Assignment Code: ;DNHE-2/AST-2/TMA-2 /23

Course Code: DNHE-2

Assignment Name: Public Health and Hygiene

Year: 2022-2023

Verification Status: Verified by Professor

Maximum Marks: 100

Section A: Descriptive Type Questions (60 Marks)

All questions are compulsory.

Q1. a) List the main sources of data on vital statistics. (2)

Ans) The main sources of data on vital statistics:

Population Registers

Data on population can be retrieved via continually updated population records in several nations, like Sweden, Finland, Belgium, Israel, Taiwan, and Korea, where the names of every citizen are recorded. Important human migratory movements are also tracked. Creating this system of population registrations has as its main goal the identification and management of individuals.

National Sample Survey

The fundamental goal of the National Sample Survey has been to gather information on some significant socio-economic factors for the entire nation through its different rounds utilising the sample survey approach. Since 1950, data on numerous things has been gathered through several rounds of the National Sample Survey (NSS). The First Round was conducted in 1950.

Q1 b) Briefly discuss family planning and beyond family planning measures giving appropriate examples. (6)

Ans) Family planning is the process of deciding how many children a person wants to have, including whether or not they want to have any at all, as well as when they want to have them. Marriage status, job or employment considerations, and financial circumstances are all factors that may affect family planning decisions.

If one is sexually active, family planning may entail using contraception and other methods to regulate when children are born. These writers contend that specific non-family planning strategies can also control population expansion. In this context, they emphasised the significance of raising the age at which boys and girls can get married, as well as the importance of MTP, voluntary and involuntary separation, and other interventions outside family planning. You might now be asking how they're able to control population increase.

Raising Age at Marriage

Females in India traditionally marry soon after puberty. Such women have a prolonged fertile reproductive period of 30-35 years for conception. This is because the mean age at puberty in India ranges from 12 to 14 years. The mean age at marriage of females in India in 1981 was 18.3 years resulting high fertility of around 5 children per woman.

Medical Termination of Pregnancy

Theoretically, abortion is defined as ending a pregnancy before the foetus is viable (capable of living independently). Administratively, this has been set at 28 weeks, or about 1000 g for the foetus. Women seek abortions for a number of reasons, including birth control. As was previously mentioned, MTP has been incorporated in India by 1972.

Q2. a) What is meant by quality of life? Enumerate the indicators affecting the quality of life. (2+4)

Ans) The goal of every aspect of development, but especially of health promotion programmes, is to improve quality of life. Of course, different development programmes place a varied focus on some aspects of development schemes. However, the ultimate objective of all programmes is to improve quality of life, which is achieved through many routes of development. In this context, some social development factors that are closely related to one another must be looked at in order to understand how they interact and how well they complement one another in order to gauge overall quality of life.

Indicators

GDP – the total output of an economy. This is a guide to national output and influences the level of consumption.

1. Distribution of Income in society

2. Employment / Unemployment.

3. Life Expectancy.

4. Education Standards

5. Housing.

6. Air Pollution.

7. Levels of Congestion and Transport.

Q2. b) List the agents of infection. Describe any two of them. (2)

Ans)

Bacteria

While inside the body, bacteria cannot thrive outside of individual cells. Some bacteria, known as aerobes, need oxygen to develop, whereas other bacteria, known as anaerobes, such as those typically found in the small intestine of healthy people, can only grow in the absence of oxygen. A capsule that surrounds the majority of bacteria appears to be crucial to their capacity to cause disease 

Rickettsias

A group of microbes known as the rickettsias is named after American pathologist Howard T. Ricketts, who passed away from typhus in 1910 while pursuing his research into the disease's transmission. The rickettsias are a group of infectious disorders that are characterised by fever and a rash. They range in size from 250 nanometres to more than one micrometre, have no cell wall, and are encircled by a cell membrane.

Q3. a) How is safe drinking water supply provided to urban areas. (4)

Ans) One of the key physical environments for humans is water, which directly affects human health and cleanliness. There is no doubting that contaminated water poses a variety of health risks. Because it is so valuable to people, the WHO states that one of the main goals of environmental sanitation is to control water supplies to guarantee that they are clean and wholesome. One of the most pressing concerns for public health in poor nations in the twenty-first century is access to safe water. The Millennium Development Goal (MDG) is to reduce by half the proportion of the world's population without sustainable access to safe drinking water and sanitation by 2015. The "International Decade for Action: Water for Life" began in 2005. The Union Government appointed the Environmental Hygiene Committee in 1948–1949. This committee was the first organisation to provide a comprehensive assessment of the issues that exist throughout the nation in the field of environmental hygiene as a whole. It also made significant recommendations in this area and pushed for more efforts in this area. This group advocated a general strategy to provide water supply and sanitation services for 90% of the population within a 40-year timeframe as well as a priority-setting system for specific localities.

Q3. b) What precautions would you take to prevent occurrence of accidents at home. (3)

Ans) Taking the essential safety precautions is the greatest method to avoid accidents or injuries in the house. To ensure that you try your hardest to prevent injuries at home, there are some extremely easy repairs that you may make. Here are 10 methods to make your house a safer place for you and your family.

1. Clean-up spills right away. Clean up spills of liquids, grease, or anything else that could cause you to fall as soon as you can to prevent injuries.

2. Stable rugs Secure carpets with non-skid pads or buy rugs with slip-resistant backings to stop them from shifting around and creating slips. Use double-sided carpet tape as an additional option to hold the rug in place.

3. Take care when putting hot liquids. Always be cautious of where you place that cup of hot coffee if you have young children in the house. Avoid setting hot beverages on tables with runner or tablecloths hanging over since the child could tug on the fabric and spill the liquid on them. In general, avoid leaving hot drinks in areas where kids can access them.

Q4. a) What is a therapeutic diet? Explain the major therapeutic modifications of the normal diet. (3)

Ans) Therapeutic diets are nutrient-balanced eating regimens based on whole foods that help with symptom relief, inflammation reduction, and mucosal healing. Foods that have been proven to be detrimental (processed foods and additives) are avoided, and foods that may be hazardous to IBD sufferers (gluten, sugar, and dairy) are either avoided or consumed in moderation, while the consumption of fruit and vegetables is increased.

The normal diet may be modified:

1. To provide a change in the constituents of the diet.

2. To maintain, restore or correct nutritional status.

3. To include all nutrients in the diet.

4. To increase or decrease the energy value of the diet.

5. To provide foods bland in flavour.

6. To modify the intervals of feeding.

Q4. b) Describe the dietary management of diabetes mellitus. (4)

Ans) In this overview, the significance of nutrition in the treatment of some kinds of diabetes mellitus is examined, and dietary concepts, recommendations, and guidelines are given. We believe that making the right changes and monitoring your diet will help you manage your diabetes mellitus effectively, help you lose weight, and keep your blood sugar and plasma lipid levels under control. Despite the fact that oral and/or insulin medications are frequently needed to treat diabetes, nutrition therapy is still an important tool in the management of this condition and should always be regarded as the cornerstone of therapy because good blood glucose levels control is unlikely to be achieved with insulin or oral therapy alone when diet is neglected. We advocate for personalised nutrition therapy for diabetics, taking into account each person's typical food and eating habits, metabolic profile, treatment objectives, and anticipated results.

In order to determine whether adjustments in medication are necessary and to guarantee positive results, it is also crucial to monitor metabolic indicators including glucose, HbA1c, lipids, blood pressure, body weight, and, when suitable, renal function. The onset of type 1 diabetes or autoimmune linked to type 1 has been linked to a number of nutritional variables. For instance, one study discovered that eating vegetables every day while pregnant decreased the likelihood that a kid would have type 1-associated autoimmunity. Another discovered a link between higher iron intake during the first four months of life and a higher risk of type 1 diabetes. Other research, however, has not discovered links between food and type 1 diabetes onset.

Q5. Enumerate the symptoms, causes and prevention of any two of the following food borne diseases: (4+4)

i) Cholera

Ans)

Symptoms

1. High fever.

2. Weight loss.

3. Increased thirst.

4. Feeling of nausea.

5. Vomiting sensation.

6. Bloating in the belly.

Cause

1. It is caused due to factors like contaminated water supply.

2. It arises due to the consumption of contaminated foods and drinks.

3. The vegetables that are grown with the use of water with human wastes.

4. The consumption of contaminated sea foods, which are polluted with sewage.

5. Caused by the consumption of foods that affect the digestive system.

Prevention

1. Drink water which is boiled.

2. Avoid consumption of raw foods.

3. Avoid dairy products as much as possible.

4. Wash fruits and vegetables before you eat.

5. Washing your hands before you eat is a good way to keep the disease away.

ii) Dysentery

Ans)

Symptoms

1. Diarrhoea with belly cramps

2. Fever

3. Nausea and vomiting

4. Blood or mucus in the diarrheal

Cause

1. Bad sanitation and hygiene

2. Contaminated water

3. Contaminated food

Treatment

Oral rehydration is the typical method used in rehydration therapy. The patient loses bodily fluids while suffering from dysentery. He or she is urged to drink lots of water as a result. When dehydration is persistent, a medical professional would typically advise intravenous fluid replacement (drip is given to the patient). Antibiotics and amoebicidal medications can kill the bacteria or amoeba that causes dysentery. If bacillary dysentery is the cause of the patient's symptoms, neither amoebicidal nor antibiotics are necessary.

Q6. a) Enumerate the symptoms and complication of tuberculosis. (4)

Ans)

Symptoms

1. A cough that lasts for more than three weeks

2. A cough that produces green or yellow sputum (phlegm) that may also be streaked with blood.

3. Shortness of breath or chest pain

4. Fatigue

5. Loss of appetite and weight loss

6. Night sweats

7. Fever

Complications

1. Spinal discomfort. Stiffness and back discomfort are frequent side effects of TB.

2. Joint injury. Hips and knees are typically affected by tuberculous arthritis (arthritis caused by the disease).

3. The membranes that enclose your brain swelling (meningitis). This may result in a persistent or sporadic headache that lasts for weeks as well as potential mental alterations.

4. Kidney or liver issues. Your liver and kidneys aid in cleansing your bloodstream of waste and pollutants. These organs' abilities can be compromised by tuberculosis.

Q6. b) What are the common fungal infections of skin that occur in India? Who gets the disease and how can it be prevented? (1+2)

Ans) Everywhere there are fungi. They can be located in the body as well as in the air and soil. They can also be discovered on skin, surfaces, or living things. Unless they multiply abnormally quickly or enter the skin through a cut or lesion, these microscopic organisms usually don't harm your skin. A fungal skin infection is frequently contracted directly.

A possible example of this is coming into contact with mushrooms in or on:

1. another person

2. an animal

3. items such as clothing

4. gyms

5. gym mats, like those used in wrestling.

6. hot tubs, saunas and steam rooms

Some types of fungal skin diseases are highly prevalent. Unless you have impaired immune system, the infection is usually not serious, despite the fact that it can be painful and perhaps contagious. During a physical examination, a primary care physician should be able to identify a yeast infection of the skin. To establish that yeast is the organism causing your symptoms, they might also swab your skin and do a skin culture. Instead, if you visit a dermatologist, they could do a skin scraping of the rash and examine the sample under a microscope to detect if Candida growth is present.

Q7. a) Enlist the essential components of primary health care. Discuss any two components in detail.

Ans)

Clean Water and Sanitation

A population's health can be considerably improved by providing access to clean, safe drinking water as well as basic sanitation practises for waste, sewage, and water cleanliness. This can result in a decrease or even elimination of many diseases that could be prevented.

Maternal and Child Health Care

Another crucial component of primary health care is providing children and mothers, both pregnant and not, with thorough and adequate medical treatment. WHO gives future generations a chance to flourish and contribute to society by taking care of those who are most vulnerable to health issues. Care for these people can occasionally include providing them with necessary family planning and safe sex education.

Q7. b) What are the objectives and components of the following programmes:

i) ICDS (4)

Ans) I

Objectives

1. to improve the nutritional and health status of children in the age group of 0-6 years

2. to lay the foundations for proper psychological, physical and social development of the child

3. to reduce the incidence of mortality, morbidity, malnutrition and school dropouts

4. to achieve effective co-ordination of policy and implementation amongst the various departments to promote child development, and

Component

1. Supplementary nutrition (SN)

2. Immunisation

3. Health check-up

4. Referral services

5. Treatment of minor illnesses

6. Nutrition and health education to women

7. Pre-school education to children in the age group of 3-6 years

ii) National iodine deficiency disorders control programme (2+2)

Ans)

Objectives

1. to conduct the initial surveys to assess the magnitude of the iodine deficiency disorders supply of iodised salt in place of common salt to the entire country.

2. to conduct resurveys to assess the impact of iodised salt after 5 years.

Component

1. Notification for banning the use of non-iodised salt: 18 states have outright bans on the sale of non-iodized salt, while 6 states have partial bans. The government is firmly committed to iodizing all salt.

2. Establishment of Goitre Cell : A Goitre Cell has been formed in the state health directorates of 17 states and 3 UTs to guarantee proper monitoring and efficient execution of the NGCP.

3. Information education and communication activities: The Central Government has given cash incentives to states and Union Territories for the creation of health education materials, the execution of health education initiatives on [DD, as well as for conducting surveys.

Q8. a) Name the various anti-poverty programmes for the rural poor in India. Discuss any one in detail.

Ans) Numerous anti-poverty initiatives in India are designed to help the rural poor by giving them access to essential services, income support, and job opportunities. The following are a few instances of such programmes:

1. Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA): With the help of this programme, rural households can spend 100 days a year on public construction projects for a guaranteed income. Many rural households have benefited from this initiative by receiving jobs, especially during tough economic times.

2. Pradhan Mantri Awaas Yojana – Gramin (PMAY-G): This program aims to provide affordable housing to rural households. It provides financial assistance to build new homes or upgrade existing ones.

3. National Rural Livelihoods Mission (NRLM): By encouraging chances for rural poor people to earn a living, this programme seeks to eliminate poverty. It offers assistance with starting self-help groups, enhancing financial availability, and creating market connections for rural goods.

Q8. b) Write short notes on the following:

i) Deforestation(1+2)

Ans) Even now, the process is still going on, but considerably more quickly. The use of wood as fuel, for the manufacturing of paper pulp and commercial timber, as well as shifting agriculture, which is common in several Indian regions, are other reasons of deforestation. Large dams on rivers, which need the clearance of several hectares of forest, have also contributed to widespread deforestation. According to estimates, for instance, 4,000 hectares of productive forest land will be submerged as a result of the construction of the Tehri dam in the Garhwal Himalayas, a little downstream at the confluence of the Bhagirathi and Bhilganga rivers. Additionally, deforestation results in habitat loss, which negatively impacts biodiversity and wild life. Numerous other forest animals and plants may suffer if one plant or animal species is exterminated. Many animals have been listed as endangered species, and some have even gone extinct, as you may already be aware.

ii) Role of NGO’s in promoting healthy environment. (2+2)

Ans) The Dashauli Gram Swarajya Sangh (DGSS), which helped launch the Chipko Movement in the Chamoli district in the early 1970s, serves as an example of the function of NGOs as pressure and action groups. The initiative started when locals realised that fast deforestation was to blame for the floods that were wreaking havoc on their area. This was taking place as a result of years of extensive commercial tree cutting. Therefore, DGSS was tasked with organising the residents of numerous villages to safeguard their trees by engaging in a distinctive "Chipko" action, which involves clinging to trees even while they are being threatened with death by the contractors. In order to defend their traditional forest rights and safeguard themselves from the disastrous impacts of deforestation, they pushed for their defence. The Chipko Movement was effective in getting influential individuals to support keeping the forest cover in the communities of the Himalayan region.

Section B – Application Questions (AQ) (40 marks)

1. Identify any five public health problems affecting individuals in our country. Prepare an information based pictorial pamphlet to educate the community about the causes, symptoms, prevention and treatment of any one of these health problems. (Refer to Activity 6 of Practical Manual-Part 2) (10)

Ans)

2. Write down five messages to promote environmental protection. Also elaborate on your role in environmental protection. (Refer to Unit 24) (5+5)

Ans) Here are five messages to promote environmental protection:

1. "The earth is our home. Let's work together to protect it for future generations."

2. "Every little action counts. Reduce, reuse, and recycle to help protect the environment."

3. "Small changes in our daily habits can have a big impact on the environment. Choose sustainable options, like walking or cycling instead of driving."

4. "The world's wildlife is in danger. Let's protect them and their habitats from pollution, climate change, and deforestation."

5. "The future of our planet depends on us. Let's take action to protect our environment and create a better world for everyone."

Human beings have a critical role to play in environmental protection. Here are some ways in which individuals and communities can contribute to protecting the environment:

1. Reducing their carbon footprint: By making simple adjustments to their daily routines, such as switching to energy-efficient light bulbs, shutting off electronics and lights when not in use, taking public transit or carpooling, and eating less meat, people can lessen their carbon footprint.

2. Conserving water: Individuals can conserve water by fixing leaks, using low-flow showerheads and faucets, and minimizing water usage for activities such as lawn care.

3. Recycling: Individuals can reduce the amount of waste going to landfills by recycling materials such as paper, plastic, and metal. They can also compost food scraps and yard waste to create nutrient-rich soil for gardening.

4. Supporting conservation efforts: Individuals can support conservation efforts by donating to environmental organizations, volunteering for community clean-up events, and advocating for policies that protect the environment.

5. Sustainable consumption: A person's carbon footprint can be reduced by making simple adjustments to their daily routines, such as switching to energy-efficient light bulbs, shutting off gadgets and lights when not in use, taking public transit or carpooling, and eating less meat.

3. Visit a nearby school where Mid-day meal is being served. Write down the details of supplementary nutrition provided to children under the mid-day meal scheme. Record the menu provided to children on different days of the week. Interview and find out the likes, dislikes and acceptance of food by the children. (Refer to Unit 22)

Ans) The geography, culture, taste preferences, and familiarity with the food products can all affect how well youngsters take to food when participating in India's mid-day meal programme. Following are some typical preferences and elements that may influence kids' willingness to eat during the mid-day meal programme:

Likes

1. Children generally enjoy foods that are familiar to them, such as rice, dal, and vegetables that are commonly consumed in their region or community.

2. Sweet dishes, such as desserts or fruits, are usually popular among children.

3. Non-vegetarian items, such as eggs, chicken, or fish, may be liked by some children, especially those who do not have access to such foods at home.

Dislikes

1. Spicy or strongly flavoured foods may be less accepted by some children, especially those who are not used to such flavours.

2. Unfamiliar or uncommon foods, such as some types of vegetables or regional dishes, may be less accepted by some children.

3. Poor hygiene, taste, or quality of the food may also reduce the acceptability of the meals.

4. Observe how waste is disposed off in your home, locality and city/town. Record your observations and comment on the following: ( Refer to Unit 5)

i) Is there segregation of wet and dry waste?

Ans) Yes, it is crucial to separate dry and wet garbage while managing waste. It entails separating organic or biodegradable garbage from inorganic waste such as plastic, metal, and glass. Examples of organic waste include food leftovers and yard debris. Wet and dry garbage should be separated since doing so encourages composting and recycling and lowers the amount of waste that ends up in landfills. Wet trash, also known as organic waste, can be composted to create a fertiliser that is rich in nutrients and is suitable for use in agriculture and gardening. Dry trash, also known as non-biodegradable waste, can be recycled, reused, or repurposed, lowering the demand for new materials and reducing energy use.

There are laws and regulations in many nations, including India, which demand the separation of garbage at the point of generation, such as homes, businesses, and institutions. The waste generator is in charge of segregating waste, and sanctions may apply if this obligation is broken. Numerous municipalities and cities in India have put in place programmes to encourage garbage segregation and to provide the necessary infrastructure and facilities for waste management. However, the public's engagement and willingness to adopt the practise of trash segregation are essential to the success of such initiatives.

ii) How does the municipal corporation of your city or town collect waste?

Ans: Depending on the size of the city or town, the accessibility of resources and infrastructure, and local laws, the municipal corporation's method of garbage collection may differ. However, the following procedures are generally included in rubbish collection by the municipal corporation:

1. Collection of waste from households, commercial establishments, and institutions: Municipal workers or designated contractors collect waste from households, commercial establishments, and institutions, using either door-to-door collection or community bins.

2. Transportation of waste: The collected waste is then transported to a transfer station or a landfill site using waste collection vehicles such as trucks, tractors, or trolleys.

3. Segregation of waste: At the transfer station or landfill site, the waste is segregated into different categories such as wet and dry waste, hazardous and non-hazardous waste, and recyclable and non-recyclable waste.

4. Treatment and disposal: Different techniques of treatment and disposal are utilised depending on the type of waste. Non-biodegradable trash, on the other hand, may be burned or dumped in a landfill, whereas biodegradable waste could be composted or turned into biogas.

iii) How does the municipal corporation in your city or town dispose of the rubbish that has been collected? (10)

Ans) Depending on the type of trash, the availability of resources and infrastructure, and other factors, the municipal corporation may choose a different method of disposing of waste. Following are a few typical trash disposal techniques employed by municipal corporations:

1. Landfilling: The debris is carried to a landfill site and buried there, making this the most popular method of waste disposal. Landfills are specially constructed locations intended to protect the environment and promote public safety. If not adequately managed, landfills can potentially result in pollution and health risks.

2. Incineration: With this technique, the trash is burned at high temperatures, turning it into ash and gas. While the gas is used to produce power or heat, the ash is disposed away at a landfill.

3. Composting: This method is used for the disposal of biodegradable waste such as food scraps and garden waste. Composting involves the breakdown of organic matter by microorganisms, which results in the production of a nutrient-rich fertilizer.

4. Recycling: This method involves the separation and processing of recyclable materials such as paper, plastic, and metal, which can be used to make new products. Recycling reduces the amount of waste going to landfills and conserves natural resources.

5. Bioreactor technology: With this technique, the trash is burned at high temperatures, turning it into ash and gas. While the gas is used to produce power or heat, the ash is disposed away at a landfill.