Determinants of health best notes

DETERMINANTS OFHEALTH
BY : MD DANISH RIZVI
M.SC (N)
COMMUNITY HEALTH NURSING

INTRODUCTION
• Aperson whoisphysically,mentallyand sociallyhealthyissaidto be
inastateof optimum health.
• T
oachievethehighestdegreeof healthshould bethegoal of every
human being.
• The healthof anindividual isnot static. Itisadynamicphenomenon,
to maintainpositiveor optimumhealth,needsto discussdeterminants
of health.
• Health is multifactorial. Thefactorswhichinfluencehealthlies both
internally and externallyinthesocietyinwhichhe/she lives.

DEFINITIONOF DETERMINANTSOFHEALTH
• Definition: Determinants of health include the range of personal, social,
economic and environmental factors which determine the health status
of individualsorpopulations.

Determinantsof health includes:
• Incomeand socialstatus:Higherincomeand socialstatusarelinkedto
better health. Thegreaterthegapbetweentherichesand poorest
people, the greater the differences in health.
• Education:Loweducationlevelsarelinkedwithpoor health,morestress
and low self-confidence.
• Physicalenvironment:Safewaterand cleanair, healthyworkplace,safe
houses,communitiesand roadsall contributeto good health.
Employmentand workingconditions- people inemploymentare
healthier, particularly thosewhohavemorecontrol overtheirworking
conditions.

Determinantsof health includes:
• Socialsupport network:Greatersupport fromfamilies,friends and
communitiesislinkedto better health. Culturecustomsand traditions, and
the beliefs of the family and community all affect health.
• Genetics:Inheritanceplaysapartindetermininglifespan,healthinessand
thelikelihood of developing certain illnesses. Personalbehaviorand coping
skills-balanceddiet,keepingactive,smoking,drinking,and howw
edeal with
life’sstressesand challengesall affect health.
• Healthservices:Accessand useof servicesthatpreventand treatdisease
influences health.
• Gender:Menand womensufferfromdifferent typesof diseasesatdifferent
ages.

EUGENICS
• ThewordeugenicsetymologicallyderivesfromtheGreekword ‘eu’
means‘good or well’and the‘genes’means‘born’.
• ThetermeugenicswascoinedbySirFrancisGaltonin1883.

DEFINITIONOFEUGENICS
• Eugenicsisthestudyof hereditaryimprovementof thehumanraceby
controlledselective breeding.
- American Heritage English Dictionary

TYPESOFEUGENICS
• POSITIVE EUGENICS: It is the selection of breeding between mates who
possessed favorable genes. The number of good people in the world is
increased by encouraging good people to breed. This is called positive
eugenics.
• Varieswaysof positiveeugenicsareinvitrofertilization.
• NEGA
TIVEEUGENICS:Itrefersto decreasethenumberof bad people in
theworldbyfinding waysto makeitsothatbad people would not
breed. Thiswascallednegative eugenics.
• Varieswaysof negativeeugenicsare:abortion, sterilization, adoption of
familyplanning methods.

ENVIRONMENT
• The term environment refers to all external factors living and non living,
material and non material which surrounds man, e.g. air, water
, soil and
alsosocial,economicalconditionsunder whichw
elive.
• Environmentisdefinedasall twoexternalfactorsincludinglivingand
non livingmaterialwhichsurrounds man.

TYPES/COMPONENTSOF ENVIRONMENT
• INTERNALENVIRONMENT:
• Itrefersto eachand everycomponentpart,everytissues,organand
organsystemand theirharmoniousfunctioning withinthe system.
• EXTERNALENVIRONMENT:
• It is defined as all that whichis external to the individual human host.
• Externalenvironmentisdividedintothreecomponents:
– Physical environment
– Biological environment
– Social environment

PHYSICALENVIRONMENT
AIR
• Airis one of themost important physical environments. Itisthebasis
for health and survival. T
omaintainhealthylife,pureand clean
atmosphericair is necessary
.
• Compositionof air isthemixtureof gasesmainlyoxygen,nitrogenthat
surroundsthe earth.
Percentage of Gases present in air
1. Nitrogen 20.96%
2. Oxygen 20.96%
3. Carbon dioxide 0.03%
4. Watervapors,restof gasessuchasneon, krypton,
etc.
0.94%

FUNCTIONSOFAIR
• Airpurifiestheblood byinterchangeof oxygenwithcarbon dioxidein
thelungsand regulatesbody temperature.
• Human body iscooled bytheair contact.
• Airact asachannelfor carrying bacteria.
• Airhelpsthespecialsensesof hearingand smellto function throughair
transmitted stimuli.

AIRPOLLUTION
• Airpollution isanexcessiveconcentrationof foreignmattersintheair
whichadverselyaffectsthewell-beingof anindividualor causes
damagetoproperty.
- AmericanMedicalAssociation

SOURCESOFAIRPOLLUTION/CAUSESOFAIR
POLLUTION
1. INDUSTRIES:Therearemanyindustrieswhichemitvariousgasesand
particulate matter. Someof theimportantindustrialsources are:
i. ThermalpowerplantwhichproduceSulphurdioxide,nitrogen oxide
and ash particles.
ii. CementfactorieswhichproduceSulphurdioxide,carbon monoxide
and particles.
iii. Steel plants whichproduce Sulphur dioxide, carbon monoxide and
particles.
2. CHEMICALFERTILIZERS:Thechemicalfertilizerswhichareused to
increaseagricultureproductionproducepollutants likenitrogenoxide,
Sulphurdioxide,ammoniaand ureadustwhichpollute theair inthe
communityand neighborhood.

SOURCESOFAIRPOLLUTION/CAUSESOFAIR
POLLUTION
3. COMBUSTIONOFCOAL,FUELOILANDNA
TURALGAS:Theseareused
infactories,power plants,kitchens insome places, etc. Theseproduce
carbon dioxide,carbon monoxide,Sulphurdioxide,ashparticlesand
thuspollute air.
4. TOBACCOSMOKE:Tobaccosmokereleasedbysmokersinthe
households and publicplacespollutetheair of thehousesand public
places. Thetobaccosmokeemitsnicotinewhichisveryinjuriousto
healthof the people.
5. OTHERS:Overpopulation, nuclear explosion.

CONTROLOFAIRPOLLUTION
1. CONT
AINMENT:Controlof air pollution atthepoint of its origin.
2. REPLACEMENT:Replacementof coaland gasbyelectricitywill
minimizeair pollution.
3. DILUTION:Bygrowingvegetationand plantsbetweentheindustrial
zone and the residentialareas pollution can be minimized. These
areasarecalledgreen belts.
4. CONTROL OF POPULATION GROWTH: It helps to reduce congestion of
air and space, so that government has adopted the small family norm-
’wetwow
ehaveone’.

PREVENTIONOFAIRPOLLUTION
• EDUCA
TIONOFPEOPLE:
– Usesmokelesschulhasisessentialto reducethe pollution.
– Legislation act: Government has taken strict measures by passing suitable laws.
Government has planned for industrial areas and steps are taken to prevent air
pollution by industries.
– Avoidpassive smoking.
• LOCATIONOFINDUSTRIES,RESIDENTIALAREAS:
– Properplanning of industriesand housing colonies.
– Locatetheplantsintheoutskirtsof townsand citiesto avoidnuisancesdueto
smoke,gasesand dust.
– Residentialareasareplannedto beawayfrom industries.

PHYSICALENVIRONMENT
LIGHT
• Good light is necessary for effective vision. Imperfect light is one of the
causesof illnessand accidents.
• Lightfactorsessentialfor effective vision:
– Sufficiency: Light should be sufficient to enable the eye to discern the details of the
objectsaswellasthesurroundingwithouteyestrain.
– Distribution: The distribution of light should be informed, having the same intensity over
thewholefieldof work.
– Absence of glare: Glare is excessive contrast. Glare may be a direct glare from a light
sources . Glare causes annoyance. One eye cannot tolerate glare because it causes
acutediscomfortand reducescritical vision.
– Absenceof sharpshadows: Shadowcausesconfusion to theeyeand thereforeshould
not bepresentinfieldof vision.
Steadiness: One sourcelightshouldbeconstant.
–
– Color of light: Natural light has a soothing effect on the eye, the artificial light is not
very important.

PHYSICALENVIRONMENT
VENTILA
TION:
• Ventilationmaybedefinedasexchangeof air betweenindoors and
outdoors.
IMPORT
ANCE:
• Itwillimprovethehealthstatusbothphysicallyandmentally
.
• Itwillpreventfatigue,instability,lossof workingcapacity,dizziness, loss
of appetite, insomnia.
• Goodsystemof ventilationimprovestheknowledge.

PHYSICALENVIRONMENT
TYPESOFVENTILA
TION:
• Natural ventilation:
Thewind:Thewindisanactiveforceof ventilation.
Diffusion:Airpassedthroughthesmallestopeningsor spacesby diffusion.
–
–
– Inequalityof temperature:Airflowsfromhighdensityto lowdensity,itrises whenslightly
heated and escapes from openings provided high-up in the room.
• Mechanical ventilation:
drivenby electricity
.
– Exhaustventilation:Airisextractedor exhaustedto theoutsidebyexhaustfans usually
– Plenum ventilation: Fresh air is blown into the room by centrifugal fans, so as to create a
positivepressureand displacethevitiated air.
– Balancedventilation:Thisisacombinationof theexhaustand plenumsystemsof
ventilation.
– Air conditioning: Air conditioning is defined as simultaneous control of all, or at least the
first3 of thosefactorsaffectingboththephysicaland chemicalconditions of the
atmospherewithinanystructure.

PHYSICALENVIRONMENT
helpsin many
WA
TER
• Water isvery necessary to lead a healthy life. Water
ways, i.e.:
– Itreplacelossof fluidsfromtissues.
– Itmaintainsfluidity of blood andlymph.
– Ithelpsinexcretionof wasteproducts.
– Itactsasavehicleof dissolving food.
– Ithelpsindigestionand regulatesbodytemperature.

PHYSICALENVIRONMENT
PURPOSES/USE OF WA
TER:
• Domesticpurpose: cooking,washing,bathing,personal cleanliness,
cleaning.
• Public/community purposes:cleaningof streets,washingof drains,
maintenanceof publicgardens,swimmingpool, firefighting etc.
• Industrialpurposes:washingand producingelectricity,for processing
and cooling.
• Agriculturepurposes:growingplant, vegetables.
• Businesspurposes:hostel,hospital, restaurant etc.

PHYSICALENVIRONMENT
SOURCESOF WATER:
• RAIN:Itisthemainsourceof water,therainsinks into
theground water
.
• SURF
ACEWA
TER: The rain reach to the surface it is
calledsurfacewater,e.g.lakes,river,tank, ponds.
• GROUNDWA
TER:
– Well’s
– Shallowwell:Ittapesthesubsoil waterfromabovethefirstimperviouslayerin
the ground.
– Deepwell:Deepwellwhichtapesthewaterfrombelowthefirstimperviouslayer of
the ground.
– Artesianwell:Waterinbetweenfirstand secondimperviouslayer.
– Springs: whentheground comesto thesurfaceand flowfreelyunder natural
pressureiscalledsprings.Springsaredivided into:
– Shallowspring:presentfromfirstimperviouslayer.
– Deepspring:belowimperviouslayer.
– Thermalspring:aftervolcaniceruptions thespringwillformthatisthermal spring.

PHYSICALENVIRONMENT
WA
TERPOLLUTION:
• Waterpollution isdefinedasthepresenceof pollutants (organic,
inorganicor biological) inwatersto suchextentthatit:
– Reducesthequalityof water
.
– Makesunfitfor drinking
– Constitutes hazards to plants, animals and human beings.
– Waterwillbepollutedbecauseof industrialwaste,domesticwaste,and sewage.
These are affecting the physical and chemical properties of water
.

PHYSICALENVIRONMENT
CAUSESOFWA
TERPOLLUTION:
• SEWAGE:Thewastewaterfromthehouse,agriculturalland and
industriesdirectlymixwiththeriverwaterleads to waterpollution and
alsowaterborne diseases.
• INDUSTRIALWASTE:Industrialwastelikealcohol,sugar,paper, cloth,
water,chemicals,pumpfertilizersand insecticidesarepollutingthe
water
.
• AGRICUL
TURALWASTE:Excessiveuseof fertilizersand insecticidesnot
only polluting thesoilbutalsothe watersources.
• WA
TERBORNEDISEASES:Presenceof microorganismslikebacteria,
virus,protozoa, spirochetalhelminthictoxicsubstanceleadsto water
borne diseases.

PHYSICALENVIRONMENT
HARDNESSOFWA
TER:
• Hardnessof waterisdefinedasthepresenceof impuritiessuchas
chloride, sulfates,bicarbonatesof calciumand magnesiuminwater
.
CLASSIFICA
TIONOFHARDNESSOFWA
TER:
• TEMPORARYHARDNESS:Itisdue to thepresenceof bicarbonatesof Ca
and Mg.
• PERMANENTHARDNESS:Itisdueto thepresenceof sulfates,chlorides
and nitratesof Caand Mg.

PHYSICALENVIRONMENT
METHODSOFREMO
V
ALOFHARDNESSOFWA
TER:
• TEMPORAR
Y HARDNESS:
– Boiling : boiling of waterconverts biocarbonates into insoluble carbonate. Carbondioxide is removed from water
.
– Addition of lime:One ounceof limeisadded to every700gallonsof waterfor eachdegreeof hardness.
– Addition of sodaash (sodium carbonate) : Sodaash(sodiumcarbonate)removesbothtemporaryandpermanent
hardness.Sodaashisadded to removecarbonate,bicarbonate,sulfatesandchloridesof Caand Mg.
– i
t
Permut process : Permutit is a complex compound of sodium, alluminium and silica. It is a base exchangeprocess
for treatmentof largewatersupply
.Whenhardwaterispassedoveritpermutitreadily exchangescalciumand
magnesiumionsandgivesodiumionsto the water
• PERMANENTHARDNESS:
– Addition of sodaash(sodiumcarbonate):Sodaash(sodiumcarbonate)removesbothtemporaryand permanent
hardness.Sodaashisadded to removecarbonate,bicarbonate,sulfatesandchloridesof Caand Mg.
– i
t
Permut process: Permutitisacomplexcompoundof sodium,alluminiumandsilica.Itisabase exchangeprocess
for treatmentof largewatersupply
.Whenhardwaterispassedoveritpermutitreadily exchangescalciumand
magnesiumionsandgivesodiumionsto the water

PHYSICALENVIRONMENT
WA
TERPURIFICA
TION:
• LARGESCALEPURIFICA
TION:
– Storage
– Filtration
– Disinfection
• SMALLSCALEPURIFICA
TION:
• Boiling
• Chemical disinfection
• Filteration
• Disinfectionof wells

PHYSICALENVIRONMENT
LARGE SCALE WA
TERPURIFICA
TION:
• STORAGE:waterisdrawnout fromthesourceand impounded innatural
or artificial reservoirs.Storageprovidedasreserveof waterfromwhich
furtherpollutionis excluded.
• FIL
TRA
TION:Filtrationisthesecondstageinthepurification of water and
quiteanimportantstagebecause98-99 percentof thebacteriaare
removed by filtration apart from other impurities.
– Slowsandor biological filters:
– Elementsof aslowsandfilter:
– Supernatant(raw) water
– Abedof graded sand
– Anunder-drainagesystem
– Asystemof filtercontrolvalves
– Rapidsand/ mechanicalfilters:

PHYSICALENVIRONMENT
SLOWSAND FIL
TER:
1. SUPERNA
T
ANT(RAW)WA
TER:the
supernatantwaterabovethesandbed, whose
depthvariesfrom1 to 1.5meter,servestwo
important purposes:
• Itprovidesaconstantheadof watersoasto overcomethefilterbedand thereby
promotethedownwardflowof waterthroughthesandsend bed.
• It provides waiting period of some hours (3 to 12 hours, depending upon the filtration
velocity) for the raw water to undergo partial purification by sedimentation, oxidation
and particlesagglomeration.Thelevelof supernatantwaterisalwayskeptconstant.
2. SAND BED: the thickness of the sand bed is about one meter. The sand grain are
carefully chosen so that they are preferably rounded and have an affective diameter
between0.2and 0.3 mm.

PHYSICALENVIRONMENT
SLOWSAND FIL
TER:
3. UNDERDRAINAGESYSTEM:Atthebottom of thefilterbedistheunderdrainagesystem. It
consists of porous or perforated pipes whichserve the dual purpose of providing an outlet for
filteredwater,and supporting thefiltermedium above.
4.FIL
TERCONTROL:Thefilterisequippedwithcertainvalvesand deviceswhichare
incorporatedintheoutletpipesystem.Thepurposeof thesedevicesisto maintaina
constantrateof filtration.

PHYSICALENVIRONMENT
RAPIDSAND/ MECHANICALFIL
TER:
1. COAGULATION:therawwaterisfirsttreatedwithachemicalcoagulantsuchasalum,thedoseof which
variesfrom5-40 mgperliter,depending upon theturbidity,color, temperatureandpHvalueof the
water
.
2. RAPIDMIXING:thetreatedwateristhensubjectedto violentagitationinamixingchamberfor afew
minutes.Thisallowsaquickand throwout thebulkof thewater
.
3. FLOCCULATION: it involves a slow and
gentle stirring of the treated water in a
flocculationchamberfor 30 minutes.
Thisslowand gentlestirringresults
intheformationof athickcopious
whiteflocculentprecipitateof
aluminium hydroxide.

PHYSICALENVIRONMENT
RAPIDSAND/ MECHANICALFIL
TER:
4. SEDIMENT
A
TION:thecoagulatedwaterisledintosedimentationtankswhereitisdetained
for 2-6 hours whenflocculenttogether withimpuritiesand bacteriasettledowninthetank.
5. FIL
TERA
TION:thepartlyclarifiedwaterisnowsubjectedto rapidsand filteration.
– Filter beds
– Chlorination
– Filteration
– Backwashing

PHYSICALENVIRONMENT
FIL
TERA
TION:
• Filter beds: each unit of filter bed has a surface of about 80 to 90 m2. Thesizeof sand particles
is between0.4-0.7 mm. The depth is about 1 meter. Below the sand bed is a layer of granded
gravel30-40 cmdeep.Thedepthof thewateron thetop of thesandbedis1.0-1.5 m.the rate
of filterationis5-15 m3/hour.
• Chlorination:Waterchlorination isthe processof adding chlorineor chlorinecompoundssuch
as sodium hypochlorite to water
. This method is used to kill certain bacteria and other
microbesintapwateraschlorineishighly toxic.
• Filteration: asfilterationproceedsthealum-flocculationnot removedbysedimentation isheld
backon thesandbed.
• Backwashing:rapidsecondfiltersneed
frequentwashingdialyor weekly
,
dependingupon thelossof head,washing
isaccomplishedbyreversingtheflowof
waterthroughthesandbed,whichis
calledbed washing.

PHYSICALENVIRONMENT
DISINFECTION:
• Chlorination:chlorine isusedto killpathogenicbacteria,oxidizediron,manganese,cyanogens sulfate.
• Action:whenchlorine isadded, thereisformationof hydrochloric and hypochlorousacid.Thehydrochloric
acidisneutralized bythealkalinityof thewaterthehypochlorousacidionizesto formhydrogenionsand
hypochlorides ionsas follows:
– Chlorine demand of water: a fixed amount of chlorine is added according to the pH and temperatureof water
.
– Freeresidualchlorine: excessamountof chlorinepresentinwatermaybe0.5mg/dl.
– Breakpoint:thepointwhichthechlorineamountof chlorineisfulfilled for waterpurificationiscalledbreak point.
– Orthotoludine test: to find out the amount of free residual chlorine. In 1 ml of water0.1ml of orthotoludine
reagentwillbeadded.Thesolutionchangedintoyellowcolormeanscholrineispresentinthe water
.
– Chlorine derivatives:
– Chlorine gas
– Chloramine
– Perchloron
– Bleaching powder

PHYSICALENVIRONMENT
PURIFICATION OF WATERON SMALL SCALE:
1. HOUSEHOLDMETHODS PURIFICATION:
• Boiling:boilingof waterfor 5-10 minuteswillkillthe bacteria.
• Chemicaldisinfection:
– Bleaching powder: bleachingpowdershouldbeusedinadosageof 6.8gm/1000 Lof water
.
– Chlorine solution: chlorinesolutionmaybepreparedfrombleachingpowder.If 4kgof bleachingpowder
with25% availablechlorineismixedwith20Lof water
,itwillgive5% solutionofwater
.
– High test hypochlorite: thisisacalciumcompoundwhichcontains60-70% available chlorine.
– Chlorine tablets: a single tablet of 0.5g is sufficient to disinfect 20L of water
.
– Iodine: 2 drops of ethanol solution of iodine is sufficient for 1L of clear waterfor 20-30 minutes.
– Potassium permanganate: itmaykillcholeravibrious,butisof littleuseagainstotherdisease organisms.
• Filteration: watercanbepurifiedthroughceramicfiltersuchasPasteurchaberland filter,
berkefeldfilterand katadyn filter.
2. DISINFECTIONOFWELL:
• Doublepot method:

PHYSICALENVIRONMENT
Steps in well disinfection:
1. Find out the volume of water present in the well using the given
formula
liters
2. Find the amount of bleaching powder required for disinfection,
Using ‘Horrock’s Apparatus’
3. Dissolve the required amount of bleaching powder in water
4. Delivery of the chlorine solution into the well
5. Allow a “Contact period” – one hour
6. Orthotolidine Arsenite (OTA)test, to test if the ‘free’residual
chlorine is > 0.5 mg/L

PHYSICALENVIRONMENT
DOUBLEPOTMETHOD:
• By this method, it ispossible to maintain
continuous chlorinationof waterfor aperiod of 2-3 weeks.Thereare 2 cylindrical
pots.
• Outer pot:
Inside height is 30 cm
Inside diameter is 25 cm
A hole (1 cm diameter) is made at 4 cm above thebottom
• Theinnerpot containsamixtureof 1kgof bleachingpowderand 2kgof sand.Theinner
pot is introduced into the outer pot and closed.
• There are 2 holes, one in each pot and each hole having a diameter of 1cm.
• Thedouble pot sofilledwithbleachingpowderand sandisloweredintothewellfor a
depth of 1 meter and fixed at that level by means of a rope.
• Aconstantsupplyof chlorineisprovidedbythedouble pot for aperiod of 2-3 weeks
dependingupon thesizeof the well.

PHYSICALENVIRONMENT
ST
ANDARDOF HOUSING:
• Housinginthemodernconceptnot only thephysicalstructureprovidingshelterbut
also the immediate surrounding and the related community services and facility.
1. Site:
– The site should be elevated its surroundings so that it is not subjected to flooding during rain.
– The site should have an independent access to a street of adequate width.
– Itshouldbeawayfrombreedingplacesof mosquitoes and flies.
– Itshouldbeawayfromnuisancessuchasdust,smoke,smell,excessivenoiseand traffic.
– Itshouldbeinpleasing surroundings.
– Thesoil shouldbedry and safefor foundingthestructureand shouldbewelldrainage.
2. Setback:Thereshouldbeopenspacesall aroundthehouse.

PHYSICALENVIRONMENT
ST
ANDARDOF HOUSING:
3. Floor: thefloor shouldbepakkaand should besatisfyingthefollowingcriteria:
– Itshouldbeimpermeablesothateasilywashedand cleanand dry.
– Thefloor mustbesmoothand mustbefreefrom cracks.
– Thefloor shouldbe damp-proof.
– Theheightof theplinthshouldbe2-3 feet.
4. Walls:Thewallshould be:
– Reasonably strong
– Shouldhavealowheatcapacity
– Weather resistant
– Unsuitablefor harbourageof ratsand vermin.
5.Roof:theheight of theroof should not beless than 10 feet. Theroof should havea
lowheattransmittance coefficient.

PHYSICALENVIRONMENT
ST
ANDARDOFHOUSING:
6. Room: the number and area of rooms should be increased according to size of family so that the
recommendedfloor spaceperpersonmaybemadeavailable.
7.Floorarea:Thefloor areaof alivingroomshouldbeatleast120sq.feet.Foroccupancybymorethanone
personand atleast100 sq.feet.
8.Windows:Everylivingroomshouldbeprovidedwithatleast2 windows,and atleastoneof themshouldbe
openeddirectlyinto theopenspace.Thewindowshouldbeplacedataheightof not morethan3 feetabovethe
ground.
9. Lighting : the day light factor should exceed 1% over half floor area.
10.Kitchen: everyhousemusthaveseparatekitchen.Itmustbeprotectedagainstdustand smoke.
11. Privy: asanitaryprivymustbeinevery house.
12. Garbageand refuse: these should be removed from the dwelling at least daily.
13. Washingand bathing:thehouseshouldhavefacilitiesfor bathingand washingexclusivelyproviding privacy
.
14. Watersupply: watersupplyavailableatall time.

PHYSICALENVIRONMENT
REFUSEDISPOSALORDISPOSALOF WASTE:
• Refuseisdiscardwastematter.Refusefromhouses,streets,sweeping,commercial,industrial
and agricultural operations is called solid refuse. Refuse is also called solid waste.
• Hazardsof refuse:theaccumulationof refuseinmanenvironmentisdangerousto health
because:
– Itdecomposesand increasefly breeding.
– Itattractsratsand vermin.
– Thepathogenicorganismwhicharepresentintherefusemaybeconveyedbackto man’sfood through
fliesand dust.
– Waterand soilmaygetpolluteddueto refuse.
– Heaps of refuse presentan unsightly appearance and are a nuisance.
• Variousmethodsof wastedisposal
– Small scale methods: burning, feeding the animals, burial.
– Largescalemethods:incineration,dumping,controlledtipping, composting.

PHYSICALENVIRONMENT
REFUSEDISPOSALORDISPOSALOF WASTE:
• Methodof composting:
1. Bangalore method:
– Thismethodwasintroducedbyenvironmentand sanitationcommitteeof bangaloresoitiscalled
bangalore method.
– Inthismethodatrenchwillbemade90cmdeep1.5to 2.5broadand 10mlong inthattheexcretaand
refusecanbe disposed.
– Inthattrenchthefirstlayershouldbewastein15cmthicknessand excreta5cmthickness.Likethis
alternatively filled.
– Thetoplayershouldberefuse.Itwilltake7 daysfor decompositiontheaerobicand anaerobicbacteria
digestthe waste.
– Itis also called hot fermentation method.This must be done awaythe city almost 800 m.
2.Mechanical composting:
After
– Inthismethodamechanicaldevicewillbeusedto grinditemslikestick,clay,plastic,glass,etc.
grindingsamemethodwillbefollowed.

PHYSICALENVIRONMENT
DISPOSALOFDEADBODIES
• TYPES:
1. CREMA
TION:
– Itisthebestmethod.Theusualquantityof fuelrequiredto disposethebody inaproperwaywillbeabout400
pounds.
– If thismuchisnot inuseditwillcauseincompleteburningof thebodies.
– Half burntremainsof thedead willbethrowninto thestreamor riverswhichwillbeveryunsanitary.
– Nowadaysbodiesarecrematedbytheuseof furnaces.Eitherbygasor electricitythebodiesareexhumed.
Thisiseasyand sanitary method.
2.BURIAL:burial of adead body isaexpensivemethodsincethepartyhaveto payfor theground
wherethedead hasto beburiedand for thecoffin,etc.followthese methodsduringburial:
– Location: it should not be too close to a residential area, but should be easily accessibleby a road.
– Site:theland liableto floodingisnot unsuitable,nor shoulditbetoo highto pollutewateratalowerlevelby
natural drainage.
– Soil:thesoilshouldbeporousand light,freefromwater
.Sandyloamsoilisgood wherebacteriahelpinthee
disintegrationof thebody.Chalkyand claysoilareto be avoided.
– Size:¼acreland 1000 populationisminimumrequirement.Apitof 3-5 feetdepthneverbelow8 feetnor
within2 feetof thesurface soil.
– Coffins: it should be made of easily destroyable wood.

PHYSICALENVIRONMENT
NOISE
• Noise is defined as the wrong sound in the wrong place at wrong time.
Effects of noise exposures:
1. Auditory effects:
• Auditory fatigue: it appears in the 90 ds region and greatest at 4000 Hz. It my be associated with
side effects such as whistling and buzzing in the ears.
• Deafness: most temporary hearing loss occurs in frequent range between 4000-6000 HZ.
Repeated exposure to noise around 100 decibels may result in a permanent hearing loss.
2. Nonauditory effects:
• Interference with speech: the frequencies causing most disturbance to speech communication lie
in 300-500 HZ range.
• Annoyance: neurotic people are most sensitive than balanced people.
• Efficiency: where mental concentration is to be undertaken, a low level of noise is always desired.
• Physiological changes: physiological changes like rise in BP
,rise ICP, increase HRand breathing
and increase in sweating.
• Noise

FOOD HYGIENE
• Thetermfood hygieneisusedto describethepreservationand preparationof
foods inamannerthatensuresthefood issafefor humanconsumption.
AIMS:
– T
opreventfood poisoning
– T
opreventfood bornediseases
PRINCIPLESOF FOOD HY
GIENE:
– Preventcontaminatingfood withpathogensspreadingfrompeople,pets,and pests.
– Separaterawand cookedfoods to preventcontaminatingthecookedfoods.
– Cookfoods for theappropriatelengthof timeand attheappropriatetemperatureto kill
pathogens.
– Storefood atthepropertemperature.
– Dousesafewaterand cooked materials.

FOOD PRESERVATION
• Food preservationcanbedoneattwomethods:
• Householdmethods :
– Cold storage: thehomerefrigeration hasnowmadeitpossibleto storeand preservea variety
of foods.Fruitsand vegetablesshouldbekeptjustabovefreezingpointi.e.0 degree C or 31-
33 degree F
. Meatand butterarekeptatmuchlower temperature.
– Drying and dehydration: dryingremoveswaterand intheabsenceof watermicro-organism
can’t grow
.
– Smoking: smokecontainsphenolswhichhelpin preservation.
– Salting and pickling: saltisa preservative.
– Canning: home canning is not recommended unless the technique employed is fool proof.
• Commercial methods:
– Canning: the food is first sterilized at high temperature (135-175°C) for a short time, then
cooled and filled ispre-sterilized containersinasterile atmosphere.
– Freezing: at17.8°Cvegetablescanbepreservedfrom8 to 10 monthsand meatfor about 3
months.
– Chemicals: Certainchemicalslikebenzoicacid,sodiumbenzoatemaybeusedfor
preservation but their use is strictly limited by government.
– Irradiation: microorganismsaredestroyedbygamma-rays.Wheat,potatoesand onions may
bepreservedby irradiation.

MILKHYGIENE
MILKBORNEDISESES
• Infections of animals that can be transmitted to man:
– Tuberculosis
• Infections of primary to man that can be transmitted to milk:
– Typhoid
– Paratyphoid fevers
– Shigellosis
– Cholera
– Enteropathogenicescherichicoli (EEC)

MILKHYGIENE
P
ASTEURIZA
TIONOF MILK:
• Accordingto WHOpasteurizationmaybedefinedasthehearingof milkto
suchtemperatureand for suchperiodsof timeasarerequiredto destroyany
pathogensthatmaybepresentwhilecausingminimalchangesinthe
composition, flavor and nutritive value.
Methods of pasteurization:
• Holder method:
30 minutes and
inthismethodmilk isheatedand kept t 63 – 66 degreeCfor
thenquicklycooled to below5 degree C.
• HTSTmethod(HighTemperatureAndShortTimeMethod):milkisheated
rapidlyto atemperatureof 72 degreeCand thenquicklycooled to below5
degree C.
• UHT(Ultra HighTemperatureMethod):thetemperatureof milkisraisedto 125
– 150degreeCfor afewsecondsonly and thenrapidly cooled.

MEATHYGIENE
• Thediseasestransmittedthroughunhygienicmeatconsumptionareas
follows:
– Tapeworminfestation
– Diarrheal diseases
– Anthrax
– Tuberculosis
– Food poisoning
Measuresto maintainmeat hygiene
– Meatinspection-beforeand after slaughter.Itisnecessaryto identifythepresence
of infection.
– Cleanlinessof storage place.
– Cleantransportation of meat.
– Cleantheanimalsbeforeslaughtering.

FRUITSANDVEGETABLES
• Measuresto betakento maintainhygieneof fruitsand vegetables
include:
– Wash thoroughly before eating the fruits and vegetables.
– Vegetablescanbeimmersedinsalinewaterfor fewhours to neutralize the
pesticides.
– Fruitsand vegetablesmustbestoredincool and dry places.

HYGIENEOFFOOD HANDLER
• Clean hands.
• Tiethehair or coverthehead to preventfall of hair in food.
• Usecleanapron
• Avoidlicking fingers.
• Avoidcoughingor sneezingwhile cooking.

FOOD PREPARATION
METHODOFCOOKING:
Frying
Roasting
Baking
– Boiling: cookinginwaterat 100°C.
– Simmering:cookingbelowboilingpoint.
– Steaming:cookingbysteam.
– Stewing:cookingbelowboilingpointwithsmallquantityof water
.
–
–
–
– Broilingor grilling

FOOD ADULTERATION
• Food adulterationisthedeliberatecontaminationof food materialwithlowquality, cheap
and nonedible or toxicsubstancesiscalledfood adulteration.
TYPES:
• Milk: itisadulterated bytheaddition of water,starch,skimmilkpowderand removal of
cream.
• Ghee: itisadulterated withVanaspatiand animalfatssuchaspig’sfat.Inorder toimprove
the flavor of adulterated ghee tributyrin is added.
• Cereals: riceand wheataremixedwithstones,sandgritand mudto increasethe bulk.
• Flour: wheatflour ismixedwithsoapstoneand Bengalgramflour isadulterated with khesari
dal or lathyrus flour.
• Pulses: theyareadulterated withkhesaridal stones.T
oxicchemicalsuchasmetanilyellow
areadded to old stocksof pulsesto improvetheircolor appearance.
• Edible oil: theyaremixedwithcheaperoil, toxicoil and mineral oil.
• Tea and coffee: tealeavesareadulterated withsawdustand coffeewithchicory
.
• Honey: itisadulterated withsugarand jaggery
.
• Medicines: evendrugsare adulterated.

PREVENTIONOFFOOD ADULTERATIONACT: 1954
• In1954,thegovernmentof Indiaenactedacentralpreventionof food
adulteration act.
• PURPOSE:
– T
oprotecthealthof consumerand alsoto assurefoods honestnutrientvalue.
• ADV
ANT
AGES:
– Helpinmaintainingqualityof foodstuffs.
– Helpsto providepunishmentto thepeopleand organizationresponsible for
adulteration.
– Helpsinprovidespecialrightsto consumerand voluntaryorganizationsothattheycan
playan effective.
– Checkingthequalityof importedediblestuff.
– Establishingpublicanalysis,consumertestsand food testinglabsand trainingtheir
workers.

THE DRUGS AND COSMETICS ACT, 1940
• This act control and maintain the standard and quality
of drugs and cosmetics.
• It prevents the counterfeiting of drugs and cosmetics.
• Food can transmit disease from person to person as well
as serve as a growth medium for bacteria that can cause
food poisoning.
• It is necessary to maintain hygiene throughout the
food chain to prevent diseases and promote health.

DEFINITION
• Drug is a chemical substance used as a medicine to
promote health and to prevent, diagnose, to alleviate over
cure disease.
• The word ‘drug’ is defined as any substance that when
taken into the living organism, may modify one or more
of its function. (WHO)
• The Drug And Cosmetic Act 1954 is effective for
standardization of medicines and cosmetics, control of
quality, give recognition to new medicines and such
activities.
• Under is the central drug standardization control
organization (CDSCO) is informed.

The functions of central drug standardization
control organization are as follows:
• Implementation of medicine laws and policies.
• Keeping control over the quality of imported medicines.
• Establishing better coordination in the work of drug
control officers.
• Recognition to new drugs made in the country.
• Establishing standards of medicines and instruments
• Regulation of human blood transfusion, parental drugs.
• Providing license for the preparation and sale of serum
and vaccines.

BIOLOGICAL ENVIRONMENT
• Biological environment refers to all living organisms
surrounding man.
• It includes arthropods, rodents, microorganism, etc.
ARTHROPODS:
– Arthropods are the invertebrate animals include insects and cyclops.
Anthropods can transmit many diseases to human being.
• MOSQUITO CONTROL MEASURES:
– The mosquito larva can be destroyed by maintaining proper sanitation,
using chemical
insecticides and by using certain fish like guppy which eat the mosquito
larvae.
– The adult mosquitoes can be controlled by residual insecticides.
– Mosquito nets, meshes and repellents can protect against mosquito bites.

FLY AND FLEA CONTROL MEASURES:
• The flies and fleas can be controlled by
maintaining good environmental sanitation and
by using the residual sprays.
• Fly papers and meshes also are effective in control flies.
• Use of repellents and control of rodents (by trapping and
fumigation)
are helpful in controlling the fleas.
RODENT CONTROL MEASURES:
– Rat poisons
– Traps
– Fumigation
– Environmental sanitation

RODENTS
• Diseases caused by rodents:
– Rat bite fever
– Salmonellosis
– Plague
– Murine typhus
– Leptospirosis
– Trichinosis
– Amebic
• Control of rodents:
– Trapping
– Rat poisons
– Fumigation (cyanogas)
– Improvement of sanitation

FOOD AND WATER BORNE DISEASE
FOOD BORNE DISEASES:
• Food borne infections and diseases may be classified as below:
Bacterial: typhoid and paratyphoid, diarrhea, dysentery.
Viral: viral hepatitis (jaundice), poliomyelitis.
Protozoal: amebiasis
Intestinal: tape worm and round worm
–
–
–
–
– Others: poisoning
• Preventive measures:
– Personal hygiene: a high standard of personal hygiene among individuals
engaged in the handling preparation and cooking of food is needed.
Food handlers: they can spread disease by their unhygienic habits.
–
– Food handling techniques: the handling of ready to eat foods withbare hands should be
reducedto a minimum.
– Sanitaryconditions: sanitationof allworksurfacesutensilsand equipmentmustbe
ensured.

FOOD AND WATER BORNE DISEASES
WATER BORNE DISEASES:
A.Biological water borne diseases: those caused by presence of an
infective agent:
– Viral : viral hepatitis A, hep B, poliomyelitis, rotavirus.
– Bacterial: typhoid, parathyroid fever, dysentery, E.coli, diarrhea, cholera.
– Protozoal: amebiasis, giardiasis.
B. Helminthic: round worm, thread worm, hydatid disease.
– Leptospiral: Well’s disease.
– Those due to the presence of an aquatic host:
– Snail: schistosomiasis
– Cyclops: guinea worm
C.Chemical: this causes shigellosis, trachoma conjunctivitis,
ascariasis, scabies.

SOCIAL ENVIRONMENT
• The social environment of an individual or community is
the culture that he/she was educated and/or lives in,
and the people and institutions with whom the person
interacts.
• The social environment includes the following
components:
– Customs
– Taboos
– Values
– Norms
– Culture
– Traditions

SOCIOCULTURAL ASPECTS OF COMMUNITY
• The word ‘culture’ is widely used in sociology. It is the central
concept round which cultural anthropology has grown.
• Culture is defined as ‘learned behavior which has been
socially acquired’.

Cultural factors affecting health
• Supernatural causes:
– Spirit or ghost intrusion
– Gods goddesses
– Evil eye
– Past sins
– Breach of taboo
• Food habits
– Psychological roots
– Associated with love and affection
– Religion
– Social prestige
– Self-image
– Local conditions
– Beliefs
– Customs
• Cultural practices affecting health
– Early marriage of girl
– Low status of women
– Preference for male child
– Traditional folk
– Folk media

HYGIENE
• The word hygiene has evolved from Greek term ‘Hygia’ which means
‘Goodness of health’. Hygiene is the science of health and includes
all factors which contribute to healthful living.
• Hygiene can be defines as the science and art which is associated
with the preservation and promotion of health.
OR
• Hygiene is defined as that science of health which includes all the
factors contributing to the healthful living.

TYPES OF HYGIENE
1. SOCIAL HYGIENE: social medicine has replaced the word social hygiene, its
objective tostudy man as a social animal in its total social environment. The scope of social medicine
includes science of social structure and functions, social pathology and social
treatment etc.
2. INDUSTRIAL HYGIENE: its scope is extended up to the health of labor working in
all types of occupation and different aspects of health.
3. SCHOOL HYGIENE: it facilitates optimum health to school children.
4. PREVENTIVE MEDICINE: preventive medicine plays primary role in immunization a
specific protection and general methods of improvement in health.
5. PERSONAL HYGIENE: personal hygiene is not only limited to taking care of body
and keeping it clean, rather the mental and spiritual aspects are also an
integral part of it.

PERSONAL HYGIENE
• Personal hygiene is defined as that ‘the healthy practices and
lifestyle helps in the maintenance and promotion of individual
health physically, emotionally, socially and spiritually.’
IMPORTANCE:
– To prevent illness
– To promote good health
– To improve the standard of health
– To maintain quality life of an individual
– To promote mental well-being
– To promote socially and spiritually health
– To improve the self-esteem in the society
– To maintain resistance and prevent from infections.

PRINCIPLES OF PERSONAL HYGIENE
1. Hygiene practices are learnt.
2. Changes occur throughout the life span, it also affects the
health care practices.
3. Individual differences exit from one individual to other.
4. Health practices of people vary with cultural values and
personal values.
5. Health practices directly influences the physical, mental,
social and spiritual health of an individual.
6. Good health practices prevent entry of microorganism into the
body.
7. Nature act as a first line of defense on human health natural
light and ventilation.

DISEASES DUE TO POOR PERSONAL HYGIENE
• Skin diseases
• Leprosy
• Trachoma
• Conjunctivitis
• Dental carries
• Impetigo etc.

EXERCISE (PHYSICAL ACTIVITY)
• Exercise is defined as ‘the physical exertion done to improve the health or to
correct the physical deformities of the body.’
OBJECTIVES:
– To promote and harmonious development of the whole body.
– It also helps in correcting physical deformities.
– Maintenance of health especially in the growing child.
IMPORTANCE:
– To look good.
– To reduce the risk of heart diseases.
– To lower blood pressure
– To reduce risk of diabetes, osteoporosis.
– To increase longevity
– To improve balance and reduce the risk of injuries
– To remain productive
– To increase overall strength
– To be happy.

TYPES OF EXERCISE
1. ACTIVE EXERCISE
– Patient performs the exercise to move the joint without any assistance to the
muscles surrounding the joint.
2. PASSIVE EXERCISE
– Therapist or equipment moves the joint through the range of motion with no
effort from the patient.

RECREATION
• The word recreation means relaxation and amusing oneself.
• IMPORTANCE:
– It relieves mental tension.
– It relieves fatigue.
– It contributes to a feeling of well-being.
– It may be active or passive.
– It provides energy and freshness.
– Division or recreational therapy is used to cure many mental
diseases.
– Physical exercise is an active form of recreation.

RECREATION
TYPES:
• Active recreation: exercise, indoor games, outdoor games,
light work like writing.
• Passive recreation: reading, watching, listening to radio, talking,
playing cards, enjoying the nature.
• Recreation centers are being provided in many cities for public
use so that people may use their leisure time for improvement of
their physical and mental health.

REST AND SLEEP
• For the maintenance of health, the body needs rest and sleep.
These can be defined as:
• Sleep: sleep is subjective or personal needs that provide the
person a feeling of rest or relaxation.
• Rest: rest can be expressed as the condition of reduced labor
whether it is physical, mental or both.

REST AND SLEEP
Advantage of rest and sleep:
• Improvement in health.
• Person feels fresh.
• Reduces the working capacity.
• Relieves pain.
• Fatigue disappears.
• Facilitates health and peace of mind.
• Enhance happiness, aging and ability to make decision.
• Assist in the growth and physical development.
• Sleep requirement: the amount of sleep required varies with age, sex,
environment, and the nature of work and the temperament of each
individual:

REST AND SLEEP
• Infant: 20-22 hours
• Children: 12-14 hours
• School going boy: 9-10 hours
POINTS TO REMEMBERED DURING SLEEPING:
• Use flat beds and single pillow.
• Face should not be covered during sleep.
• Room should be dark and well-ventilated
• Use mosquito nets during sleep.
• Drug should not be taken to induce sleep.

SEXUAL LIFE
LIFE SKILLS EDUCATION PROGRAMS:
• Abstinence that is complete absence of sex before marriage
and loyalty and faithfulness within the marriage bond is the
supreme principle of all religions.
• People use this as an instrument to prevent the spread of HIV
and other sexually transmitted infections.
• People who follow moral and ethical guidelines in sexual
relationship are the real preventive boosters of sexually
transmitted diseases.

Benefit of sex on health
• It lowers blood pressure and help in stress reduction.
• It boost immunity.
• Burn calories.
• Reduce the risk of heart attack.
• It boost self-esteem.
• It boost intimacy.
• Increased level of oxytocin causes hike in endorphin that
reduces pain.
• Ejaculation reduce the risk of prostate cancer.
• It strengthen pelvic floor muscles.
• It promotes sleep.

Safest sex
• The safest way to prevent HIV or STI is abstinence, means
no sex at all.
• Safest sex is sex that is shared between two people who
are not infected with any STIs including HIV who only have
sex with each other, and who do not use injectable drugs.

SELF-RELIANCE
• Self-reliance is defined as the capacity to manage one’s own
affairs, make one’s own judgements, and provide for oneself.
• Characteristics of a self-reliant person:
– Self-assurance: self-reliant person is self-confident in all his doings.
– Self-contained: he will try to accomplish things without leaning much on
other people for assistance unless it is very much essential.
– Independent: he self-ruled in all his thoughts and actions.
– Courageous: self-reliant person is courage enough to take up risks and find
solutions for problems.

SELF-RELIANCE IN COMMUNITY
• Self-reliance in community is defined as the development on the basis of
a country’s own resources, involving its populations based on the
potentials of its cultural values and traditions.
– The concept of self-reliance is the core concept of community development.
– Self-reliance supports people to improve their condition using locally available
resources and manpower.
– This is readily accepted as a new method for community development.
– It is most operative method that promotes people participation in their own
development.
– Self-reliance in community development expects all community members to
apply their knowledge and skills using the available resources.
– Self-help empowers the local people to exploit their advantage resources
which would life inactive and continue the awareness and poverty of the
community.

DIETARY PATTERN
A combination of different food, drinks, and nutrients in diets,
quantity, and the frequency with which they are usually
consumed constitutes dietary pattern.
There are a numerous factors that affect the choice of food.
These are classified under six key determinants:
• Biological determinants: includes hunger, appetite, taste and
satiety.
– Taste/palatability: palatability increases individual’s pleasure from eating.
• Economic determinants: the cost of food and the ability of an
individual to purchase specific foods are primary factors that
influence food choice.
• Physical determinants:
– Accessibility and availability
– Education and knowledge
– Time constraints.

DIETARY PATTERN
• Social determinants:
– Social class/socioeconomic: there are food choices between higher
and lower socioeconomic groups.
– Cultural influences: the traditions, beliefs and values are the main factors
influencing preference, mode of food preparation, and nutritional status of
people.
– Social context: includes both people who have an impact on an
individual eating behavior and individual consumes their dietary
choice.
• Psychological determinants:
– Stress: some people consumes more food and make unhealthy food choices
and other consume less food.
– Mood: food can change an individual’s temperament and mood and
influences food choice.
– Attitudes, belief and knowledge

EDUCATION
• Health education is defined as any combination of learning experiences
designed to help individuals and communities improve their health, by
increasing their knowledge or influencing their attitudes.
• Principles of health education:
– Credibility: it is the extent to which the message communicated is perceived as
trustworthy by the receiver.
–
Interest : health programme should assess the felt needs of the people.
– Participation: it tend to create a sense of involvement, personal acceptance
and decision making.
– Motivation: in every person, there is a fundamental desire to learn. Awakening
this desire is called motivation.
– Comprehension: assess the level of understanding, education, and literacy of
people to whom the teaching is intended for.
Reinforcement: messages that are repeated are more likely to remembered.
Learning by doing
Feed back: it provides the base to plan again.
–
–
–
– Leaders: leaders are agents of change and they can be made use of in health
education work.

OCCUPATION
• Occupation refers to a group of purpose oriented daily activities which
may be related to any life area, such as leisure, education, or self-care,
not necessarily work alone.
• One of the key factors for promoting well-being life in balancing
one’s daily life occupation and the nature of these occupations.
• An individual’s occupation can be a source of his happiness and
income; at the same time his mismatched occupation may become as a
major source of his stress and illnesses.
• Therefore, it is always necessary for a community health nurse to
collect thorough history about client’s occupation.

OCCUPATION
The results of joblessness:
• Psychological consequences
• Loss of identity and self-esteem
• Increased stress from various sources
• Greater future uncertainty
• Feeling of social isolation
• Many physical health problems like obesity,
hypertension, diabetes
• Poor quality of well being.

DEFINITION OF FINANCIAL MANAGEMENT
• According to Guthman and Dougal, financial management
means, “the activity concerned with the planning, raising,
controlling and administering of funds used in the business.”

Objectives of financial management
• To ensure availability of adequate funds and effective
utilization.
• To ensure adequate profit.
• To generate more funds for further expansion and growth.
• To coordinate the activities of the finance department with
the activities of other departments of the organization

INCOME
• Income is the flow of cash or cash-equivalents received from
work (wage or salary), capital (interest or profit), or land (rent).
• Net income is the excess of revenues over expenses.

NATIONAL INCOME
• National income is the total value of a country’s final output of all new goals
and services produced in 1 year.
Methods of calculating national income:
• The income method: This is generated by adding up all income received during a
given year.
• The output method: This is the combination of value of the new and final output
resulted in all sectors of the economy, including manufacturing, financial
services, transport, leisure and agriculture.
• The expenditure method: This method sum up all expenditure in the economy
by households and firms on new and final goals and
services.

BUDGET
• CIMA defines a budget as “A plan quantified in monetary terms, prepared prior
to a defined period of time to attain a given objectives.”
• Budgeting helps us to control money that helps to lead our life. It gives a
detailed picture on how much money we have, how much we spend, and how
to proceed further to make money.
Uses of budgeting:
• Helps to settle debts quickly.
• Keep up with your bills.
• Save money for specific tasks.
• Able to settle unplanned expenses.
• Buy luxuries by matching with the money.

BUDGET
Purposes of budget:
– To plan and act
accordingly.
– Keep up with your bills.
– Save money for specific
tasks.
– Able to settle
unplanned
expenses.
– Buy luxuries by
matching with the
money.
Functions of budgets:
– Planning annual operations.
– Coordinating the activities of the
various parts of the organization and
ensuring that the parts are in
harmony with each other.
– Communicating plans to the
various responsibility center
managers.
– Motivating managers to strive to
achieve
the organization goals.
– Controlling activities
– Evaluating the performance of
managers.

PURCHASING POWER
• The value of a currency expressed in terms of the amount of goods or services that one unit
of moneycanbuyiscalledaspurchasingpower
.
• Priceistheamountabuyerpaysfor aproductorservices.
INFLATION:
• Inflation is an increase in the general level of prices for goods and services.
• Inflation reflects price-rise.
• Consumer price index (CPI) is used to measure inflation.
Causes of inflation:
• Consumers may want to buy more goods or services than are available,
increasing the prices.
• Producers may have to spend more to produce products leading to increase
in prices.
• Both the above situations can lead to inflation.

PURCHASING POWER
DISINFLATION:
• In other words, prices are rising, but at a decreasing rate. Disinflation occurs
when prices are rising, but at a slow rate.
REFLATION:
• Reflation occurs when prices are high but then drop due to lower demand.
HYPERINFLATION:
• When prices are rising so rapidly they are out of control, this is called
hyperinflation.
• Deflation is the lowering of overall price levels. In other words, prices are going
down.
INFLATION AND EMPLOYMENT:
• When prices are high, producers can make more money.

FACTORS AFFECTING PURCHASING POWER
• COST-PLUS PRICING: Cost-plus pricing calculates the total cost of making
and distributing a product.
• VALUE-BASED PRICING: The seller determines the price based on
consumer’s value for the product.
• MARKET-BASED PRICING: The price is fixed to be competitive with
prices of similar products currently in the market.
• BUYING STRATEGIES BY CONSUMERS: Consumers use two basic strategies
for buying goods. They attempt to spend as little as possible, or they try
to get maximum worthy product for the money spent.
• ECONOMIZING: Consumers are saving as much as possible. So they buy
only it is very much necessary.
• Optimizing means getting the highest value for the money spent.

FACTORS AFFECTING PURCHASING POWER
• Strategies by sellers: Seller use many other strategies, apart from price,
and promotion of goods.
• Convenience:
– Provision of convenient and pleasant environment for customers.
– Store location is easily accessible.
– A clean, safe and comfortable, complex.
– Appointing people friendly sales persons.
– Accepting all modes of payment.
– Provision of refreshment.
– Popular people icons are used as promoters.
• Customer service:
• Good customer service includes many techniques.
• A warm, friendly greeting and prompt and polite help are some of the
examples.

BUYING STRATEGIES
• Before shopping:
– Prepare a shopping list.
– This list can resist impulse buying and helps to prevent forgetting.
• While shopping:
– While at the store, stick on to list.
– Check the unit prices.
– Avoid going to grocery shops when hungry. It may affect our choices.
– Stick on to budget.
• After shopping:
– Keep all the receipt and warranties for all items purchased.
– Open package carefully.
– Make sure the item/product functions properly.
– Evaluate whether the expense is within the budget.

BUYING STRATEGIES
• Security:
– A brokerage is defined as a financial institution that aids the buying and selling of
financial securities between a buyer and seller.
• Financial securities:
– A securities brokerage is defined as a firm trading stocks and bonds on behalf of its client.
• Brokerage firms:
– Brokerage firms provide assistance to their clients for buying or selling stocks, bonds and
other securities.
• Full or discount brokers:
– Discount brokers help for those do their own research and need help in only in
executing orders without any investment advice.
• Broker versus dealer:
– While a broker act as an agent, implementing his clients orders, a dealer has his own
account from which he buys and sells securities for his client.

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