ENGLISH-COMMUNITY HEALTH NURSING 2-16/02/2018 – PAPER SOLUTION NO-7

COMMUNITY HEALTH NURSING 2 (PAPER SOLUTION GNM 3RD YEAR) 16/02/2018 -Paper No.7

Q-1

a. What is ‘Small family Norms’ – સ્મોલ ફેમેલી નોર્મસ એટલે શું? 03

Small family norms are a set of social and cultural rules and beliefs that encourage a low number of children in a family, especially one or two children. These norms include ideas and habits that prioritize keeping families small, so that the health, education, and economic conditions of family members are better and the society can develop in an all-round way. This concept also covers medical terms like population control, maternal and child health, and family planning, which aim to reduce the risks to female health from having more children. Therefore, the main objective of small family norms is to build a healthy, social, affordable, and sustainable family.

b. Write demographic trends in India – ઇન્ડિયા મા ડેમોગ્રાફીક ટ્રેન્ડ્સ વિશે લખો. 04

Demographic Trends in India

India is a developing country where the population and its structure are continuously changing. Demographic trends are the changes that indicate the age of the population, gender ratio, birth rate, mortality rate, life expectancy, and epidemic effects in the country. All these parameters directly affect the healthcare system, economy, and social structure.

1. Population Growth Rate:

The population growth rate in India has slowed down from the previous decades, but the population size is still high. The main reason for population growth in the present time is high fertility rate and youth population.

2. Youth Bulge:

India is called a “Young Nation” because the percentage of people between the ages of 15 and 34 is high. This young generation is the productive power of the country, but if they do not get proper employment and health care facilities, they can also prove to be a burden.

3. Increase in Aging Population:

Now the number of elderly people in India is also gradually increasing. As life expectancy is increasing, chronic diseases like hypertension, diabetes, osteoporosis are seen in people above the age of 60. Such an increasing load falls on the healthcare system.

4.Infant Mortality Rate & Maternal Mortality Rate:

Infant Mortality Rate is decreasing compared to the previous year, but there are still problems in many rural areas. However, there has been improvement due to Newborn Care and Prenatal Checkups. Maternal Mortality Rate is also gradually decreasing as patients are getting technical facilities and antenatal care.

5.Urbanization and Migration:

People are moving from villages to cities for employment and standard of living. Due to this shift, population density in cities is increasing and the burden on infrastructure is increasing. The number of slums and transmissible diseases has increased in cities.

6. Gender Imbalance:

In the recent period, the ratio of male and female is becoming imbalanced. In many states, there is a decrease in gender ratio because sex-selective abortion and gender bias are still prevalent in some areas.

7. Shifting Disease Burden:

In the past, communicable diseases like tuberculosis and malaria were more prevalent in India. Now non-communicable diseases like cardiovascular diseases, cancer, and obesity are increasing. This change has happened due to lifestyle, diet, and sedentary habits.

Demographic trends of India are very important for health policy, public health interventions, and human resource development in the country. If we understand these changes and do healthcare planning accordingly, then every patient in the country can get proper care.

c. Describe role of community health nurse in family planning programme. ફેમીલી પ્લાનીંગનાં પ્રોગ્રામમાં કોમ્યુનીટી હેલ્થ નર્સનો રોલ વર્ણવો. 05

The Community Health Nurse plays a central role in the Family Planning program. She not only provides information to the patient, but also works as an advocate, educator, counselor, and care provider:

1. Education and Awareness:

The Community Health Nurse educates couples and their family members about the importance of family planning. She is an expert in providing information related to Conception, Contraception, Fertility, and Reproductive Health.

Explains to the patient about various contraceptive methods such as oral contraceptive pills, copper T, injectable contraceptives, condoms, and sterilization.
Gives information to the patient about their health rights.

2. Counseling:

Choosing the right option in family planning is a very personal decision. The nurse helps the patient to choose the contraceptive according to their needs through personalized counseling.

Advises the patient to choose the right method according to their medical history and current health condition.

Special considerations are given to multiparous women, teenage girls, or high-risk patients.

Provides understanding about natural methods like Lactational Amenorrhea Method, Calendar Method.

3. Primary Care and Contraceptive Provision:

Nurses directly distribute various contraceptives and teach how to use them properly.

Assists in the service of methods like IUCD (Intrauterine Contraceptive Device), Copper T etc.

Provides timely education for Emergency Contraception.

Provides oral pills and condoms regularly.

4. Follow-up and Observation:

Regular monitoring of the patient’s condition is necessary after choosing a family planning method. The nurse keeps following up the patient.

Observes for side effects, complications or signs of pregnancy.

If there is any problem, refers it to a high level health care center or PHC (Primary Health Center).

5. Record Keeping and Reporting:

The nurse maintains the data of each patient and submits reports, which are useful for public health policy and planning.

Prepares reports according to how many females use which type of contraceptive.

Maintains patient confidentiality while providing services.

6.Training and Community Participation:

Nurses train other health care workers like ANM (Auxiliary Nurse Midwife) and Asha workers and provide leadership to raise awareness at the community level.

Conduct IEC (Information, Education and Communication) activities in collaboration with Mahila Mandal, Youth Groups and Gram Panchayat.

7.Advocacy and Policy Implementation:

The role of community health nurses is not limited to service providers only. They are also advocates for the implementation of health policies.

Raises voice for female health rights and safety of their reproductive options.

Works under the National Family Health Mission and Reproductive and Child Health (RCH) programs.

The Community Health Nurse is the pillar for the optimal implementation of the family planning program. She is a competent combination of medical knowledge, humanistic ethics and service delivery. The nurse provides the highest quality health service by considering the physical, mental and social aspects of each patient.

Therefore, the Community Health Nurse is the most important link for a successful family planning campaign.

OR

a. List specialized community health services. સ્પેશયલાઇઝ કોમ્યુનીટી હેલ્થ સર્વિસીસ ની યાદી બનાવો. 03

Specialized Community Health Services are healthcare services that are focused on specific population groups or specific health conditions rather than the general population. The aim of these services is to ensure effective, targeted, and patient-centric care, especially for high-risk patients. They can be disease-specific, age-specific, or population-specific. Such service modules strengthen the public health system and are integrated with national health programs.

The complete list of specialized community health services is as follows:

Maternal Health Services

Neonatal Health Services

Infant Health Services

Child Health Services

Adolescent Health Services

Reproductive Health Services

Family Planning Services

Geriatric Health Care Services

Mental Health Services

Disability Care Services

Palliative Care Services

Home Based Patient Care Services

Transgender Health Services

Tribal Health Services

Urban Health Services Services

School Health Services

Workplace Health Services

Health Education and IEC/BCC Services

Tuberculosis Control Services

HIV/AIDS Intervention Services

Rabies Prevention Services

Cancer Care Services

Cardiovascular Disorder Management Services

Diabetes Management Services

Opioid De-Addiction Care Services

Nutritional Rehabilitation Services

Multi-Drug Resistant Disease Care Services

Encephalopathy Care Services

Patient Transportation Services (Patient Transportation Services – 108, 102)

Rehabilitation Services for Paralysis, Amputation etc.

Environmental Health Services

Vector Borne Disease Control Services

Juvenile Justice Committee-Linked Health Services

Migrant Population Health Services

COVID-19 Response and Vaccination Services

These services reflect a holistic healthcare approach that provides specific, needs-based and public health impact oriented care for each patient group. Ensures that the planning, implementation and monitoring of each service is medically, ethically, population responsive and leads to health system strengthening.

b. Write RCH-II objectives, RCH-II ના હેતુઓ લખો. 04

Objectives of RCH-II Programme

RCH-II stands for Reproductive and Child Health Phase II Programme, which is a national health programme launched by the Government of India. The main aim of this programme is to improve the health of mothers and children and reduce their mortality rate by making reproductive health services more effective.

RCH-II was launched in the year 2005 under the National Rural Health Mission (NRHM). The clear and defined objectives of this programme are as follows:

1. Reduction of Maternal Mortality Rate:

Providing quality antenatal care, safe delivery and postnatal care to the patient.

Enhancing facilities for emergency obstetric care.

Ensuring delivery by trained birth attendants.

2.Reduction of Infant Mortality Rate:

Bringing awareness about Newborn Care, Immunization, and Breastfeeding.

Special nutritional intervention for low birth weight children.

Establishment of Neonatal Care Unit.

3.Reduction of Total Fertility Rate:

Providing contraceptive services like IUCD (Intrauterine Contraceptive Device), Oral Pills, Sterilization to more people.

Providing counseling and medical guidance to patients for family planning.

Campaigning for Reproductive Health Education.

4.Strengthening Adolescent Health Services:

Awareness of reproductive and mental health in adolescence.

Provide services for iron supplementation, nutritional advice and menstrual hygiene management.

Establish ARSH (Adolescent Reproductive and Sexual Health) Clinic.

5.Control of RTI/STI

Ensure timely diagnosis and treatment of RTI (Reproductive Tract Infection) and STI (Sexually Transmitted Infection).

Provide confidential consultation and free medicines to patients.

Conduct awareness programmes at community level.

6.Prevention and Management of HIV/AIDS

Providing ART (Antiretroviral Therapy) for HIV positive patients.

Ensuring PMTCT (Prevention of Mother-To-Child Transmission).

Working for blood screening, counseling and community sensitization.

7.Improvement in Quality of Care

Ensuring medication, equipment and qualified staff for patients.

Skilled Birth Attendant (SBA) training program.

Regular monitoring and evaluation of health facilities.

8.Strengthening Health Infrastructure

Enhancing facilities for PHC (Primary Health Centre), CHC (Community Health Centre) and sub-centres.

Creating multi-disciplinary health care teams.

Increasing the use of telemedicine and mobile medical units.

9. Community Participation and Convergence

Collaboration with ASHA workers, NGOs (Non-Governmental Organization), and local bodies.

Providing services at the local level through events like Village Health and Nutrition Day.

IEC (Information, Education and Communication) activities.

RCH-II is a holistic health program that not only provides treatment to the patients, but also aims to improve their overall health and lifestyle. Each objective of this program leads to comprehensive improvement of the public health system and works towards sustainable improvement in the condition of maternal and child health. It is very important for the students to understand these objectives and contribute to reproductive and child health.

C. Describe role of community health nurse in RCH-II. RCH-II માં કોમ્યુનીટી હેલ્થ નર્સનો રોલ વર્ણવો.05

Role of Community Health Nurse in RCH-II:

Community Health Nurse performs several important duties under RCH-II (Reproductive and Child Health – II) program. This nurse plays a key role in the delivery of services related to Maternal, Neonatal, Infant, Child and Reproductive Health of the patient or community:

1.Antenatal Care:

Community Health Nurse provides education for regular check-ups of pregnant women during pregnancy. This includes registration, hemoglobin level, blood pressure, edema check, iron and folic acid supplementation, tetanus toxoid vaccination etc. She also provides necessary referral services by identifying risk factors.

2. Intranatal Care:

The role of the nurse is important in taking steps to ensure safe maternity services such as clean and safe delivery, emergency obstetric care, and minimal maternal mortality during delivery.

3. Postnatal Care:

After delivery, maternal and neonatal health services such as lactation management, bleeding monitoring, thermal care of the baby, and personal hygiene education, infection prevention, etc. are focused on.

4. Immunization Services:

Provides necessary vaccines for the newborn and mother under the Universal Immunization Programme. Such as BCG, OPV, DPT, Pentavalent, Measles, etc. Records are maintained and reminders and follow-up are also done.

5. Family Planning and Counseling:

Community Health Nurse provides information to couples in the community about various contraceptive options such as OCPs (Oral Contraceptive Pills), IUCD (Intrauterine Contraceptive Device), condoms etc. Along with this, she also provides knowledge about the reproductive rights of the patient.

6. Reproductive Tract Infection (RTI) and Sexually Transmitted Infections (STI) Management:

The nurse provides education to the patient about RTI/STI, identifies the primary symptoms, refers for treatment and provides counseling to prevent its recurrence.

7. Health Education and Awareness:

Under RCH-II, the nurse spreads awareness in the community. Which provides education on nutrition, hygiene, puberty, sanitation, breastfeeding, HIV/AIDS and teenage health.

8. Record Keeping and Reporting:

The Community Health Nurse records data for each patient such as ANC registration, delivery record, PNC visits, vaccination data and family planning services. This report is sent to the health department.

9. Community Participation and Intersectoral Coordination:

The nurse implements the RCH-II service by collaborating with the local ANM, ASHA Worker, AWW (Anganwadi Worker). At the village level, she coordinates with the Mahila Mandal, schools, and local leaders.

10.High-Risk Patient Identification and Referral Management:

Nurses play an important role in timely referral of patients with complications such as pre-eclampsia, anemia, bleeding disorders to high-level health services.

Community Health Nurses provide patient-centric care, education, prevention and referral services for all aspects of reproductive and child health of the community under RCH-II. The effectiveness of these services makes a very important contribution to improving the health indicators of the community and reducing maternal-infant mortality.

0.2

a. Enlist environmental sanitation problems and Describe preventing and Controlling measures of it by government. એન્વાયરમેન્ટલ સેનીટેશન પ્રોબ્લેમ્સ લખો અને સરકારશ્રી તરફથી લેવામાં આવતાં નિયંત્રણ અને નિવારણનાં પગલાઓ જણાવો.08

Main Problems of Environmental Sanitation:

1. Open Defecation:

In many backward and rural areas, people still urinate in the open, resulting in pollution of water and soil. Due to this, water borne diseases like Cholera, Typhoid and Hepatitis A are seen in the patients.

2. Unhealthy Waste Management:

Proper disposal of household waste, industrial waste and biomedical waste is a major problem. Due to unhygienic environment, problems like Skin Infections, Respiratory Illnesses arise.

3. Contaminated Drinking Water:

Due to the lack of clean drinking water, pathogenic diseases like Gastroenteritis, Diarrhea and Dysentery are increasing among patients.

4. Insufficient Solid Waste Segregation:

Due to the lack of proper segregation of dry and wet waste, the recycling process remains incomplete and cases of pollution increase. Such improper segregation is responsible for health hazards.

5.Vector-borne Diseases:

Mosquitoes multiply rapidly in stagnant areas, dirt and places without drainage, due to which diseases like Malaria, Dengue and Chikungunya spread.

6.Poor Hygienic Habits:

Lack of cleanliness, lack of handwashing and use of dirty clothes increase the risk of skin related illnesses like scabies, fungal infections among patients.

Prevention and control measures taken by the government:

1.Swachh Bharat Abhiyan:

The aim of this campaign is to completely eliminate the problem of open defecation. Toilet facilities are being provided in every household. Surveillance and Awareness Campaign are being conducted.

2.National Rural Drinking Water Program:
Clean drinking water is distributed in villages through PIE (Piped water Infrastructure and Equipment). Real-time Water Quality Monitoring is also being implemented.

3.Solid and Liquid Waste Management Policy:

Separate treatment plants, landfill sites and source level segregation of waste are encouraged. A special incineration plant is being set up for biomedical waste.

4.National Health Mission:

Under this mission, training on hygiene awareness, personal care and sanitation is provided at the household level by ASHA workers, public health nurses and health inspectors.

5.Vector Control Programs:

Fogging, Larvicide Application and Anti-malarial Drug Distribution are being done. Special drives are being conducted in urban and rural areas.

6.School Health and Sanitation Program:

Children are trained in hygiene, pure handwashing techniques and anti-health risk awareness at the school level so that healthy habits are developed in children.

7.City Sanitation Plan:

Centralized drainage system, sewage treatment plant and refuse collection system have been implemented by municipal corporations to make cities clean and healthy.

Environmental sanitation is not just about cleaning the space, but is an essential infrastructure for public health. It is the responsibility of every patient and citizen to maintain physical health, while the government is taking policy, system and urgent steps for this. Solving the problems of environmental sanitation becomes possible through public participation and intersectoral collaboration.

b. Describe role of community health nurse for environmental sanitation. એન્વાયરમેન્ટલ સેનીટેશન માટે કોમ્યુનીટી હેલ્થ નર્સની ભૂમિકા વણવો.04

Broad and Important Role of Community Health Nurses for Environmental Sanitation:

Environmental sanitation is a very important link in public health. A clean environment prevents the transmission of diseases from person to person and reduces the risk of disease. In this context, community health nurses play an important role as an important link in the health care system. At the community level, they play various responsibilities for health promotion, disease prevention and sanitation improvement.

Broad and Important Role of Community Health Nurse:

1. Health Education:

Community health nurses provide information to patients about environment-related diseases, such as diarrhea, cholera, hepatitis A, and scabies. They provide training on handwashing techniques, toilet hygiene, and personal cleanliness.

2. Household and Community Surveillance:

Observes the cleaning of homes and surrounding areas, testing of waste and water sources. Reports unhealthy conditions immediately.

3.Vector Control Activities:

Community Health Nurses train citizens on fogging campaigns, larvicide use and elimination of vector breeding spots. Spread awareness to prevent mosquito-borne diseases like Malaria and Dengue.

4.Waste Management Awareness:

Gives information about segregation of dry and wet waste. Teaches patients how important it is to clean household waste.

5.Water Purification Guidance:

Community Health Nurses show patients how to keep drinking water pure through water purifiers, boiling, chlorination etc. Provides guidance to prevent water-borne diseases.

6.Public Health Camp and Endorsement:

Organizes camps related to environmental health in which blood samples, stool examination and health screening of patients are done. Encourages the community to adopt a healthy lifestyle.

7.Emergency Response:

Community Health Nurses organize immediate sanitation drives and relief actions during epidemics spread due to water and dirt after natural disasters.

8.Intersectoral Collaboration:

Participates in community sanitation improvement programs by joining hands with other departments such as municipalities, water supply departments, schools and NGOs.

The contribution of community health nurses to strengthening and sustaining environmental sanitation cannot be ignored. They play the role of advisor, teacher, monitor and leader to reduce health risks of patients, prevent epidemics and lead the community towards a clean lifestyle. Their work is not only sufficient for treatment, but also fundamental for sustainable health development.

Q.3 Write Short Answers (Any Two) ટૂંકમાં જવાબ આપો. (કોઇપણ બે) 2×6=12

a. Functions of State ministry of health. સ્ટેટ મીનીસ્ટ્રી ઓફ હેલ્થ ના કાર્યો લખો.

Main functions of the State Ministry of Health:

The safe management and expansion of the healthcare system starts from the state level. The State Ministry of Health creates the basic template of public health services. The work area of ​​this ministry covers important responsibilities like policy formation, health service delivery, patient care, epidemic control, human resource development and fiscal management.

Main functions of the State Ministry of Health:

1. Health Policy Formulation:

The ministry is responsible for formulating and implementing health policies at the state level based on the population, disease trends and health indicators of the state. These policies cover preventive, corrective and promotive healthcare.

2. Management of Health Institutions:

The management of Primary Health Centers, Community Health Centers, District Hospitals and Tertiary Care Hospitals is the main responsibility of the State Ministry. Supervision and audit are done to ensure timely and quality service to the patients.

3. Implementation of National Health Programs:

The aim is to successfully implement the programs launched by the Union Ministry of Health such as National Tuberculosis Control Program, Reproductive Maternal Neonatal Child Health and Mission Indradhanush at the state level.

4. Epidemiological Surveillance:

The State Ministry monitors the epidemic situation through a surveillance system. Real time data is collected on communicable and non-communicable diseases and necessary interventions are taken.

5. Medical Education and Training:

The Ministry is responsible for establishing and running medical colleges, nursing schools, pharmacy colleges and paramedical institutions in the state. Efforts are also made to upskill the health workforce.

6. Financial Allocation and Monitoring for Health Services:

Distribution of the health budget and auditing and tracking of funds for each health project are done. Transaction monitoring is done through Public Finance Management System.

7. Health Awareness and IEC Activities (Information, Education and Communication Activities):

Awareness is spread through media, rallies, workshops etc. for health education, disease prevention and behavior change among patients. Effective communication is provided especially against real health threats.

8. Catastrophe Response and Disaster Management:

Emergency response and rehabilitation operations are led by the State Ministry in the event of natural disaster or epidemic. Medical supplies, mobile medical units and quarantine facilities are managed.

9.Increasing Community Participation and Public Engagement:

Health service delivery is linked to Jan Aadhaar by partnering with ASHA workers, ANMs, local Panchayats and NGOs. Such community collaboration is important for extending health services to rural and backward areas.

The State Ministry of Health is the strong foundation of the health system. Its aim is not only to provide patient care, but also to work on policy, management and coordination to ensure that equal health services reach every public. The State Ministry has an effective and integral role in the health chain from prevention to rehabilitation.

b. Functions of Indian Red Cross society.- ઇન્ડીયન રેડક્રોસ સોસાયટીના કાર્યો.

Functions of Indian Red Cross: Indian Red Cross was started in 1920 and has more than 400 branches in India.

Functions of Indian Red Cross:

1) Relief work,

2) Milk and medical supplies

3) Care of sick and disabled children

4) Maternal and child welfare services

5) Family planning,

6) Research,

7) Provide scholarship for nurses to upgrade themselves.

8) Blood bank.

9) Aid to institutional

10) Junior Red Cross,

11) First aid and ambulance services.

1) Relief Work: It provides relief work during natural disasters like flood, drought, earthquake, flood, or war. At such times, it collects food and clothes and delivers them to those in need.
It also works during epidemic diseases.
It arranges workshops for workers during disaster management.

2) Milk and Medical Supply: It provides milk powder and medication by going to hospitals, maternity homes, children’s welfare centers, schools, and orphanages etc.

3) Care of Sick and Disabled Soldiers: Providing care and first aid to injured, sick and wounded soldiers in combat is the main aim of the Red Cross Society.

4) Maternal and Child Welfare Services: Many centers are available to set up maternal homes and child centers as well as provide technical advice.

5) Family Planning: Indian Red Cross Society also provides family planning services in which camps are planned and services for family planning are provided.

6) Research: Indian Red Cross Society also helps in research activities and distributes materials for child care and mother care. St. John Ambulance Association, it runs First Aid Classic Training for males and Nursing Course for females.

7) Provides Scholarship for Nurses to Upgrade Themselves: It provides scholarships to nurses for further studies. Due to which the nurse can be upgraded.

8) Blood Bank: Indian Red Cross Society runs a first aid service and blood bank, maintains a list of donors and provides services when needed.

9) Aid to Institutional: Provides assistance to hospital dispensaries, Maternal Health Care (MCH) Reproductive and Child Health (RCH) centers, schools, orphanages.

10) Junior Red Cross: Junior Red Cross is a branch of the Children’s Society which gives boys and girls the opportunity to work during epidemics and helps the youth to live with a sense of brotherhood and prepares them for first aid services.

11) First Aid and Ambulance Services: It provides first aid services and also provides ambulance services.

12) Health Education:

Health education is provided by Indian Red Cross through posters, pamphlets, slides and films, due to which health related awareness among the people can be improved.

Thus, Indian Red Cross Society plays an important role in providing health services.

c. 12th Five years plan. – 12મી પંચવર્ષીય યોજના.

The 12th Five Year Plan (Twelfth Five Year Plan) organized by the Government of India ran from 2012 to 2017. This plan was prepared by the Planning Commission. Under this plan, keeping in mind the overall development of the country, special attention was focused on health, education, nutrition and literary development.

Main Aim:

1. Inclusive Growth:

Development should be such that it includes all sections of people, especially those from rural and backward areas.

2. Poverty Reduction:

Improving the lifestyle of patients and other citizens living in poverty.

3. Health Sector Reform:

To improve healthcare infrastructure and establish more Primary Health Centres, Community Health Centres and District Hospitals.

4.Human Resource Development:

Consolidation of human resources in education and health sector.

Special focus on health sector:

Special attention was given to the health sector during the 12th Plan. The following important reforms were brought in:

Universal Health Coverage: Aims to provide health facilities to every patient.

Maternal and Child Health: Schemes to improve the treatment and nutrition of patients and newborns during pregnancy.

Immunization Programs: Increase vaccination for children and focus on Preventive Healthcare.

Non-Communicable Diseases: Active detection and control of diseases like Cardiovascular Diseases, Respiratory Disorders, Diabetes, Cancer etc.

Mental Health Services: Establishment of different types of therapy, counseling and rehabilitation centers for mental health.

Medical Education and Training: Increase the number of Medical Colleges and Nursing Institutes.

Launch a new training scheme for Paramedical Staff.

Telemedicine: Use of technology to provide healthcare facilities in remote areas.

Economic Allocation:

A total of Rs. 300,018 crore was allocated to the Health Department for the 12th Plan. A major portion of this was earmarked for the National Health Mission.

The 12th Five Year Plan was a comprehensive and strategic effort aimed at not only improving the economy but also improving the health and lifestyle of patients. The progress made in the health sector became a guide for subsequent policies.

The plan was a resolution to make India’s health map more equitable and accessible to all.

Q.4 Write Short notes (ANY THREE) ટુંક નોંધ લખો (કોઇપણ ત્રણ)3×4 =12

a. Occupational health hazards.- ઓધીગીકરણને લીધે થતી આરોગ્ય પર જોખમી અસરો.

Occupational Hazards:

Occupational hazards involve a wide range of risks that workers may experience based on their specific job role and environment.
Occupational hazards are potential risks or dangers that health care workers are exposed to in their workplace environment.
These hazards arise from various aspects of the workplace such as,
physical conditions,
chemical materials,
biological agents,
psychological factors, and
mechanical hazards, etc. These factors pose a risk to the health, safety, and well-being of workers and can lead to injuries, illnesses, or even death if proper precautions and safety measures are not taken.

Occupational hazards that workers may be exposed to include:

1) Physical hazards,

2) Chemical hazards,

3) Biological hazards,

4) Mechanical hazards,

5) Psychological hazards.

1) Physical hazards:

Physical hazards are caused by exposure to heat and cold. Workers are exposed to direct exposure to high temperatures of the sun such as farmers, builders, laborers etc.

There are also high temperatures inside the valley such as the Kotar Gold Valley in Mysore, some industries will have local ‘hot spots’ such as ovens and furnaces that radiate heat such as bakeries, metal works, asbestos factory engine rooms etc.

The effects of high temperatures include extreme heat, heat allergies, heat exhaustion, and muscle cramps.

Many workers are exposed to low temperatures such as in ice factories, high altitudes, cold storage, cold laboratories, etc. These workers may develop chills (pain, itching, and swelling in the hands and feet due to poor blood supply due to excessive exposure to cold), erythrocyanosis, and respiratory difficulties.

High Humidity:

In industries such as textile, paper, and ice factories, high humidity increases the effects of heat and cold along with exposure to extreme temperatures.

Noise:

Loud noise is produced in steel, oil, textile, and automobile factories. Loud noise is harmful to health. Its effects depend on the intensity and duration of exposure to loud noise. Loud noise can cause fatigue, nervousness, irritation and partial or complete hearing loss.

Light:

Workers may come into contact with poor or glaring and bright light. Poor light causes strain and pain in the eyes, eye strain, headaches. Blurring and bright light causes discomfort, blurring of vision, irritation and visual fatigue.

Vibration:

Vibration occurs while working on machines like grinding, cutting, drilling boring machines etc. Vibration can cause fatigue, nervousness and local effects such as hand and joint injuries etc.

Radiations:

Exposing yourself to radiation from X-rays and radioactive isotopes can cause skin and blood cancer, which can result in genetic changes, malformations, sterility etc. People working in radiology departments, watch factories, ammunition factories come into contact with ionizing radiation. Ultraviolet (UV) radiations such as during welding cause conjunctivitis and keratitis. Ultraviolet radiation can cause sunburn. Roadbuilders, sailors, shepherds and farmers can be affected by ultraviolet radiation.

2) Chemical Hazards: Factories use some or the other chemicals. Chemicals work in 3 ways.

1) Local Action: Some chemicals can cause conditions like dermatitis and eczema.

2) Inhalation: Inhalation of gases and vapors can cause respiratory diseases.

3) Ingestion

Mercury, lead, arsenic, zinc, chromium and cadmium, phosphorus etc. cause various diseases.

Types of which are hazardous

Gas like carbon monoxide, ozone, carbon dioxide, hydrogen and cyanide etc.

Fumes and vapors from various types of acids, vapors of mercurial etc.

Mists Mist from the electroplating industry.

•Dust: Small particles formed by crushing and grinding rocks, ores, metals, wood, etc.

Chemical agents that are harmful to the skin, respiratory system, and gastrointestinal system.

Skin problems include dermatitis, eczema, urticaria, ulcers, and cancer.

Respiratory problems include various types of pneumoconiosis. Silicosis due to quartz dust,
Anthracosis due to coal dust,
Byssinosis due to cotton dust,
Asbestosis due to asbestos dust,
Respiratory distress due to carbon monoxide, hydrogen sulfide and hydrogen
Cyanide Various pungent gases like chlorine, ozone, nitrogen oxide, sulfur dioxide can cause throat irritation. Lung cancer can be caused by asbestos, beryllium, coal tar, mineral oil.

3) Biological Hazards:

Biological hazards are caused by infectious and parasitic agents like viruses, rickettsia, bacteria. Due to this, hookworm infestation can also occur in farmers. Leptospirosis can occur in workers working in mines.

Various zoonotic diseases like brucellosis, mycotic infections, parasitic infections and anthrax can occur in tanning factories, veterinary hospitals and dispensaries, zoos, circuses, agricultural workers, butcher shops etc.

Health workers working in hospitals/dispensaries can come in contact with patients infected with diseases like tuberculosis, HIV and serum hepatitis etc.

4) Mechanical Hazards: Unprotected machines and their protruding and moving parts and machines with low safety can cause various accidents and injuries, which can lead to partial and permanent disability.

5) Psychological Hazards:

Different types of work adjustment problems such as lack of proper job satisfaction,

Insecurity, frustration and environmental tension prevent a person from adjusting properly. Due to these conditions, physical health problems such as increased blood pressure, indigestion, insomnia,

loss of appetite and conditions like heartburn can occur.

Thus, to prevent such hazards from occurring among workers, it is important to identify them early and properly and take preventive measures.

b. Over population’s problems. વસ્તીવધારા ને લીધે ઉદ્ભવતા પ્રોબ્લેમ

Problems due to population growth:

Health-related and social problems due to population growth

Continuous and excessive increase in population i.e. overpopulation has become a serious concern at the global level in today’s times. Due to this rapid growth rate of population, many types of health-related, social, and environmental problems are arising.

1. Burden on Healthcare Infrastructure:

Due to population growth, there is a lot of pressure on hospitals, clinics and other healthcare institutions. Due to the excessive increase in the number of patients, the public healthcare system becomes overloaded. As a result, patients do not get timely treatment and there is a delay in diagnosis and *treatment. Due to this, the *mortality rate also increases.

2. Malnutrition and Food Insecurity:

With the increase in population, the demand for food also increases, but agricultural production does not increase accordingly. Therefore, many people do not get enough and nutritious food. Problems like malnutrition, anemia and immunity reduction are seen especially in children and pregnant women.

3. Pollution-related Health Issues

Due to population increase, vehicles, factories and municipal waste increase, which pollutes air and water. Due to this, respiratory diseases like asthma, bronchitis and cardiopulmonary disorders occur more frequently. Contaminated water also spreads gastrointestinal infections and hepatitis.

4. Impact on Mental Health

As the population increases in wetlands, a crisis-like situation arises. Competition for living space, employment, education and health facilities increases, due to which people suffer from anxiety, depression and stress-related disorders.

5. Reduction in biodiversity and scarcity of natural resources (Environmental & Ecological Impact)

Due to population growth, natural resources such as water, land and fuel are used in large quantities. As a result, there is an imbalance in the environment and a negative impact on the ecosystem. This increases the risk of zoonotic diseases like Nipah, Avian Flu.

6. Increased Risk of Epidemics and Pandemics

Since many people live together in a small space, transmission spreads rapidly. Diseases like Tuberculosis, Meningitis, Coronavirus spread rapidly. Densely populated slums and improper hygienic conditions can lead to rapid transmission of viruses.

Overpopulation is not just a demographic problem but also poses a serious challenge to health, livelihood and mental well-being. If timely and appropriate measures are not taken, health systems can become completely crippled. That is why family planning, education and health awareness can be the best solution.

c. Uses of Vital health statistics – વાઇટલ હેલ્થ સ્ટેટીસ્ટીક્સ ના ઉપયોગો.

Uses of Vital Health Statistics:

Vital health statistics, which involve various data related to births, deaths, diseases and other health-related events in a population, serve several important purposes in public health and health care management.

Here are the main uses of vital health statistics:

1) Monitoring health trends:
Vital health statistics provide crucial information for monitoring population health trends.

This involves changes in birth rates, death rates, fertility rates, life expectancy and disease prevalence over time.
By analyzing these trends, health authorities can identify emerging health issues, evaluate the effectiveness of public health interventions, and allocate resources appropriately.

2) Epidemiological Studies:

Vital health statistics are fundamental to epidemiological research.

These vital health statistics allow epidemiologists to assess the distribution of any disease and its determinants in a particular population.

For example, data on disease incidence and mortality rates can reveal patterns of disease outbreaks, identify risk factors associated with certain diseases, and guide strategies for disease prevention and control.

3) Health Policy Formulation
Governments and health organizations use vital statistics to inform health policy decisions.
For example, data on maternal and child health outcomes guide policies aimed at improving prenatal care and reducing infant mortality rates.
Similarly, statistics on chronic diseases influence policies for preventive health services and health promotion initiatives.

4) Resource Allocation:
Vital health statistics assist in the allocation of health care resources.
By understanding the health needs of the population through data on disease prevalence, mortality rates, and use of health care services, policymakers can provide funding and prioritize health care services where they are most needed.

5) Health Service Planning and Evacuation:
Health systems use vital statistics for planning and evaluating health care services.
For example, birth and death data help predict future health care demand, determine staffing levels for health care services, and evaluate the impact of health care interventions on health outcomes.

6) Public Health Surveillance:
Vital health statistics are essential for public health surveillance systems.
Surveillance involves the ongoing collection, analysis and interpretation of health data to identify health risks, monitor disease trends and allocate health resources in a timely manner.
Vital statistics form a key component of these surveillance efforts.

7) International Comparison:
Vital health statistics provide a facility for comparing health outcomes and health care systems across countries or regions.
These comparisons can highlight disparities and identify best practices for health care services and support global health initiatives.

Overall vital health statistics are essential for making evidence-based decisions in public health, health care planning, and policy development that contribute to better health outcomes and improvements in population health.

d. National family welfare policy – નેશનલ ફેમીલી વેલફેર પોલીસી

Family Welfare Policy:

The National Family Welfare Policy was first implemented in 1966 on the basis of a target-free approach, focusing on the National Welfare Policy.

The main aim of the Family Welfare Policy was to improve the overall quality of life of the family.

The Family Welfare Policy is a structured set of government strategies and programmes formulated to promote the well-being of families.

The aim of this policy is to help families achieve better health, economic stability and overall quality of life.

Nutrition

Family Planning,

Education,

Health Services,

Employment,

Women Welfare and Rights,

Salt,

Environmental Sanitation,

Safe Drinking Water.

All these services are included under the Family Welfare Policy.

Introduction:

Family Welfare Policy is a comprehensive framework designed and implemented by the government to address various aspects of the lives of families.

This policy is developed to provide support and resources that help

families manage their health,

plan their families,

educate their children, and

achieve economic stability.

The main aim of the Family Welfare Policy is to improve the quality of life of individuals and families by fulfilling their health, education and social needs.

The following components are involved in this policy:

1) Health Services: Access to medical care for mothers, children and families.

2) Family planning, contraceptive services and education on reproductive health are provided.

3) Economic Assistance: Programs are run to provide economic assistance and eradicate poverty.

4) Educational Programs: Initiatives are taken to improve literacy and provide educational opportunities.

5) Social Services: To provide support and counseling to victims of domestic violence and services for the elderly and disabled.

6) Child Protection: To implement programs for child development, protection from abuse and support for children’s rights.

••> Objectives of Family Welfare Policies:

Family Welfare Policy is designed to achieve various objectives to improve family life and societal health.

Here are the objectives of Family Welfare Policies:

1) Promote Maternal and Child Health and Reduce Mortality:

Objective: To improve the health of the family, especially focusing on maternal and child health, and to reduce infant and maternal mortality rates.

Action

Provide prenatal and postnatal care to mothers

Implement child vacation programs to prevent children from diseases.

Provide nutritional support for children and monitor their growth.

Improve access to health care services for mothers and children.

2)Enhance Reproductive Health and Family Planning:

Objective

To assist individuals and couples in managing reproductive health and family size. Action

Contraceptive methods and family planning services are offered.

Education and counseling on reproductive health are provided.

Promote safe motherhood and prevent unwanted pregnancy.

3)Improve Education and Awareness:

Objective

To improve public knowledge about health, family planning and welfare services. Action

• Programs are run to create awareness among the public about health and family planning.

Educational workshops are organized for parenting, nutrition and health.

To integrate family welfare topics into the school curriculum.

4) Support Economic Stability:

Objectives

To achieve financial security of families and improve their quality of life.

To provide financial assistance through action subsidies and welfare programs.

To offer job training programs and support for small businesses.

To facilitate microfinance opportunities for low-income families.

5) Promote Gender Equality:

Objectives

• To eliminate gender imbalance and empower women and girls. Action
• Provide legal aid and shelter for victims of domestic violence.

Support women’s rights and gender equality initiatives.

Provide education and professional opportunities for women and girls.

6) Strengthen Family Structure:

Objectives
Strengthen healthy family relationships and support families in crisis situations.

Action:

Provide family counseling services for relationship and family issues.

•Organize parenting workshops and support groups.

•Provide crisis intervention services for families facing domestic violence.

7) Support Elderly and Disabled Family Members:

Objective
To provide support to elderly and disabled persons. Action

To provide pension and financial support to elderly persons.

To provide home care services and specialized medical care to disabled persons.

To provide accessibility of assistive technology to disabled persons.

8) Promote Child Development and Protection:

Objective
Children are healthy, safe and have opportunities to develop. Action

Implement early childhood education programs.

Develop child protection services to prevent child abuse and neglect.

Advocate for the rights of children and their legal protection.

9) Encourage Community Involvement:

Objective
Encourage community engagement in family welfare efforts. Action

Provide support for community best welfare programs and voluntary opportunities.

Involve local organizations to provide family welfare services.
•Promote community awareness of family health and welfare issues.

10) Address urban and rural disparities:

Objectives
To ensure equal access to family welfare services in both urban and rural areas. Action

To develop targeted programs in rural and affected areas.

To allocate resources to bridge the gap between urban and rural services.

To involve special initiatives to meet the unique needs of different communities.

11) Facilitate mental health support:

Objectives
To assess mental health issues in families and promote mental wellbeing. Action

Provide mental health counseling and psychological support.

Raise awareness among community members about mental health issues prevalent in the community and eliminate mental health related stigma.

Implement programs for stress management and emotional support.

12) Promote Safe and Healthy Environment:

Objective

To ensure safe living conditions and promote environmental health. Action

Implement public health initiatives to ensure clean water, hygiene and safe housing.

Promote environmental stability through community programs. Thus, family welfare policies aim to improve the overall well-being of families through various objectives, focusing on health, education, economic stability, and social support.

Q.5 Write Definition (ANY SIX) વ્યાખ્યા આપો. (કોઇપણ છ) 6 × 2=12

a. Fertility – ફર્ટીલીટી

When women have the ability to conceive and bear children, it is called fertility. Fertility is the natural capacity to produce offspring.

b. School Health Services – સ્કુલ હેલ્થ સર્વીસીસ

School Health Services: School Health Services means providing need-based comprehensive health services to school children or pupils, teachers and other persons so that their health can be promoted, diseases can be prevented and controlled and their health can be maintained.

c. Demography – ડેમોગ્રાફી

Demos means people
Graphine means the record.

Demography
The scientific study of human population and its elements i.e. size, composition and distribution is called demography. Demography is the scientific study of population.

Concept of Demography

Demography is a branch of science that studies human population and focuses on only three elements.

1) Any changes in the size of the population i.e. increase or decrease in size.

2) Structure of the population (basic of age and size).

3) Geographical distribution on the basis of state or region.

d. TFR- ટીએફઆર

TFR (Total Fertility Rate)

The rate at which a child is born to a woman in each age group, the average number of children a woman can give birth to in her total reproductive years is called Total Fertility Rate (TFR).

Total fertility rate (TFR):=

45 – 49
5× Σ ( ASFR)

15 – 19

1000

(ASFR = Age specific fertility rate)

e.Health – Health

In 1948, W.H.0 (World Health Organization) gave the definition of health, which is as follows.
“Health is a state of complete physical, mental, social and spiritual well-being and not merely an absence of disease or infirmity.” As per WHO, “Health is a state of complete physical, mental, social and spiritual well-being and not merely an absence of disease or infirmity.”

f. GOBIFFF – ગોબીફ

GOBIFFF (GOBIFFF) is an acronym for the Child Health Improvement Schemes implemented by the Indian Government, which are mainly designed for the health and overall development of the child. In this GOBIFFF word, ‘G’ : Growth monitoring (Growth Monitoring) i.e. the child’s development record, ‘O’ : Oral rehydration therapy (Oral Rehydration Therapy),
‘B’ : Breastfeeding (Breastfeeding),
‘I’ : Immunization (Immunization),
‘F’ : Female education (Female Education),
second ‘F’ : Family planning (Family Planning) and
last ‘F’ : Food supplementation (Food Supplementation) are shown. The main objective of GOBIFFF is to reduce child mortality rate, improve nutrition and improve maternal and child health.

g. I.M.N.C.I આઇ.એમ.એન.સી.આઇ

I.M.N.C.I (IMNCI) stands for Integrated Management of Neonatal and Childhood Illness, a holistic approach developed by the World Health Organization (WHO) and UNICEF, for the early diagnosis and appropriate treatment of common and serious illnesses in newborns and children. IMNCI includes guidelines for the identification and management of diseases such as newborn care, diarrhea, pneumonia, malaria, malnutrition and measles. Its specialty is that this approach can be implemented at the village-level by civil society, paramedical workers and healthcare workers to further improve child health.

h. I.M.R. – આઇ.એમ.આર

IMR- I.M.R(Infant Mortality Rate)

The number of children who die within the age of 1 year out of the total number of live births in a given population of one thousand in the same year is called Infant Mortality Rate (IMR).

IMR =

Number of deaths of children less
than one year of age in a year
_ x 1000
Number of live births in the same year

Q.6 A. Fill in the blanks, ખાલી જગ્યાઓ પૂરો. 05

1.Balam Sukham Mission’s three layers services are as …… , …… And ……
બલમ સુખમ મીશન ની સેવાઓનાં ત્રણ સ્તરો ……. , …… અને …… છે. Village Child Nutrition Centers (VCNC), Child Malnutrition Treatment Centers (CMTC), and Nutrition Rehabilitation Centers (NRC).

2.N.S.V. stands for …… એન.એસ.વી. એટલે …… Non-Scalpel Vasectomy(નન-સ્કેલ્પલ વેસેકટોમિ)

3.R.N.T.C.P stands for …… આર.એન.ટી.સી.પી એટલે …… Revised National Tuberculosis Control Programme (રીવાઇઝ્ડ નેશનલ ટ્યુબરક્યુલોસિસ કન્ટ્રોલ પ્રોગ્રામ)

B. State whether following statements are True or False નીચેના વિધાનો ખરા છે કે ખોટા તે લખો. 05

1.AIDS is a contagious disease.- એઇડસ એ સ્પર્શથી ફેલાતો રોગ છે. False – ખોટું છે. વિગતવાર સ્પષ્ટતા: AIDS (Acquired Immuno Deficiency Syndrome) is not spread by casual contact or touch. It is a communicable disease but spreads only through specific modes like unprotected sex, sharing infected needles, and from mother to child.

2 Head of municipal corporation’s health department is medical officer of health.
મેડીકલ ઓફીસર ઓફ હેલ્થ એ મ્યુનીસીપલ કોર્પોરશનના હેલ્થ વિભાગનાં વડા છે. True – ખરુ છે.
વિગતવાર સ્પષ્ટતા: In urban areas, the Medical Officer of Health (MOH) is the senior official responsible for public health services under the municipal corporation.

3.USHA stands for Urban Social Health Activist. USHA એટલે અર્બન સોસીયલ હેલ્થ એકટીવીસ્ટ. True – ખરુ છે. વિગતવાર સ્પષ્ટતા: Urban Social Health Activist (અર્બન સોસીયલ હેલ્થ એક્ટીવિસ્ટ)

4.There is one Female Health Supervisor for 50,000 populations. 50,000 ની વસ્તી માટે એક ફીમેલ હેલ્થ સુપરવાઇઝર હોય છે. False – ખોટું છે. વિગતવાર સ્પષ્ટતા:
ફીમેલ હેલ્થ સુપરવાઇઝર (Female Health Supervisor) એટલે કે Lady Health Visitor (LHV) સામાન્ય રીતે 30,000 ગ્રામ્ય વસ્તી માટે એક રાખવામાં આવે છે.

5.Mosquitoes responsible for dengue bites at night. ડેન્ગ્યુ માટે જવાબદાર મચ્છરો રાત્રે કરડે છે. False – ખોટું છે.
વિગતવાર સ્પષ્ટતા: Dengue is transmitted by Aedes aegypti mosquitoes which bite during the daytime, especially early morning and late afternoon.

C . Match the following, નીચેના જોડકા જોડો. 05

A B

a. P.H.C. પી.એચ.સી. i. Helps for blindness અંધજનો માટે મદદ

b. DANIDA ડી.એ.એન.આઇ.ડી.એ. ii. F.R.U. Center ફે.આર.યુ. સેન્ટર

c. Oral Polio Vaccine-2 iii. 14 Weeks 14 અઠવાડીયા
ઓરલ પોલીયો રસી-2

d. Measles Vaccine ઓરીની રસી iv. Covers 30,000 population ૩૦,૦૦૦ની વસ્તી આવરી લે છે.

e. C.H.C. સી.એચ.સી v. 9 months 9 મહીના

vi. 10 weeks 10 અઠવાડીયા

C.Correct answer

A	B	Correct Match
a. P.H.C. (પી.એચ.સી.)	iv. Covers 30,000 population (૩૦,૦૦૦ની વસ્તી)	a → iv
b. DANIDA (ડી.એ.એન.આઇ.ડી.એ.)	i. Helps for blindness (અંધજનો માટે મદદ)	b → i
c. Oral Polio Vaccine-2 (ઓરલ પોલીયો રસી-2)	vi. 10 weeks (10 અઠવાડિયા)	c → vi
d. Measles Vaccine (ઓરીની રસી)	v. 9 months (9 મહિના)	d → v
e. C.H.C. (સી.એચ.સી.)	ii. F.R.U. Center (એફ.આર.યુ. સેન્ટર)	e → ii

Final Answers:

a → iv
b → i
c → vi
d → v
e → ii