immunization of pregnant women against tetanus also
reduces maternal and neonatal mortality

37.  Lack of health awareness due to ignorance
 In order to increase the utilization of health services, people
need to be given full information about this, like, what are the
services available, what their importance is and how to utilize
them. Many a times people are not given this information and
this prevents them from utilizing the services.
 The lack of participation by the community in health and the
lack of relationship between the community and health staff
result in such problems

38.  Physical activity and fitness – exercises minimum 30 min a
day
 Nutrition and weight control- balanced diet
 Stress reduction-meditation ,yoga , prayer, relaxation
technique
 Worker safety and health
 Blood pressure and/or cholesterol education and control
 Alcohol, smoking and drugs

39.  Wash hands with soap in the morning after getting up from
bed , after bowel movement and before eating
 Bathe every day , often during hot weather , after working
hard or sweating frequent bathing prevents skin infections
, dandruff , pimples , itching and rashes .sick person and
babies should be bathed daily
 Do not allow children to go out with barefoot
Because hook worms enter the body through the soles of the
feet

40.  Brush your teeth every morning and every night before
going to bed
 Wash your mouth after each meal
 Do not eat too many sweets and chocolates
 Cut the finger nails often because germs and worm eggs
often hide beneath long finger nails
 Change your clothes daily after bath every day

41.  Water should be boiled before drinking and stored safely
 Do not let flies and other insects land or crawl on food
 Do not leave food scraps or dirty dishes lying around as
these attract flies and breed germs
 Protect food by keeping covered or In boxes or cabinets
 Before eating fruits or vegetables ,wash it well
 Do not let children pick up and eat food that has been
dropped.
 Eat meet that is cooked well
 Do not eat food that is old or smells bad .it may be
poisonous

42.  Do not let pigs come in to the house or places where
children play
 Do not let dogs lick children or climb up on beds
 Avoid open field defecation
 Hang or spread sheets and blankets in the sunlight ,if
bedbugs are found pour boiling water on the sheet and
then wash
 Do not spit on the floor
 When you cough or sneeze cover your mouth with your
hand or cloth
 Clean the house every day
 Sweep and wash the floor, walls and beneath furniture
 Delouse the whole family once in week

44.  Health is a state of complete physical ,
mental social ,economical an spiritual
wellbeing and not merely the absence of
disease or infirmity-WHO