Professional Documents
Culture Documents
MS.M.VENKATA VARALAKSHMI
IST YEAR M.Sc. (N) NURSING
COMMUNITY HEALTH NURSING
2011-2013
HARSHA COLLEGE OF NURSING
HARSHA HOSPITAL CAMPUS
NO 193/4, SONDEKOPPA CIRCLE
NH-4, NELAMANGALA,
BANGALORE-5621231
AND ADDRESS
2.
NAME OF INSTITUTION
Bangalore
3.
COURSE
OF
STUDY
AND
SUBJECT
4.
5.
DATE
OF
ADMISSION
TO
COURSE
06/05/2011
STUDY
TO
ASSESS
THE
REGARDING
DOMESTIC
SELECTED
RURAL
AREA,
HEALTH
PAMPHLET.
EDUCATION
INTRODUCTION:
Water is one of the very crucial natural resources. It is available abundantly on the
surface of earth .There is about 1.4 billion cubic kilometer of water on the earth which
comes about 71percent of the earths surface. About 97 percent of the water on the earth
is in the oceans. The ocean water is salty and is not suitable for human consumption. The
remaining 3 percent of the total water is available in the form of ice sheets, cloud, river,
lakes, ponds, well and springs. Only 1-1.6 percent of the 3 percent of water, is useful for
human consumption.
The water on the surface of earth has its own journey. The water from the ocean
gets evaporated by the suns heat. Evaporated water, rises up into the air and forms clouds
and later fall onto the earth in the form of rain and snow and flows on the earth as
streams, lakes, rivers which ultimately fall in the oceans like air, water is also very
essential for man to survive. But unlike air, man can live without water for about a week
or so. The water which is required for human consumption should be palatable and free
from any kind of impurities so that it is safe and suitable for daily activities1.
The National Water Supply and Sanitation Programme was launched in 1954 by
the govt. of India as part of the health plan to assist the states to provide adequate water
supply and sanitation facilities in the entire country. Provision has been made in the
successive 5yrs plans to improve the water supply. In 1972 a special programme known
as the Accelerated Rural Water Supply and Sanitation Programme. During 5 th plan, rural
water supply was included in the minimum needs programme of the state plans. The
central govt. is supporting the efforts of the states in identifying problems villages
through assistance under Accelerated Rural Water Supply Programme. A problem
village has been defined as one where no source of safe water is available within a
distance of 1.6km,or where water is available with in a distance or depth of more than
15meters,or where water source has excess salinity, iron, fluorides and other toxic
elements ,or where water is exposed to the risk of cholera.
The Govt. of India launched the International Drinking Water Supply and
Sanitation Decade Programme in 1981.Tergets were set on coverage-100% coverage for
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water, both urban and rural,80% for urban sanitation and 25% for rural sanitations and
Swajaldhara was launched on 25thdec.2002 sajaldhara has certain fundamental reform
principles, which need to be adhered to by the state govt. and the implementing agencies.
Swajaldhara is a community led participating programme, which aims at providing safe
drinking water in rural areas, with full ownership of the community, building awareness
among the village community on the management of drinking water project including
better hygiene practices and encouraging water conservation practices along with rain
water harvesting.
Mans health affected by the ingestion of contaminated water either directly or through
food and by the use of contaminated water for purpose of personal hygiene and
recreation. The term water-related diseases include the classical water-borne diseases.
Developing countries carry a heavy burden of water-related diseases, the heaviest being
the diarrhoeal diseases.
In India, water pollution is becoming a serious problem. To protect water from
being contaminated, Parliament in 1974 passed the water (prevention and control of
pollution)Act. The Act seeks to provide legal deterrent against the spread of water
pollution. The Act is a comprehensive piece of legislation. It provides for the constitution
of Central and State Water Boards and Joint Water Boards endowed with wide powers for
controlling pollution.
Much of the ill-health which affects humidity, especially in the developing
countries can be traced to lack of safe and wholesome water supply. Water that is easily
accessible, adequate in quantity, free from contamination, safe and readily available
throughout the year .There can be no state and positive health and wellbeing without safe
water. Water is not only the vital environmental factor to all forms of life, but it has also a
great role to play in socio-economic development of human population. Each country
should develop its own water resources, exploitation and hydrogeology. In 1980,the
United nations general assembly launched the International drinking water supply and
sanitation decade,1981-1990 the aim being to provide all people with adequate supplies
of safe water and sanitation by 1990.In 1981,the 34th World Health Assembly in a
resolution emphasized that safe drinking water is a basic element of primary health
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care which is the key to the attainment of Health for All by the yr 2000 AD. Water is
also integrated with other PHC components because it is an essential part of health
education, food and nutrition and also MCH. 2
1.8 million people die every year from diarrhoeal diseases (including cholera); 90%
are children under 5, mostly in developing countries.
2.4 billion people in the world do not have access to adequate sanitation, about twofifths of the worlds population.
2.2 million people in developing countries, most of them children, die every year
from diseases associated with lack of access to safe drinking water, inadequate
sanitation and poor hygiene.
Some 6,000 children die every day from diseases associated with lack of access to
safe drinking water, inadequate sanitation and poor hygiene equivalent to 20 jumbo
jets crashing every day.
At any one time it is estimated that half of the worlds hospital beds are occupied by
patients suffering from water-borne diseases.
200 million people in the world are infected with schistosomiasis, of whom 20
million suffer severe consequences. The disease is still found in 74 countries of the
world. Scientific studies show that a 77% reduction of incidence from the disease was
achieved through well designed water and sanitation interventions.
The average person in the developing world uses 10 litres of water a day.
The average person in the United Kingdom uses 135 litres of water every day.
In the past 10 years diarrhoea has killed more children than all the people lost to
armed conflict since World War II.
In China, India and Indonesia twice as many people are dying from diarrhoeal
diseases as from HIV/AIDS.
In 1998, 308,000 people died from war in Africa, but more than two million (six
times as many) died of diarrhoeal disease.
The simple act of washing hands with soap and water can reduce diarrhoeal disease
by one-third.
In Zambia, one in five children die before their fifth birthday. In contrast in the UK
fewer than 1% of children die before they reach the age of five.
A study in Karachi found that people living in areas without adequate sanitation who
had no hygiene education spend six times more on medical treatments than those with
sanitation facilities.
Improved water quality reduces childhood diarrhoea by 15-20% BUT better hygiene
through handwashing and safe food handling reduces it by 35% AND safe disposal of
childrens faeces leads to a reduction of nearly 40%.
At any time, 1.5 billion people suffer from parasitic worm infections stemming from
human excreta and solid wastes in the environment. Intestinal worms can be
controlled through better sanitation, hygiene and water. These parasites can lead to
malnutrition, anaemia and retarded growth, depending upon the severity of the
infection.
It is estimated that pneumonia, diarrhoea, tuberculosis and malaria, which account for
20% of global disease burden, receive less than 1% of total public and private funds
devoted to health research.
nitrogen, 0.55 kg phosphorous, and 1.28 kg potassium per person per year from
faeces and urine. This is enough to produce wheat and maize for one person every
year.
inadequate knowledge and poor practice of domestic methods of water purification and it
couses water borne diseases to the under five children. The rural mothers show the
negligence in prevention of water borne diseases. Thus the investigator was fascinated to
assess the mothers knowledge, attitude and practices regarding domestic methods of
water purification.
Thus researcher felt that it is essential to emphasize the awareness to the mothers
especially under five children and prevent from waterborne diseases and to educate are
the key determinants in home level of water purification. As a responsibility of nurses, it
is important to help the mother and community to bring awareness of domestic methods
of water purification and prevent from water borne diseases.
The study was conducted in Nepal to improve hygienic practices among the rural
housewives . The study was conducted in two villages where the chemical and biological
water quality was analyzed by some hygienic practices. In one village they given health
education about water hygiene practice and another village not given the education. After
three months the water quality of the houses was tested to ensure the quality aspects of
the hygiene practices. Based on the findings, the chosen methodology was able to
promote a real change in improving to water hygiene practices. So the researcher
revealed that for hygiene practice the housewives need adequate knowledge . 11
A study was conducted in Dhaka to improve the practice on storing water and
handling water from storage containers at home. They given the instruction to used Na
DCC tab. In the 100 households while storing water. One half houses given for health
education another half not given how to used the Na DCC tab. After 4 month the post test
was done in the both group and the storage water was tested. The water quality from first
group was free from E. coli bacteria and second group water was present for E. coli
bacteria. Results indicated that second group not having any idea how much and how to
used the NaDCC tab. This was supported by insignificant improvements in the
microbiological water quality. So the researcher revealed that through health education
can improved the practices for storing and handling water quality.12
A cross-sectional study was done in Ramallah among the mothers to increase
awareness at the household level about certain hygienic practices and to develop water
quality. The quasi-experimental design was selected in two villages where chemical and
biological water quality was analysis as well as residential behavioral aspets related to
hygiene practices before and after intervention. A questionnaire was used to evaluate the
housewives knowledge and practices regarding hygienic practices and water use,
followed by face-to-face health education and awareness sessions to the selected
housewives. After 3month, another assessment was conducted using the same
questionnaire to measure improvement in their knowledge and practices. The water
quality was tested to ensure the water quality. Based on these findings the chosen method
can improved the water quality in the household level. So the study concluded that by
improving knowledge and practices the water hygiene practices also can improved. 13
11
The study was done over 13,000 children in rural India, under the ages of 3years,
it examines the relative effects of the different factors-the quality of water supply,
mothers literacy, housing conditions and the level of development of the villages in which
the children lived contributing to diarrhea. The study highlights the importance of two
factors:that children born to undernourished mothers may be more susceptible to
infection than children whose mothers are well nourished, and that good hygienic
practices within the home, such as washing hands with soap before feeding a child, can
reduce the incidence of diarrhea. The results emphasize the importance of mothers being
literate, of household affluence and of institutional support in promoting domestic
hygiene. 14
Literature related to water borne diseases:
The study was done for chlorination and safe storage of household drinking
water in developing countries to reduce waterborne disease. The use chlorination and
storage in special plastic containers of gathered household water for improving microbial
quality and reducing diarrhoeal illness.
and
Microbes in stored
water samples and 300 water samples from household storage contains were tested for
fecal coliform (Fe) concentration.
covered household storage contain s was significantly lower than uncovered containers.
It is shown that safe drinking water was achieved by the combination of a protected and
high quality sources at the initial point and maintaining quality from the initial supply
point. 16
12
The study was conducted among HIV affected household in rural area to safe
water systems (S. W. S.) and to reduce diarrhea and death. It is a home based health care
package that included rapid diarrhea diagnosis treatment of 196 households with
relatively good water and sanitation coverage. The high SWS cost per DALY gained
was probably caused by a lack of mortality benefit in a trial designed to rapidly treated
diarrhea.
6.4 OBJECTIVES:
1.
based
on the findings.
.
6.5 OPERATIONAL DEFINITIONS
1. Knowledge- Knowledge is referred to level of understanding and awareness of
mothers regarding domestic methods of water purification.
2. Practices-It refers to methods adopted by mothers for domestic water
purification.
3. Mothers-In this study mothers who are married housewives having under five
children.
4. Domestic methods of water purification-It refers to a process of purifying water
at home level by domestic filtering ,boiling and chemical disinfection of well.
6.6 HYPOTHESIS OF STUDY
6.7 ASSUMPTION
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6.9 VARIABLES
Research variables on the concept at various levels of abstraction that are entered
manipulated & collected in a study.
Study variables
Study variable includes knowledge and practices of rural mothers regarding domestic
methods of water purification.
Demographic variables- Age, religion, education, occupation, income, type of family,
number of children , sources of water, methods of purification of water.
7.2
Structured self administered questionnaire will be used to assess the knowledge and
checklist to assess the practice of mothers regarding domestic methods of water
purification.
7.2.1 SAMPLING TECHNIQUE:
Probability sampling technique, Simple random sampling (Lottery method)
7.2.2 SAMPLE SIZE:
The sample of the study consists of 60 Mothers.
Duration of study:
4 weeks
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-Frequency and percentage distribution will be used to study the demographic variables
of the mothers regarding domestic methods of water purification.
-Mean and standard deviation will be used to determine the level of knowledge and
practices regarding domestic methods of water purification.
Inferential statistics
Pearsons correlation: will be used to assess the relation between knowledge and
practices of mothers regarding domestic methods of water purification.
Chi-square test: will be used to bring out the association between the knowledge and
practice with selected demographic variables. Level of significance was fixed at 5%
level.
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8. LIST OF REFERENCE:
1. Gulani k.k. Principles and Practice Community Health Nursing. 1 st ed. Delhi: kumar
publishing house; 2007; 244-245.
4. Water for life, 2005-2015. International Decade for action. Booklet for the
international water for life Decade. 2005; 20.
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5. WHO water, Sanitation and Hygiene links to health: Facts and Figure updated nov.
2006. 29kb. Diarrhoea.
6. Kirlinger FN. Foundation of Behavioral Research, 2nd ed. London: Mc.Millan
Company; 1986. P.50.
7. Sobel J, Mahon B, Mendoza CE, Passaro D, Cano F, Baier K et al. Reduction of
Fecal contamination of street-vended beverages in Guatamala by a simple system
for water purification and storage, hand washing and beverage storage. Am J Trop
Med Hyg. 2006 sep; 59(3); 380-87.
9. . Nagueir G, Nakamura CV, Tognim MC, Abreu Filho BA, Dias Filho BA.
Microbiological quality of drinking water of urban and rural communities, Brazil.
Rev saudapublica. 2003 Apr; 37(2); 232-36.
10. Ahamad KU, Jawed M. Evaluation of media used in indigenous household iron
filter units of rural and semi-urban Assam, India J Env Sci Eng. 2007 Oct; 49(4);
241-46.
11. Ngi TK, Shrestha RR, Dangol B, Maharjon M, Murcott SE. Design for sustainable
development-household drinking water filter for arsenic and pathogen treatment in
Nepal. J Environ Sci Health A Tox Hazard subst Environ Eng. 2007 Oct; 42(12);
1879-88.
12. Lea M Biological sand filters: low-cost bioremediation technique for production of
clean drinking water. Currprotoc Microbial. 2008May; chap 1: unit 1G.1.1-1G.1.28.
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13. Saud TF, Clasen T, Boisson S, Edmondson P, Shipin O. Household water treatment
using sodium dichloroisocyanurate (NaDCC) tabs: a randomized, controlled trail to
assess microbiological effectiveness in Bangladesh. Am j Trop Med Hyg. 2007 Jan;
76(1): 187-92.
14. Mimi a, Salman R, Water quality and improving Hygienic practices of the rural
community in the Vicinity of Ramallah, Palestine. Int J Env Health Res. 2008 Oct;
18(5): 375-85.
15. Omokhodian FO, Oyemade A, Sridhar MK, Olaseha IO, Olawuyi JF. Diarrhoea in
children of Nigerian Market women: Prevalence, knowledge of causes and
management. J. Diarrhoea Dis Res: 2006 sep, 16(3): 194-200.
16. Luby SP, Syed AH, Faizen MK. Limited effectiveness of home drinking water
purification efforts in Karachi, Pakistan. Int. J. Infect Dis.2004; 4(1): 1-2.
17. Sobey MD, Handzel T, Venezel L. Chlorination and safe storage of household
drinking water in developing countries to reduce waterborne diseases. Water Sci
Technol 2003 Jan; 47(3): 221-8.
18. Haque BA, Hallman K, Levy J, Bouis H, Ali N, Khan F et al. Rural drinking water
at supply and household levels: quality and management. Int. J Hyg Environ Health.
2006 Sep; 209(5): 451-60.
19. Shnestha RK, Marseille E, Kahn JG, Lule JR, Pitter C, Blandford JM et al. Costeffectiveness of home-based chlorination and safe water storage in reducing
diarrhea among HIV affected household rural Uganda. Am J Trop Med Hyg.2006
May; 75(5): 884-90.
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9. SIGNATURE OF STUDENT
:
Head of the
Department
Community Health Nursing
11.4 SIGNATURE
:
22
:
Head of the
Department,
Community Health Nursing
23