⏩Q-1 🔸A) Define diarrhea, give the definition of diarrhea. 03
Diarrhea is a condition in which liquid, loose and watery stools are passed more than three times in a day (in 24 hours). And the frequency of these loose, watery stools is also high.
Due to diarrhoea, excessive amount of fluid and electrolytes are lost from the body, resulting in a condition of dehydration.
Diarrhea is one of the top three causes of child mortality in developing countries.
1 St no := Respiratory infection like pneumonia.
2 nd no := diarrheal diseases and malaria,
3 rd no := premature birth complication.
There are four main types of diarrhea.
(1) Acute diarrhoea
(2) Chronic diarrhoea
(3) Persistent diarrhoea,
(4) Dysentery
••>
(1) Acute diarrhoea:
Acute diarrhea is a condition in which the onset of diarrhea is sudden and of short duration.
And for a period of less than two weeks.
Acute diarrhea is mainly caused by any infection.
(2) Chronic diarrhoea:
Chronic diarrhea is a condition in which loose watery stool is present for more than 3 weeks, it is called chronic diarrhea. Chronic diarrhea is due to any organic disease.
(3) Persistent diarrhoea:
Persistent diarrhea is a condition in which attacks of acute diarrhea persist for more than two weeks and the diarrhea is caused by an infection.
(4) Dysentery:
Dysentery is a condition in which blood, mucus, and pus are present in the stool, accompanied by abdominal colic, fever, and tennismush (a condition in which there is a need to pass stool even though the bowels are already empty). Get.
🔸B) Write components of diarrheal disease control program..04
Components of a Diarrheal Disease Control Program: Diarrheal disease control programs generally include several key components aimed at reducing the incidence, severity and mortality rates associated with diarrheal diseases. This component is:
1) Promotion of Safe Drinking Water: Ensuring access to clean and safe water sources. Implementing water purification methods such as boiling, chlorination or filtration.
Regular maintenance and monitoring of water supply system.
2) Sanitation and Hygiene:
Promoting the use of proper sanitation facilities, such as toilets and sewage systems.
Encourage regular hand washing with soap, especially before meals and after defecation.
Educate the community about proper waste disposal practices.
3) Health Education and Behavioral Changes:
To provide information about prevention and management of diarrheal disease.
Organizing community outreach programs to create awareness about hygiene practices.
Training health care workers and community members on effective hygiene and sanitation measures.
4) Vaccination:
Implementing vaccination campaigns (campaigns) for diseases like rotavirus which cause diseases like diarrhoea.
Ensuring that vaccines are available, accessible and administered according to timetable.
5) Oral rehydration therapy (ORT):
Provide education to caregivers on the use of oral rehydration solutions (ORS) for the treatment of dehydration due to diarrhea. Ensuring availability of ORS in health care facilities and communities.
6) Treatment of Diarrheal Diseases:
Provide access to medical care for persons with severe diarrhea. Ensure availability of appropriate treatment, including zinc supplementation and antibiotics if necessary.
Training health care providers to identify and manage severe cases of diarrhea.
7) Surveillance and Monitoring:
Establish systems for early detection and reporting of outbreaks of diarrheal diseases.
Monitoring trends in the incidence of diarrheal diseases and evaluating the effectiveness of controlling measures.
8) Research and Development:
To provide support to research for prevention and intervention of diarrhea and disease.
Developing and testing new vaccines, treatments and diagnostic tools.
9) Emergency Preparedness and Response:
Making immediate plans during outbreaks of diarrheal diseases and emergencies.
Coordination with local, national and international agencies for effective response in case of diarrheal disease outbreaks.
These components work together to address the multifaceted challenges of diarrheal diseases and improve public health outcomes.
🔸C) Write preventive strategies of diarrhea. 05
Preventive strategies for diarrhea focus on reducing the risk of developing diarrhea and maintaining overall health.
Major strategies involve:
1) Clean drinking water:
Access to Clean Water:
Ensuring that communities have reliable access to safe sources of drinking water.
Water Treatment:
Using methods like boiling, chlorination or filtration to purify water.
2) Hygiene and Sanitation:
Proper disposal of waste:
To promote the construction and use of sanitation facilities like toilets.
Hand washing:
Encourage regular hand washing with soap and water, especially before eating and after using the toilet.
Safe Food Handling:
Educate about proper food preparation, storage and cooking practices to prevent contamination.
3) Health Education:
Awareness Campaigns:
To provide education in the community about hygiene, sanitation and prevention of diarrheal diseases.
School Programs:
Implement hygiene education programs in schools to teach children about preventive practices.
4) Vaccination:
Rotavirus vaccine:
Ensuring children receive rotavirus vaccination, which protects against the main cause of diarrhea in young children.
Other vaccines:
Encouraging vaccination against other pathogens that cause diarrhea, such as cholera.
5) Promote Best Fitting:
Exclusive Breastfeeding:
Encouraging exclusive breastfeeding for infants below six months, which provides essential nutrients and immune protection.
Continued Breastfeeding:
Provide regular breastfeeding support with proper complementary food to the child till the age of two years.
6) Oral Rehydration Solutions (ORS):
Access to ORS:
Ensure that ORS are available and care givers know how to prepare and use them to manage mild dehydration.
7) Safe Food Practices:
Food Safety:
Promote practices like washing fruits and vegetables, cooking food thoroughly and avoiding the use of raw or undercooked food.
8) Proper disposal of diarrheal waste:
Safe Disposal:
Ensuring proper disposal of diarrheal waste to prevent the spread of infection.
9) Regular Health Checkup:
Encouraging regular health checkups for early identification and management of potential health issues.
10) Imprude Infrastructure:
Community Project:
Invest in infrastructure projects to improve access to clean water and sanitation facilities.
11) Emergency Preparedness:
Develop and maintain emergency response plans for potential outbreaks of diarrheal disease.
Implementation of these strategies can help significantly reduce the incidence of diarrheal diseases and improve public health.
🔸OR🔸
🔸a) What is demography? 03
Demography Definition:
Demos Means People
Graphene Means the Record.
Demography
The scientific study of human population and its elements ie size, composition and distribution is called demography. Demography means the scientific study of population.
Concept of Demography
Demography is a branch of science which studies human population with special provision on only three elements.
1) If there is any change in the size of the population i.e. the size increases or decreases.
2) Structure of Population (basic of age and size).
3) Geographical distribution based on state or territory.
🔸B) list the stages of demography. .04
Stages of Demography:
There are mainly 5 stages of demography.
1) First stage = high stationary stage,
2) Second Stage = Early Expanding,
3)Third Stage = Late Expanding,
4) Fourth Stage = Low Stationery,
5) Fifth Stage = Decline Stage
1) First Stage = High Stationary Stage:
In the high stationary stage there are no changes in the size and composition of the population.
Birth Rate : ↑High
Death Rate : ↑High
Because it has high birth rate and high death rate i.e. both cancel each other and due to which the population remains stationary.
Until the middle of the 17th century, the world population was in this stage and India was in this stage till 1920.
Ex: India in 1920
2) Second Stage = Early Expanding:
In the second stage, early expanding stage, the death rate decreases as the health condition improves and the birth rate remains unchanged.
Birth Rate : ↑Unchanged
Death rate : ↓decline
In the early expanding stage the birth rate does not change but the death rate decreases due to which there is a slight increase in the size of the population.
The world population was in this stage from the middle of the 17th century to the middle of the 19th century. India was in this stage from 1921 to 1950
Ex: South Asia, Africa
3)Third Stage = Late Expanding:
In the third stage, late expanding stage, the death rate declines slightly and the birth rate declines slightly.
Birth rate: ↓slide (slight) decline
Death rate :↓further decline
In the late expanding stage the birth rate declines a little while the death rate declines a little more but because the birth date is a little higher than the death rate, there is population growth.
Ex: China, Singapore and India
4) Fourth Stage = Low Stationery:
In the fourth stage, the low stationary stage, the birth date is low and the birth rate is also low, due to which the population is observed to be stationary (stable).
Birth Rate : ↓low
Death Rate : ↓low
In this stage there is stability in population due to low birth rate and death rate and this is usually seen mainly in developed and industrialized countries. Australia recorded zero population growth during 1980-1985.
Ex:=Australia in 1980-1985.
5) Fifth Stage = Decline Stage:
In the fifth stage decline stage the birth date is further reduced while the date remains unchanged due to which a decrease in population is seen.
Birth Rate : ↓Further Lo
Death Rate : ↓Unchanged
Thus in this decline stage there is a decrease in population due to the decrease in birth date and death rate which is usually seen in Germany and Hungary.
Ex:= Germany and Hungary.
The demographic cycle helps explain how populations evolve and transition through different stages of development, affected by socio-economic factors, technological advancement and cultural changes.
🔸c) Factors responsible for increased population. .04
Factors responsible for population increase:
Factors responsible for population increase can be categorized into several broad areas: social, medical, economic, and environmental factors.
Here is detailed information about these factors:
1) Social Factor:
Cultural Beliefs and Nomes:
In many societies, large families are culturally valued and seen as a sign of prosperity and security. Traditional norms and religious techniques can anchor a high birth date.
Early Marriage:
In regions where early marriage is common, it leads to high fertility rates because women begin childbearing at an earlier age and have more children during their lifetime.
Lake of Family Planning Education:
Inadequate awareness about family planning methods and reproductive health may increase the birth rate.
2) Economic Factor:
Economic Incentives:
In some countries, children are seen as economic assets that can increase household income or support parents in old age. It can anchor a large family.
Poverty:
High birth rates are found in poor regions where children are seen as sources of labor and financial support, and where access to family planning facilities is limited.
3) Medical Factor:
Improved Healthcare:
Advances in health care have reduced death rates, particularly in infants and children. Improved medical care means more children survive to adulthood, which can contribute to population growth.
Vaccination and Disease Control:
Effective vaccination programs and better control of diseases contribute to longer life expectancy, which, if the birth rate is high, can increase the population.
Fertility Treatment:
Technological advancements in fertility treatment have enabled more people to conceive than were previously able to conceive, leading to increased birth rates.
4) Environmental Factors:
Urbanization:
Rapid urbanization initially leads to population growth as people migrate to cities for better opportunities.
However, over time, the cost of living and lifestyle changes due to urbanization may reduce the birth rate.
Environmental :
If a person is getting full fulfillment of their basic requirement in adequate amount, then the birth rate can also increase due to this.
5) Political Factor:
Government Policies:
Policies that promote high birth rates, such as pronatalist policies, can contribute to population growth.
Political Stability:
A stable political environment can promote economic development and public health improvement, leading to increased birth rates and population growth.
6) Educational Factors:
Education Level:
When there is a low level of education, especially if the female is not educated, then due to this high birth rate is seen.
Due to lack of education, there is no proper awareness about family planning, which leads to increase in child birth, which can lead to population increase.
Access to Education:
Limited access to education leads to high fertility, especially for females. Due to which the birth date increases and the population also increases.
Thus, social factors, economic factors, medical factors, environmental factors, political factors, and educational factors are responsible for population increase.
⏩Q-2 🔸a) What is family welfare policy? .08
•Family Welfare Policy
••>Family Welfare Policy:
The National Family Welfare Policy was first implemented in 1966 on the basis of target free approach in addition to focusing on the National Welfare Policy.
Improvement in the overall quality of life of the family was the main aim of the family welfare policy.
Family welfare policy is a structured set of government strategies and programs formulated to promote the well-being of families.
The policy aims to help families achieve better health, economic stability and overall quality of life.
Nutrition
family planning,
education,
Health Services,
employment,
Women Welfare and Rights,
Salter,
Environmental Sanitation,
Safe drinking water.
All these services are included under the Family Welfare Policy.
Introduction:
Family Welfare Policy is a comprehensive framework formulated and implemented by the Government to address various aspects of the lives of families.
This policy has been developed to provide support and resources that,
Helping families manage their health,
In planning the family,
Educating children, and
Helps in getting economic stability.
The main aim of family welfare policy is,
It is to improve the quality of life of individuals and families by fulfilling health, education and social needs.
This policy involves the following components:
1) Health Services
There should be access to medical care for mothers, children and families.
2) Family planning
Contraceptive services and reproductive health education are provided.
3) Economic assistance
It runs programs for economic assistance and poverty eradication.
4) Educational program
Initiatives are taken to improve literacy and provide educational opportunities.
5) Social Services
Providing support and counseling for victims of domestic violence and services for the elderly and disabled.
6) Child Protection
Programs for child development, protection from abuse and support for children’s rights are run.
••> Enlist the 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:
Improving family health, with particular focus on maternal and child health, reducing infant and maternal mortality rates.
Action
Provide prenatal and positive care to the mother
Implementing child vacation program to prevent child from disease.
Providing nutritional support to children and monitoring their growth.
Improvement in access to health care services for mother and child. 2) Enhance Reproductive Health and Family Planning: Objective
Assisting individuals and couples in managing reproductive health and family size. Action
Contraceptive methods and family planning services are offered.
Education and counseling about reproductive health is provided.
Educational workshops are organized for parenting, nutrition and health.
Integrating family welfare topics into the school curriculum. 4) Support Economic Stability: Objectives
Achieving the financial security of the family and improving its quality of life. Action
Supporting women’s rights and gender equality initiatives.
To provide education and professional opportunities for women and girls. 6) STRANDHEN FAMILY STRUCTURE: OBJECTIVES
Strengthening healthy family relationships and providing support to families in crisis situations. Action:
To provide family counseling services for relationship and family issues.
•Organizing parenting workshops and support groups.
To provide pension and financial support for elder person.
To provide home care services and specialized medical care for disabled persons.
To provide accessibility of assistive technology for disabled persons. 8) Promote Child Development and Protection: Objective
Children should be healthy, safe and have opportunities to develop. Action
Implementation of Early Childhood Education Programme.
Advocating for child’s rights and legal protection. 9) Anchorage Community Involvement: Objectives
To promote community engagement in family welfare affairs. Action
To provide support to community best welfare programs and voluntary opportunities.
Involvement of local organizations to provide family welfare services.
To develop target programs in rural and affected areas.
Allocating resources to bridge the gap between urban and rural services.
Involvement of special initiatives to meet the unique needs of different communities. 11) Facilitate Mental Health Support: Objective
Assessing mental health issues in families and promoting mental wellbeing. Action
Provide mental health counseling and psychological support.
To create awareness among community members about mental health issues in the community and to eliminate mental health related stigma.
Implementation of programs for stress management and emotional support. 12) Promote Safe and Healthy Environment: Objective
Making living conditions safe and promoting environmental health. Action
🔸b) Write role of mother in family welfare programme. 04
Role of Nurse in Family Welfare Programme:
The role of a nurse in a family welfare program is diverse and multifaceted. Nurses play different roles in different settings of family welfare services. It generally depends on their post and their working capacity.
The role of the community health nurse (CHN) in family welfare services is important in promoting reproductive health, family planning and overall well-being in the community.
Here are the key aspects of his role:
1) Survey work:
To collect reviews about how many couples use contraceptives and how many people do not use them for the formation of further action plans. 2) Health Education:
To provide education about health and family planning to the individual, family, and community.
To make people aware about available family planning services.
Provide education and detailed information about different types of contraceptives to couples so that they can adopt them according to their choice.
Providing education to mothers or athletes to breastfeed their child up to one year because it works as a natural contractile.
To provide education about immunization, nutrition, first aid and personal and environmental hygiene in the community. 3) Coordinator and Provider of Family Welfare Services:
To arrange family planning clinics and camps to create awareness about people’s needs and available services.
To follow State Government and State Rules and Regulations and to provide direct services within legal and professional limits.
It coordinates the services of Gynecologists and other Family Welfare Services personnel. 5) Magnification function:
Encourages ineligible couples to adopt small family norms by using contraceptives.
Works to explain the need and importance of family planning.
To identify women who need medical termination of pregnancy and refer them to a doctor early.
Establishment of depots for adequate contraceptive supply and distribution in every village due to which adequate supply of contraceptives can be provided. 6) Administrative Role:
•Determining dates and locations of family planning clinics, arranging equipment, supplies and other resources in the clinics.
Supervise and guide multipurpose health workers in clinics and distribute contraceptives and insert and remove IUDs.
To provide assistant to the Medical Officer in conducting the clinic.
Organizing camps for family planning and assisting doctors in male-female and female sterilization operations.
Maintain aseptic technique during operation.
To provide follow up services to couples who have accepted the method of family planning.
Planning and evaluation of education programs. 7) Consultant:
Before starting any type of health care program in the community as a coordinator in family welfare services and as a direct care provider, it is important to consult them. 8) Counsellor: The nurse counsels the ineligible couples and the target couple on different contraceptive methods and provides them an opportunity to choose the best suitable method for spacing. 9) Supervisory role: As a supervisor, the nurse working in the family welfare department encourages her staff to participate actively in the family welfare program.
As a supervisor, the nurse organizes in-service education programs for health workers, professionals, and nursing personnel. 10) Domiciliary Services: Home visits are an important part of the family program. These services are provided by multipurpose health workers and health assistants.
wherein as Services,
If using IUD and pills, provide advice for follow-up and provide education for follow-up in cases of vasectomy, tubectomy, medical termination of pregnancy (MTP).
Providing domiciliary care to antenatal, postnatal, newborn and toddler.
Providing referral services if anyone has post-operative complications. 11) Record Maintenance: The nurse is responsible for maintaining all the records in the family planning program viz.
🔸a) Describe National Nutritional Anemia Prophylaxis Programme. 08
National Nutritional Anemia Prophylaxis (NNAPP) Program:
Introduction:
NNAPP (National Nutritional Anemia Prophylaxis Program) was started in 1970 to prevent nutritional anemia in pregnant women, lactating mothers, infants and children.
Under this programme, iron and folic acid tablets are given to pregnant women, lactating mothers and family planning experts.
This program has been launched by the Maternal and Child Health (MCH) Department of the Ministry of Health and Family Welfare.
In which National Nutritional Anemia Prophylaxis is conducted as a part of RCH programme.
Within the revised policy, the target group has been expanded to include 6-12 months infants, school children and adolescents aged 11-18 years who are clinically diagnosed as anemic.
Specific Objectives:
Estimate hemoglobin levels in mothers and young children to assess their baseline condition of nutritional anemia.
Antianemia treatment should be provided to mother and child with low Hb (hemoglobin) level <10 gm and <8 gm Hb respectively.
Provide prophylaxis treatment to mothers with Hb level >10 gm and child with Hb level >8 gm.
Continuous monitoring of quality and distribution of tablets and consumption of supplements.
Periodically assess hemoglobin (HB) level of beneficiaries.
Encouraging mothers to take tablets through relevant nutritional education. Activities:
The program involves the following activities:
Identifying cases of severe anemia and providing treatment.
Dosage schedule:
•Child 6 month -5 year:=
20 mg iron+ 100 µg folic acid up to 100 days when the child is found clinically anemic.
School children 6-10 years :=30 mg iron + 250 mg folic acid for 100 days.
Adolescent 11-18 years :=100mg iron + 500 µg folic acid for 100 days.
Pregnant mother:= 100mg iron + 500 µg folic acid for 100 days.
Nursing mother and family planning acceptors :=100mg iron + 500 µg folic acid for 100 days. Organization: The implementation of this program is done by the Primary Health Center and its sub-centres. Multi-Purpose Health Workers and other paramedical staff in PHCs (Primary Health Centres) are responsible for the distribution of IFA (Iron and Folic Acid) tablets to the beneficiaries.
ICDS (Integrated Child Development Services) scheme workers help in the implementation of the programme.
🔸b) Write role of nurse in Anemia Control Programme. .04
Role of Nurse in Anemia Control Program:
Nurses play an important role in anemia control programs such as:
1) Assessment and Diagnosis:
Patient Evaluation
The nurse performs a comprehensive assessment to identify the patient’s anemic condition, in which a detailed medical history, dietary assessment, and family health history are collected.
Physical Examination
To assess the condition of anemia, to assess the signs of anemia including symptoms like pallor, fatigue, shortness of breath.
Diagnostic testing
Laboratory tests to assess the condition of anemia, blood collection for this test, hemoglobin level in the test,
Assessing hematocrit levels, and iron levels. So which type of anemia can be identified.
(Ex := Iron Deficiency Anemia, Vitamin B12 Deficiency Anemia)
2) Education and Counselling:
Patient Education
To provide complete education to the patient about the causes of anemia, its symptoms and signs and the importance of its treatment. Then also provide education about how the condition of anemia affects the body.
Nutritional counselling
Providing education to the client to intake iron rich food. (Ex:= red meat, beans, spinach).
Advise the client to also intake foods that increase iron absorption (Ex:= citrus foods). Provide education to avoid foods that are responsible for reducing iron absorption (Ex: tea, coffee).
Supplement Guidance
Giving advice for correct use of iron supplement including providing education about its time, dose, duration, side effects.
3) Monitoring and follow up
Monitoring regularly
Advise the client to follow up to assess treatment efficacy, monitor hemoglobin levels and assess overall health.
4) Screening and Referral:
Population screening
Routine screening examinations in high-risk populations such as children, pregnant women, and elderly people can lead to early identification of cases of anemia.
Referral Services
Refer patients to hematologists or dieticians when they need advanced care.
5) Program Implementation:
Community Outreach
Engaging in community education initiatives for anemia prevention and management. Organizing and participating in health fairs, workshops and public health campaigns.
Supplementary Distribution
Assist in the distribution of iron and folic acid supplements through public health programs. Provide education to the community about the importance of these supplements for the prevention of anemia.
Policy Implementation
Contribute to the development and implementation of anemia control policies at local, regional or national level.
Work with health departments and organizations to increase program effectiveness.
6) Data Collection and Reporting: The nurse collects and manages data on anemia prevalence and program effectiveness, contributes to reports, and helps refine program strategies.
7) Advocacy:
The nurse advocates for the patient’s needs, and ensures that the patient receives proper care and resources.
And works to bring awareness about anemia in the community. Nurses help reduce the prevalence of anemia and improve overall public health.
Thus the nurse plays an essential role for the success of the anemia control program.
⏩Q.3 Write short answer (Any Two) 2X6=12
🔸1.Write components of RCH Phase-II.
Components of RCH Phase-II:
Reproductive and Child Health (RCH) Phase-II was one of the major initiatives by the Government of India focusing on improvement in maternal and child health services.
The aim of this program was to build on the success of RCH Phase-I and face remaining challenges.
The components of RCH Phase-II are as follows:
1) Reproductive Health Services
Family planning
Maternal Health
Adolescent Reproductive Health
2) Child Health Services
Immunization
Nutrition
Growth monitoring
3) Disease Prevention and Control
Disease Surveillance
Preventive Health Services
4) Healthcare Infrastructure and Human Resources
Facility Upgrades
Training and Capacity Building
5) Community Participation and Empowerment
Community Engagement
Empowerment Initiatives 6) Health Information Systems and Data Management
Data Collection and Management
Monitoring and Evaluation
7) Behavior Change Communication (BCC)
Communication Strategies
Educational campaigning
8 Integration of Services
Service Integration
Referral Systems 9) Policy Support and Planning
Policy Development
Program Planning ••>1) Reproductive Health Services Family Planning
Expanding access to different contraceptive methods such as short-term contraceptives (oral contraceptive pills) and long-term contraceptives (IUDs, sterilization). Maternal Health
Providing comprehensive antenatal care (ANC), skilled birth attendants and postnatal care (PNC) to ensure safe pregnancy and delivery. This involves regular check-ups, management of complications and post-delivery support. Adolescent Reproductive Health Providing Education to Adolescents About Sexual Health Prevention in Adolescent Reproductive Health
2) Child Health Services
Immunization
Implementation and expansion of vaccination programs to provide vaccination for diseases like Tuberculosis (BCG), Polio, Diphtheria, Tetanus, Pertussis (DTP), Hepatitis B and Measles.
Nutrition
Promote breastfeeding, provide nutritional supplementation (such as vitamin A and iron-folic acid), and implement programs to combat child malnutrition and growth retardation.
Growth monitoring
Regular assessment and regular monitoring of child’s growth and development through early identification of developmental delay.
3) Disease Prevention and Control
Disease Surveillance
Monitoring and management of communicable diseases through surveillance systems and response strategies.
Preventive Health Services
Offers services such as cervical cancer screening, and health education on hygiene and sanitation and disease prevention.
4) Healthcare Infrastructure and Human Resources
Facility Upgrades
Strengthening and upgrading of health care infrastructure including construction of new facilities and improvement of existing facilities to ensure delivery of quality services.
Training and Capacity Building
To provide training to health care providers to improve their skills to provide services in RCH services.
5) Community Participation and Empowerment
Community Engagement
Community involvement through awareness, health education and participation in health committees.
Empowerment Initiatives
Provide support to women’s groups, self-help groups and other local organizations in promoting community-driven health solutions.
6) Health Information Systems and Data Management
Data Collection and Management
Developing and maintaining Health Information System for collection, management and analysis of RCH related data.
Monitoring and Evaluation
Continuously evaluating and monitoring the effectiveness of the program.
7) Behavior Change Communication (BCC)
Communication Strategies
Designing and implementing behavior change communication for healthy practices for reproductive and child health.
Educational campaigning
Collection and distribution of education materials to create awareness about reproductive and child health issues.
8 Integration of Services
Service Integration
Integrating RCH services with other health programs to provide comprehensive services.
Referral Systems To provide referral services so that patients can get proper care from different levels of health care system.
9) Policy Support and Planning
Policy Development
Provide contribution to formulating policies and strategies that support the goals of RCH-II.
Program planning
To assist in the planning, management and implementation of the RCH program at different administrative levels.
These components collectively aim to improve maternal and child health, reduce death rates and promote sustainable health practices across communities.
🔸2.Write old age associated health problems.
Write about health problems related to old age.
Health problems related to old age:
Health problems commonly experienced by older individuals can vary widely but often include chronic conditions, degenerative diseases, and age-related issues.
Here are the health problems seen in elderly people:
1) Cardiovascular Diseases:
Conditions like hypertension (high blood pressure), coronary artery disease, heart failure, these conditions are usually age related and due to reduced elasticity of blood vessels and lifestyle factors, heart problems can arise in the elderly.
2) Osteoarthritis and joint problems:
Degenerative joint diseases such as osteoarthritis affect mobility and quality of life in older adults.
Due to which pain, stiffness and range of motion decrease.
3) Osteoporosis:
Osteoporosis is a condition where bones become fragile and prone to fracture, often due to a decrease in bone density with age, mainly in postmenopausal women.
4) Diabetes:
Type 2 diabetes becomes more prevalent with age, affecting the body’s ability to control blood sugar levels.
5)Respiratory problem:
Chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis, can increase with age, affecting respiration and the internal function of the lungs.
6)Neurological disorders:
Alzheimer’s disease and other forms of dementia become more common as people age, affecting memory, cognition and daily function.
7) Vision and Hearing Loss:
Age-related vision problems such as cataracts, glaucoma and macular degeneration, as well as hearing loss, are more common in older people and can significantly affect quality of life.
8) Mental health problem:
Depression and anxiety can occur in older adults, often linked to life changes, long-term illness, social isolation or bereavement.
9) Incontinence:
Bladder and bowel control problems become more common with age, affecting independence and quality of life.
10) Nutritional deficiency
Older adults may experience deficiencies in essential nutrients such as vitamin D, vitamin B12 and calcium, which contribute to bone health and other health problems.
11)Fall and Fracture:
Due to factors such as decreased muscle strength, balance problems, and osteoporosis, falls leading to fractures are a significant concern in the elderly.
12) Medication Management:
Polypharmacy (taking multiple drugs) and drug interactions can pose a risk to the elderly, requiring careful management and monitoring.
13) Skin Condition:
Skin becomes thinner and more fragile with age, increasing susceptibility to skin infections, pressure ulcers, and other dermatological problems.
14) Sleep disorder
Insomnia and other sleep disorders are common in older adults, affecting overall health and well-being.
Managing these health problems requires a comprehensive approach that includes regular health screenings, preventive healthcare measures, management of chronic conditions, healthy lifestyle choices, social support and access to appropriate healthcare services tailored to the needs of older adults.
🔸3.Write control measures for STD
Measures to control STD (Sexually Transmitted Diseases):
Controlling measures of sexually transmitted diseases involve a combination of strategies aimed at prevention, diagnosis, treatment, and public health interventions.
The following are the controlling measures of Sexually Transmitted Diseases (STDs):
1) Preventive Measures:
Health Education and Promotion
Awareness:
Sexually Transmitted Diseases (STD) to the public through community outreach, schools, media, and health care facilities.
Providing education on its mode of transmission, and its preventive measures.
Behavioral Intervention:
Adopting safer sexual behavior such as using barrier method of contraceptive methods and reducing the number of sexual partners.
Prevention Program:
A comprehensive sexual health education program is implemented in which STD prevention and contraception programs are conducted.
Access to Contraception:
Ensuring availability and access to contraceptives can reduce the risk of unintended pregnancy which increases the risk of STD (Sexually Transmitted Disease) transmission.
Vaccination:
HPV (Human Papillomavirus) Vaccine:
Promote and administer the human papillomavirus (HPV) vaccine to prevent HPV infection, which can cause cervical cancer and other genital cancers.
Hepatitis B vaccine:
Provide universal vaccination against hepatitis B virus to prevent liver disease and reduce transmission through sexual contact.
2) Screening and Early Detection:
Routine testing:
Tests for common sexually transmitted diseases including,
HIV,
Syphilis, Gonorrhea, Chlamydia, and Human Papilloma Virus (HPV).
Screening for sexually transmitted diseases regularly as part of comprehensive health visits.
Patner Notification:
To encourage individuals diagnosed with STDs to notify their sexual partners and seek diagnosis and treatment to prevent further transmission.
3) Treatment and Management:
Early diagnosis of Sexually Transmitted Diseases (STD) and after diagnosis provide appropriate antibiotic and antiviral medication to cure infection, relieve symptoms and prevent complications.
Partner Treatment:
A person who has been diagnosed with a sexually transmitted infection (STI) should also get the sexual partner of the person properly tested so that further infection and transmission can be prevented and complications can be used.
4) Public Health Interventions:
Surveillance and Monitoring:
Monitoring prevalence and trends of STDs through surveillance systems to inform public health strategies and allocate resources effectively.
Outreach and Testing Programme:
Implement outreach programs, mobile clinics, and community-based testing initiatives to reach underserved populations and promote testing for STDs.
Contact Tracing:
Conduct contact tracing, offer testing and provide counseling and treatment services to identify and notify persons in contact with STDs.
5) Promotion of Vaccine Availability:
Promote and implement vaccination programs for preventable STDs like HPV (Human Papillomavirus) and Hepatitis B to reduce the incidence of associated cancer and liver disease.
6) Addressing Social and Behavioral Determinants:
Health Equity:
Addressing social determinants of health such as poverty, stigma, discrimination, and health inequalities due to lack of health care facilities that increase the risk of sexually transmitted infections (STIs).
Behavioral counseling
Provide behavioral counseling and support services to empower individuals to adopt safe sexual practices and reduce risk factors.
7) Research and Innovation:
Provide support to research initiatives for the development of new diagnostic tools, treatments, vaccines, and preventive strategies for sexually transmitted diseases.
By implementing these compliant controlling measures, public health authorities, health care providers and communities can effectively reduce the burden of STDs, promote sexual health and improve overall population health outcomes.
🔸4.Write Functions of DGHS
Functions of the Directorate General of Health Services (DGHS):
The Directorate General of Health Services (DGHS) acts as the principal advisor to the Central Government on medical and public health matters. The Health Service appoints a Director who is assisted by Additional Directorate General of Health Services, Deputy Officers and other administrative staff.
There are three main units of the Directorate.
1) Medical Care and Hospitals,
2) Public Health,
3) General Administrative.
Functions of Director General Health Services (DGHS)
The Director General of Health Services has two main functions.
1) General Function,
2) Specific function
1) General Function:
1) Survey,
2) Planning,
3) Coordination,
4) Programming,
5) Appraisal of all health matters in the country.
1) Survey:
DGHS conducts surveys and assessments to collect data on public health indicators, disease prevalence, care needs and demographic trends.
These surveys help to understand the health status of the population and inform health and programs.
2) Planning:
After surveying and finding other data, Director General of Health Services (DGHS) plans strategies for health care services.
It involves developing long-term and short-term plans to improve healthcare infrastructure, effectively allocate resources and reduce health issues.
3) Coordination:
Director General Health Services (DGHS) coordinates activities with various health departments, agencies and stakeholders.
Due to this, it can be ensured that health programs are implemented effectively, duplication of efforts can be prevented, and utilization of resources can be optimized.
4) Programming:
Development and implementation of health programs and initiatives is the main function of DGHS.
In which, for prevention of DCs, promotion of health, maternal and child health, vaccination campaigns and other public health interventions.
including the creation of programs for
5) Appraisal of all health matters in the country:
DGHS conducts assessments and evaluations to assess the effectiveness, impact and compliance of health programs and policies.
Regular assessment helps identify strengths, weaknesses and areas for improvement in the health care system.
2) Specific Functions:
1) International Health Relations and Quarantine.
2) Control of Drug Standards
3) Medical store depots
4) Post Graduation Training
5) Medical Education
6) Medical Research
7) Central Government Health Scheme
8) National Health Programme
9) Central Health Education Bureau (C.H.E.B.)
10) Health Intelligence
11) National Medical Library Management
Explanation:
1) International Health Relations and Quarantine
Directly manages the country’s major ports and international airports, maintains health relations with various countries and exchanges information and plays an important role in controlling the spread of diseases.
2) Control of Drug Standard:
Maintains quality and standard of medication under the supervision of Drug Controller. Proper production and distribution of medicines by Central and State Government Officers as per set standards.
It also checks the quality of drugs as per the Drug Act of 1940.
3) Medical Store Depots:
The central level runs major medical depots such as Mumbai, Chennai, Kolkata, Guwahati, Karnal, Hyderabad which distribute and manage the medical equipment etc. as required by the states in their area. They produce cheap and quality medicine and supply it as needed.
4) Post Graduation Training:
Different National Medical Institutes are responsible for imparting Post Graduation (P.G. Course) training to different health persons in which,
•All India Institute of Medical Sciences at (AIIMS)- New Delhi.
All India Institute of Hygiene and Public Health – Kolkata.
All India Institute of Mental Health and Neuro Sciences- Bangalore.
National Tuberculosis Institute- Bangalore.
Central Research Institute- Kasauli.
National Institute of Communicable Diseases-Delhi.
National Institute of Health and Family Welfare Fair- New Delhi.
Rajkumari Amrit Core (RAK) College of Nursing – New Delhi.
Post Graduation Institute of Medical Education- Chandigarh. 5) Medical Education: Conducts direct management of various medical colleges viz.
•Lady Hardinge Medical College and Associated SSK and KSC,
•Maulana Azad Medical College,
Medical Colleges Puducherry & Goa Apart from these medical colleges, there are many medical colleges in India which are provided guidance and support by the Centre. 6) Medical Research: Medical research in the country is mostly organized by the Indian Council of Medical Research (I.C.M.R = founded in 1911) New Delhi.
Provides economic and other assistance in research into human diseases and their causes, treatment, survey and prevention. All kinds of funds are provided by the Union Ministry of Health.
It operates various research institutes in the medical field such as:
•Cancer Research Centre- Chennai,
Tuberculosis Chemotherapy Centre- Chennai,
Virus Research Centre- Pune,
National Institute of Nutrition at -Hyderabad. 7) Central Government Health Scheme (C.G.H.S):
Which provides insurance cover under which help is available in various accidents, diseases and death etc.
8) National Health Programme:
The National Health Program runs programs that require funds of crores of rupees. Generally these programs cannot succeed without central assistance. A very important function of planning, guidance and coordination is done by this department.
9) Central Health Education Bureau (C.H.E.B):
It does an excellent job of preparing health education to create awareness about health among the people which also plans to provide different types of training to health workers of different levels.
10) Health Intelligence:
Health Intelligence provides information regarding health in all state and international agencies.
11) National Medical Library:
The National Medical Library was declared in 1966 whose main objective is to bring advancement in medical health and allied sciences and its main objective is to exchange professional books, journals and medical reports etc.
⏩Q-4 Write short note (Any Three) 3×4=12
🔸1.Geriatric nursing care- treatment of old age
Geriatric Nursing Care:
Old age is universal. During this age, there are many different needs. Old is not a disease that we can eliminate. This is a gradual step of life and during this step there is a need to produce products from accidents, infections, disabilities.
A community health nurse should help in the care of the elderly living in the family and help such elderly to get safe housing, good diet, happy surrounding area and specific type of recreation through which the elderly can prevent infections and lead a peaceful life. Apart from this, the following cares are also involved.
Nutrition
To provide health education to the old age person for balance diet according to his performance and caloric requirement.
Educating them to consume easily digestible food and fiber rich diet to prevent constipation.
Care in Illness
Old age people need careful attention so the nurse should make frequent visits.
If battered, their family should be educated to prevent bedsores.
Apart from this, education should also be given for bathing mouth cleaning in his personal hygiene.
Elimination Care
In old age, the function of digestive system and other organs decreases so giving special education about diet.
If there is urinary incontinence, education should be given to take care of it and arrangements should be made in such a way that the toilet facility is close to the old age.
Exercise
Educating older people to exercise at their convenience as they can.
Impairment Care
Old age people have problems in hearing, vision, walking sleeping etc. Family members should be explained about this and they should contact a specialized doctor according to their needs and refer them for treatment especially hearing aid, optical dentures etc. so that their problems can be reduced.
Recreation
There should be a system so that the elderly can get creation according to their choice and convenience, they should be advised to behave as they like in the family and there should not be any kind of pressure on them.
For the recreation of the elderly, social activities, old movies, and songs, radio, reading magazines, books, etc. should be provided for education.
Psycho social problem
To involve the age person in different activities so that they do not become psychologically disturbed, due to which they can be prevented from developing psychological problems.
Prevention of old age problem
Advising the old age to do activities according to their age.
Taking measures to maintain interest in old age activities.
Taking measures to prevent ideas of future planning and activities from entering the mind of the old age.
Providing them with a separate environment so that they feel that they are an important person and are not dependent on anyone.
Present each idea in front of them.
Thus, the role of nursing in the above geriatric nursing is important to bring improvement in every factor affecting the old age, especially to maintain the quality of life of the old age.
🔸2.Functions of PHC- P. H. C. No. done
Functions of Primary Health Center:
To provide health services in rural areas, the Bhor Committee established a Primary Health Center (PHC) which is a PHC for a population of 30,000 in a plain area while a PHC for a population of 20,000 in a hilly, tribal, and backwater area. Which provides health care services to the people of the community.
The functions of a Primary Health Center (PHC) are as follows:
1) Medical care
2) MCH Services
Including family planning.
3) Safe water supply and basic sanitation.
4) Prevention and Control of Locally Endemic Diseases
5) Collection and Reporting of Vital Statistics.
6) Education about health.
7) National Health Program Establishment and Awareness
8) Referral Services
9) Training of Health Guide, Health Worker, Local Dai and Health Assistant.
10) Basic Laboratory Services.
Description:
1) Medical Care:
Primary health centers provide basic medical care to treat acute and chronic health conditions. It also provides outpatient services through diagnosis, treatment and treatment for minor illnesses and injuries.
PHC medical care is essential to meet the immediate health needs of the community.
In medical care, tablets, injections, dressings, and other treatments are provided to the patients according to their disease, besides preventive, curative, promotional care is provided.
2) MCH (Maternal and Child Health) Services including Family Planning:
Primary health centers provide comprehensive maternal and child health care including prenatal care,
antenatal checkup,
Safe Delivery Services,
Post Natal Care,
And immunization is also provided for the child.
In order to support family planning initiatives,
family planning,
counselling,
contraceptive,
And reproductive health services are provided.
This also includes RCH in Maternal and Child Health which covers maternal reproductive child health to adolescent care.
It explains about mother’s antenatal care, nutrition, hygiene, immunization, and laboratory examination etc.
Regular checkups, observations, and education about family planning are provided in the post-natal period.
3) Safe Water Supply and Basic Sanitation:
A primary health center works to improve public health in the community by providing safe drinking water and sanitation facilities in the community.
Primary Health Centers provide education on sanitation, promoting clean water sources and hygienic practices to prevent water borne diseases and improve the overall health of the community.
Steps are taken to maintain environmental cleanliness by providing education to people about basic sanitation, excreta disposal, and cleanliness of kitchen, garden.
Apart from this, there should be drinking water wells and taps which should be chlorinated for safe water supply.
4) Prevention and Control of Locally Endemic Diseases:
Primary health centers play a crucial role in the prevention, surveillance, and control of locally endemic diseases.
Measures are taken to prevent disease including providing vaccinations, providing treatment for endemic diseases, and monitoring disease trends to prevent outbreaks.
5) Collection and Reporting of Vital Statistics:
Primary Health Centers work to collect and report vital statistics such as birth rate, death rate, and incidence of any disease in a particular community. These collected data are essential for monitoring health trends for health planning, allocation of resources, improvement of health outcomes and prioritization of health interventions.
6) Education About Health:
Primary health centers provide education to individuals and communities about preventive health practices, nutrition, hygiene, sanitation and disease prevention strategies.
The Primary Health Center organizes health education sessions, workshops and seminars to bring about improvement in health conditions.
7) National Health Program Establishment and Awareness:
The Primary Health Center implements the National Health Program and Campaigns whose main aim is,
Targeting specific health issues including, immunization drives,
Campaigns are conducted on disease eradication effects, nutrition supplementation, and health awareness.
They spread awareness about national health priorities and encourage community participation in health initiatives.
Each National Health Program has important functions. The clinic provides services related to the National Health Program such as,
Anemia Control Program,
Malaria, Diarrhea, Leprosy, Immunization, TB Control Program, Supplementary Program Referral of mother in abnormal condition during labor for additional services, refer her to Primary Health Center to Female Health Worker, Auxiliary and Nurse Midwife or Medical Officer.
8) Referral Services:
When a patient requires any specialist medical treatment or requires any specific diagnosis and if its facilities are not available in the primary health center then the primary health center also works to refer the patient.
The primary health center provides immediate referral services as per the patient’s need, due to which the patient’s health condition can be improved and complications can be prevented.
9) Training of Health Guide Health Workers, Local Dais, and Health Assistants.
Primary health centers conduct training programs in which training is provided to community health workers, traditional birth attendants, health assistants, and other health care personnel to improve their skills and knowledge.
The main objective of this training is to promote health, prevention of diseases, maternal and child health, and improving the skills of health care personnel in basic medical care.
10) Basic Laboratory Services:
Primary health centers conduct basic laboratory services in which tests like diagnostic tests, blood tests, microscopic tests, urine tests etc. are performed.
Through all these functions provided by the primary health center, preventive, promotional, curative care is provided to the community due to which the overall health condition of the people of the community can be improved and their well-being can be maintained.
🔸3.Emergency ambulance services-
Introduction
Emergency ambulance service is a crucial service of public health and emergency response system.
Emergency ambulance services are designed to provide immediate medical care and transportation services to a person in any urgent health crisis.
•>Purpose and Objective:
Immediate response
Ambulance services are meant to provide urgent medical care during emergency situations.
In which to stabilize the patient and provide emergency transport facility to the patient during critical health situations.
Safe Transport
An ambulance transports a patient to a medical facility such as a hospital, specialized care center, etc.
•> Type of Ambulance:
1) Basic Life Support (BLS)
It provides non-invasive medical care like C.P.R., First Aid and Oxygen Therapy by Emergency Medical Technicians.
2) Advanced Life Support (ALS)
Advanced medical care is provided by advanced care providers, including medication administration, airway management, and cardiac monitoring.
3) Specialized Services
It includes transporting neonates and pediatrics and those serious cases that require specialized equipment advanced care and critical care are transported to medical facilities through transport services services.
•>Component of Emergency Ambulance Services:
vehicle
. It has life saving equipment like defibrillator, oxygen tank, first aid supplies and communication tools available.
Personal
These include emergency medical technicians, paramedics, and sometimes doctors or nurses who provide medical care during transportation.
•> Operational Protocols:
Emergency call handling
Emergency services are accessed through designated phone numbers (such as 911 in the US or 112 in many European countries, while 108 in India.). Calls are prioritized based on the nature and urgency of the situation.
Response time
Ambulance services are meant for immediate response during emergencies
Free ambulance services are provided in every corner of the country connected to toll free numbers and reach within 30 minutes of calling.
Medical protocols
Follow established medical protocols for emergency care, including patient assessment, treatment and transportation procedures.
•> Importance and Impact:
Life saving
Provides immediate care to the patient during critical and emergency situations and improves the patient’s health outcome.
Community Health
Ambulance services are an integral part of the emergency health care system, contributing to overall public health and safety by managing acute medical situations.
Emergency ambulance services are an important part of Emergency Medical Services (EMS), designed to provide immediate care and ensure that patients get the treatment they need quickly.
Introduction:
The Bhor Committee was appointed by the British Government of India in 1943 to survey the present health condition and health organization in India and make recommendations for its future development and was chaired by Sir Joseph Bhor. He was a pioneer of public health. They met regularly for two years and submitted their report in 1946.
The Bhor Committee was established in “1946”. Its founder was “Sir Joseph Bhor”, hence it is called Bhor Committee.
Bhor Committee is known as “Health Survey and Development Committee”.
Recommendation:
The committee forwarded a comprehensive proposal for the first time for the development of the National Program of Health Services.
The important recommendations of the Bhor Committee were:
Integration of preventive and curative services at all administrative levels.
Development of Primary Health Centers in two stages: 1) Short term measures
2) Long Term Measures 1) Short Term Measures: To provide a Primary Health Center (PHC) covering a population of 40,000 in every rural area.
In Primary Health Center (PHC),
Doctors : 2,
Public Health Nurse : 4,
Nurse : 1,
Midwife : 4,
Train Dai : 4,
Sanitary Inspector : 2,
Health Assistance : 2,
Pharmacist : 2,
Class IV Employees: 15.
will be administered by
Also Secondary Health Centers are envisaged to provide support to the Primary Health Center (PHC) and to coordinate and supervise its functions.
2) Long Term Measures:
3 million scheme to set up centers (PHCs) with 75 bedded hospitals for every 10,000 and 20,000 population is also called.
Preparation of 650 bed hospital as secondary health unit and 2500 bed hospital at district level.
Major changes to be made in medical education including provision of three months training in preventive and social medicine to prepare social physicians.
Establishment of Village Health Committee for better coordination and support in the development programme.
A District Health Board will be established with representation from the public and District Health Officials.
IUCD (intrauterine contraceptive device)
Introduction
An intra-uterine device is a T-shaped small and flexible device that is inserted into the uterine cavity to prevent pregnancy.
Intrauterine devices (IUCDs) are a popular method of long-term contraception that has been involved in family welfare programs due to their effectiveness.
The use of the Grafenberg ring by Grafenberg in Germany in 1929 has led to the invention of many different types of devices which are mainly divided into two parts.
in which,
1) Copper IUCD
(Copper Tea)
Description:
Made of plastic and copper. Copper acts as a spermicidal, and prevents fertilization.
duration
Effective for 5-10 years, depending on the specific type.
Examples: Copper T 380A, Multiload 375.
2) Hormonal IUCD (LNG-IUD)
Description:
Made of plastic and releases levonorgestrel, which thickens cervical mucus, inhibits sperm, and thins the uterine lining.
duration
Effective for 3-5 years.
Examples:
Mirena, Skyla, Liletta, Kaylina.
Intrauterine contraceptive device involves the following contraceptive devices.
1)lippes loop
2) CU T 200 B
3) CuT 380 A,
4) Multiload Cu 250,
5)Multiload 375,
6)progesttasert,
7) Levonorgestrel IUCD.
1) lippes loop:
Lipis loop is a first generation intrauterine device Lipis loop is formed from polyethylene. And it is of double S ( S ) shape and a nylon thread is attached to it which remains in the vagina, which helps to remove the loop from the intrauterine cavity. It is in four sizes ie,
Available in A,B,C & D.
Lipase loop is nontoxic, reliable and stable. It can also cause perforation of the uterine wall. It contains a small amount of barium5 present which makes it visible in X-rays but is not currently used.
2) CU T 200 B:
CU T 200 B is a widely used medicated device. In which a copper wire having a surface area of 215 sq mm is wound round the vertical stem of the device.
The stem of the T-shaped device is made of a polyethylene frame. It consists of a monofilament of polyethylene that is tied to the end of the vertical stem.
This device is removed after 4 years.
CuT 200 B has a 200 sq mm surface wire containing 120 mg copper and is removed after 3 years.
3) CuT 380 A:
CuT 380 A It is Government Supply CuT 380 A. It consists of two solid copper slimes transverse arm with T shape device and copper wire on vertical stem.
Total surface area of copper is 380 Sq mm including 314 mm over wire and 33 sq mm over each coppersleeve. It consists of monofilament white thread.
It remains effective for about 10 years.
4) Multiload Cu 250: The device is available in a sterile packet with an applicator. It does not have an introducer or plunger available.
The device releases 60-100 µg of copper per day over a period of one year. The device has to be replaced after 3 years.
5)Multiload 375: It has a surface area of 375 mm² copper wire around its vertical stem. Replacement is every 5 years
6)progesttasert:
A bioactive core containing microcrystals of progestatron (38 Mg) enclosed within a plastic wall releases approximately 65 µg of progesterone daily into the uterine cavity. Release from the depot continues for one year only. Thus, it should be replaced after one year.
7) Levonorgestrel IUCD:
This is a T-shaped device
A polydimethylsiloxane membrane around the stem acts as a reservoir of the steroid. The total dose of levonorgestrel is 52mg which is released at a rate of 20 µg/day. This device is replaced every 5 years.
•>Mechanism of Action
1) Hormonal IUD
Releases copper ions, creating an environment inaccessible to sperm. Prevents fertilization of eggs by sperm. Can prevent implantation if fertilization occurs.
2) Hormonal IUD
Releases levonorgestrel to thicken cervical mucus, preventing sperm from entering the uterus.
Suppresses endometrial growth, making the lining of the uterine cavity unsuitable for implantation. Partially suppresses ovulation in some females.
Benefits
Effective:
More than 99% effective in preventing pregnancy.
Long Lasting:
Works as a contraceptive for many years.
Reversible:
Fertilization returns quickly after removal.
Convenience:
Little maintenance is required after insertion.
Cost Effective:
It is economically viable.
Insertion and Removal
Insertion:
Performed by trained health care personnel. A pregnancy can usually be rolled out during the menstrual period or at any time.
In the procedure, the IUD is inserted into the uterine cavity through the cervix.
Removal
Can be done at any time by a healthcare provider.
Fertilization usually returns immediately after removal.
Common side effects
Camping pain during and after introduction.
Irregular building and sports especially during the first month.
Heavy menstrual bleeding.
Decreased or missed periods with a hormonal IUD.
Risk
Expulsion (the IUD coming out of the uterus).
Perforation (rarely, the IUD can puncture the wall of the uterus during insertion).
Infection (slightly increased risk of infection during the first few weeks after insertion).
Nursing Responsibility
Pre-Insurance Counselling
Explain to the patient the type of IUD device, its benefits and its side effects.
Ensuring that the patient fully understands the procedure, its effectiveness and duration.
Insertion Procedure
Assisting health care providers during the insertion period.
Ask the patient to take proper rest and provide reassurance.
If there is any kind of complication, it should be treated immediately.
Post insertion care
Provide education to the patient about the side effects of the intrauterine device properly.
Provide patient education about signs of complications such as pain fever, infection, severe discharge bleeding etc.
Advising the patient for proper follow up.
Thus, intrauterine devices (IUDs) are a popular method of long-term contraception.
⏩Q.5 Define following (Any Six) 6×2-12
🔸1.Survey – serve
A survey is a systematic collection and analysis of data to identify, condition and assess the health needs of a population or specific group, and to evaluate programs.
🔸2.Census
A comprehensive and systematic collection and counting of data from every person in a population or community to collect information on various aspects such as demography, health status, and needs is called a census.
An official count of a country’s population is called a census.
In most of the countries of the world, the total process of collecting, analyzing and publishing demographic, economic and social data for all the people of a defined area of the country at a particular time is called census.
Sensors are counted at regular 10 year intervals in most of the countries of the world.
🔸3.IMR-
IMR (Infant Molality Rate)
The number of children who die under the age of 1 year out of the total number of live births in a population of 1000 in a given leap 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
4.MMR-
Maternal Mortality Rate (MMR) Maternal Mortality Rate (MMR) is the number of maternal deaths per 100,000 live births during a specific period, usually a year.
Maternal mortality rate (M.M.R) =
Total number of female deaths due to complications within 42 days of childbirth or delivery during a given year
—————- × 100,000
Total Number of Live Births in Same Year.
TFR (Total Fertility Rate)
The average number of children a woman can have in her total reproductive year at the rate at which children are born in each age group is called total fertility rate (TFR).
Total fertility rate (TFR):=
45 – 49
5× Σ (ASFR)
15 – 19
1000
(ASFR = Age Specific Fertility Rate)
Immunity is a type of resistance that is activated by the host’s body.
When any foreign body (antigen) enters the body of the host, the antibody that fights against the antigen is called immunity.
When there is an antigen (foreign body) in the body, the ability of the body to fight against it is called immunity.
There are mainly two types of immunity:
1) Innate Immunity
2) Acquired Immunity
(1) Innate Immunity- Innate immunity is the immunity that a person has by birth.
This is a type of natural immunity.
(2) Acquired Immunity- The immunity which the body gets during the wall life after birth is called acquired immunity.
7.Target couple-
Target couple means those couples who have 2 to 3 live children and need to be highly motivated about family planning are called target couple.
Definition:=
Infertility is a medical condition in which there is inability to conceive a pregnancy despite having regular and unprotected intercourse for 1 year or more, then such a condition is called infertility.
It affects approximately 10-15% of couples worldwide. Infertility can be due to various factors affecting male, female or both, and can be temporary or permanent.
Type of Infertility
There are generally two types of infertility.
1) Primary infertility,
2) Secondary infertility
1) Primary Infertility:
It is indicated for patients who have not been able to conceive a single pregnancy.
2) Secondary Infertility:
Thus, prior pregnancy indicating conception but subsequent failure to conceive is called secondary infertility.
⏩Q-6(A) Fill in the blanks. Vacancy filled.05
1.World health day is celebrated on ……..and theme of year 2018 was…… ….
World Health Day is celebrated on …….. and the motto of 2018 is……. was
7 April
2.Indian red cross society was established in ……..year
Indian Red Cross Society was established in the year …….
1920
1 April 2005
4.ASHA stands for…..
ASHA’S FULL NAME …….
Accredited Social Health Activist
⏩B) State weather following statements are True or False.(05)
State whether the following statements are true or false.
False
(Reason := Not only preventive services but also curative treatment and acute care are provided in the hospital)
False
(Reason: WHO recommends a minimum of four antenatal visits based on a review of the effectiveness of different models of antenatal care. The first visit is recommended as soon as pregnancy is suspected;
The second visit should be scheduled between 4-6 months (about 26 weeks).
3 Third visit in 8th month
(about 32 weeks) and
4th visit in 9th month (36-40 weeks) .
True
True
False
(Reason: Food fortification is the procedure of adding essential nutrients such as vitamins and minerals to food to improve the nutritional quality of food and eliminate nutritional deficiencies in the population, whereas protein may be a part of food fortification but not the primary one. Fortified nutrients include iodine, iron, vitamin A, and folic acid.)
⏩C) Write Multiple Choice Questions. Write the correct answer from the following.05
a. 1978
b. 1987
c. 1970
d. 1972
2.First five year plan in India started at
First Five Year Plan started in India
a. 1950
b. 1951
c. 1952
d. 1953
a. Killing spermatozoa
b. Prevent inflammation in endometrium
Prevents inflammation in the endometrium
c. Increasing cervical mucus
Increases cervical mucus
d. Preventing the fertilization of ovum.
Prevents the testes from fertilizing
a. Malaria- Malaria
c. Cancer- Cancer
b. T.B
d. AIDS
a. 10-15 Years
c. 10-16 Years
b. 10-19 Years
d. 10-18 Years
Q: (1) Ans
(a) 1978
Q: (2) Ans
(B) 1951
Q: (3) Ans
(A) killing spermatozoa
Q: (4) Ans
(C) cancer
Q: (5) Ans
(b) 10-19 years