Assignment Code: RDD-6/AST/TMA-6/2022-2023

Course Code: RDD-6

Assignment Name: Rural Health Care

Year: 2022-2023

Verification Status: Verified by Professor

Long Answers Questions Maximum Marks: 40

Attempt any One of the following.

Q1) Describe the major problems related to Environmental Sanitation.

Ans) The major environmental sanitation problems in India are basically associated with four factors viz., water, air, housing and disposal of wastes. Let us examine each of them briefly:

Water: Water is important for living. For people to be healthy, they need to have access to safe and enough water. Ancient societies grew up near rivers and other places where water was easy to get. In the past, there were many ways to clean water, such as keeping it in copper vessels, putting it in the hot sun, filtering it through sand and gravel, boiling it, and putting hot iron in it. India has a lot of trouble getting enough and safe water at the moment. In 1949, the Environmental Hygiene Committee said that only 16% of India's towns and 6% of the country's people had safe water supplies. In 1955, contaminated water from the river Jamuna led to one of the worst outbreaks of infectious hepatitis. This happened in the city of Delhi. For the health of the community, water supply and sanitation should go hand in hand. Giving the people of India clean water to drink could get rid of 80% of the diseases there. Diseases that are spread by water are getting worse. The State's attempts to stop these diseases have not worked out as planned. The water should be cool, clear, and taste good. It shouldn't have any harmful organisms in it, and it shouldn't be corrosive or have any other bad effects on the body.

Air Pollution: Air pollution is becoming a bigger threat to people's health all over the world. Sources of air pollution can be put into four main groups Chemicals are released into the air by chemical and metallurgical industries, oil refineries, fertiliser factories, etc.; Combustion - burning coal, oil, and other fuels in homes and factories adds smoke, dust, and sulphur dioxide to the air; Motor Vehicles - their exhausts add carbon monoxide, hydrocarbons, nitrogen oxides, lead, etc. to the air; Miscellaneous - for example, burning trash, spray.

Housing: Housing is part of a person's whole environment and has some effect on his health and well-being. Even though villages and small towns have light, air, and space, there is no plan for where to live. People live in houses that are built next to each other and are too small, dark, damp, and have poor ventilation. Villagers don't have good housing because they are ignorant, poor, stuck in their ways, afraid of theft and robbery, or just don't care.

Many old towns and cities have the same kind of random planning. Housing that is too crowded, doesn't have enough ventilation, or isn't clean all lead to an increase in illness and death. They also have effects on mental and social health that are not direct.

Disposal of Wastes: Wastes are a big part of the environment in which people live. The main things that people leave behind when they live in a community are trash or solid waste, human waste or "night soil," and sullage. The word "refuse" is used to describe all solid waste made by people. This includes both public and industrial waste. The ways that people in rural and urban areas get rid of trash are different. In villages, people do things based on tradition, social and cultural factors, ease, and cost. In cities, however, sanitation rules are enforced by local laws.

Refuse Disposal: Some of the ways to get rid of trash are to dump it on empty land, use sanitary filling or controlled dumping, burn it or set it on fire, put it in the sea or rivers, or compost it into a good organic manure. Most of the time, the way trash is thrown away is determined by how things are in the area and what resources are available.

Excreta Disposal: Human waste can make people sick and is a major cause of pollution in the environment. It is very important for health to get rid of waste in a safe way. When people don't throw away their waste properly, they pollute the soil, the water, the food, and the fly population. The sewered areas include places where water flows or where sewage is treated. The sewerage system is a network of underground pipes called "sewers" that collect and move human waste and wastewater from residential, commercial, and industrial areas to the place where it will be thrown away.

Sullage Disposal: Sullage is usually used to describe wastewater from homes and other places that does not contain solid waste. Sullage water is thrown away in towns and cities either through the sewer system or the surface drainage system. Soakage Pits can be built to get rid of sullage water by letting it soak into porous soil on a small scale. This keeps water from being collected at random and stops flies and mosquitoes from breeding.

Medium Answers Questions Maximum Marks: 15 each

Attempt any Two of the following.

Q1) Describe in brief, the role of ‘Immunization’ and ‘Vector Control’ measures in Health Care

Interventions.

Ans) Immunisation: Immunization is a very important part of health care. One good way to stop the spread of an infection is to make the host's defences stronger. Active immunisation, which is one of the most powerful and cost-effective tools in modern medicine, can be used to do this. In active immunisation, the body's immune system actively fights off disease. This is different from passive immunisation, in which antibodies from outside the body are given to the body.

India's expanded programme of immunisation (EPl) for children began at the end of the 1970s. The Indian government also made immunisation one of its technological goals, giving it a high priority. Vaccines are the most important part of all vaccination programmes. Few vaccines are like these.

1. Polio: This is a live vaccine that is given by mouth.

2. BCG: It is a live vaccine that protects against the most dangerous kinds of tuberculosis.

3. Measles: The vaccine for measles is also a live vaccine.

4. Tetanus: It has tetanus in it.

When vaccines are exposed to the temperatures in the air, they get damaged. To keep them working, they need to be kept and moved at low temperatures. The cold chain is a set of tools that are used to store and transport vaccines at low temperatures from the place where they are made to the people who need them. Cold boxes are used to ship vaccines. They are kept in "walk-in" coolers and freezers at the zone and state level. Aside from giving people the knowledge they need to make changes; health education is also a key part of immunisation. Health education is a way to teach, encourage, and help people learn and keep healthy habits and ways of living.

Vector Control: Most diseases spread by vectors can be stopped by taking steps to control vectors. These are some of the most important things in our country that spread disease:

1. Mosquito: transmits malaria, filaria, Japanese Encephalitis, dengue.

2. Housefly: transmits food borne diseases.

3. Sandfly: transmits kala-azar.

4. Rat Flea: transmits plague.

5. Cyclops: transmit guinea-worm disease.

Vectors can be controlled in several ways: Environmental control is the best technique to eliminate vectors since it can be repeated and lasts. Controlling the environment involves eliminating animal breeding grounds, installing a decent drainage system, managing water, keeping homes and yards clean, and properly disposing of waste and waste products.

Our nation uses chemical control extensively. Two issues remain. Most pesticides are becoming resistant quickly, and hazardous insecticide residues are building up in food and the environment. Gambusia fish devour mosquito larvae. This mosquito-repelling fish is reared in calm water and ponds. Fungi, bacteria, and other biological agents that kill mosquitoes without harming people are being researched. Genetically engineered breeding is best. The following can control vectors: Environmental control is the best technique to eliminate vectors since it can be repeated and lasts.

Chemical control is used a lot in our country. But there are two things wrong: Most insecticides don't work as well on insects as they used to, and toxic insecticide residues are building up in the environment and food. Gambusia are a type of fish that feed on mosquito larvae. To keep mosquitoes away, this fish is raised in still water and ponds.

More research is being done to find other biological agents, such as fungi, bacteria, and so on, that can kill mosquitoes without hurting people. Genetic engineering is the most promising way to breed animals. Mosquitoes that are broken and can't have babies. This is called "genetic control." Insect growth regulators, chemosterilants, and other newer methods are also used.

Q2) Discuss the structure, functions, and major health programmes of a Primary Health Centre.

Ans) Establishment of Primary Health Centre and sub-centre has been one of the significant

achievements in the field of health care delivery in rural India.

Functions: The district's Chief Medical Officer oversees health matters. Districts have 8–12 PHCs. PHCs have 8–10 sub-centres. The Medical Officer oversees the 80,000–100,000-person block. Two more medical officers may assist. A Sanitary Inspector, a Block Extension Educator, a male and female Health Assistant, and a Block Extension Educator supervise field employees.

PHCs should perform these:

1. Medical care.

2. Mother and Child Care including family planning.

3. Safe water and basic sanitation.

4. Prevention and Control of local endemic diseases

5. Collection and reporting of vital statistics.

6. Health education

7. Referral services

8. Implementation of national health programmes

9. Training of health guides, health workers, health assistants and local dais

Structure: A CHC or enhanced PHC's most significant component is a 30-bed hospital. It offers many professional services. The new PHC has a Medical Officer, a Community Health Officer (public health), a pharmacist, two secretaries, and four other helpers.

This is how tile CHC staffs:

1. Four Specialists (Surgeon, Physician, Gynaecologist, Paediatrician)

2. Three general duty medical officers (public health, anaesthetist, one from indigenous systems of medicine)

3. Eight nurses

4. Two pharmacists

5. Two Laboratory technicians

6. One X-ray technician

7. One extension educator

8. One ophthalmic assistant

9. Sixteen ward staff, and

10. Ten other ward staff.

Major Health Programmes in the Primary Health Centre

Some of the important health programmes undertaken through the Primary Health Centre are

Malaria: The goal of the National Malaria Eradication Program (NMEP), which was one of the largest vertical programmes in the country, was to spray DDT in all areas where malaria was a problem. The goal of getting rid of malaria by 1966 was not met. In 1977, because of the setback, the programme started using a new plan called the Modified Plan of Operation (MPO). The goals were to stop people from dying and lower the death rate, as well as to keep part gains.

Tuberculosis: In 1962, the National Tuberculosis Programme was put together. It was a programme that could be used all over the country and that worked well from an epidemiological point of view. The programme was based on the idea that a lot of people with tuberculosis were actively seeking treatment at different hospitals, and that sputum examination was a simple way to figure out who they were.

Blindness: The National Trachoma Control Program started in 1963 with paramedical workers at primary health centres who had been trained in a special way. In 1969-1970, the control strategy was changed to make the programme part of general health services. Under this, the trachoma programme is being run in 3550 PHCs in 293 districts. It has mobile units that go to the PHC and sub-centre to help people with eye care.

Mother and Child Health: The integrated Child Development Scheme, the National Programme for Prevention of Blindness, the Expanded Programme on Immunization, and the programme for Control of Diarrheal Diseases are the major special programmes that have important parts for maternal and child health. These programmes are now known as the Child Survival and Safe Motherhood Programme (CSSMP). The goal of the Expanded Programme on Immunization (EPI) was to lower the number of people who got sick or died from diseases like diphtheria, pertussis, tetanus, polio-mytetis, measles, tuberculosis, and typhoid fever. This permanent programme for children is being carried out in rural areas by PHCs and sub-centres.

Short Answers Questions Maximum Marks: 6 each

Attempt any Five of the following.

Q1) URMUL Trust

Ans) In 1986, the Uttar Rajasthan Milk Union Limited (URMUL) Trust got started. The Indira Gandhi Canal is a big irrigation project that has changed the lives of the people in the area in many ways. There aren't many medical facilities because there aren't enough people or materials. The SWASTHY A SAATHI connects the professionals who work for the Trust with the people in the village. The unique thing about this project is that it helps women get ahead and gives them the tools they need to see the world beyond their veil. URMUL Trust is also a good example of how low-cost technology made from local resources, like the URMUL-MIX, can be used successfully. This project also does a good job of mixing health and development together.

Q2) Active Immunization

Ans) In active immunisation, the body's immune system actively fights off disease. This is different from passive immunisation, in which antibodies from outside the body are given to the body. Passive immunisation will never be as good as active immunisation. In active immunisation, the organism itself or a part of it is usually used as a vaccine. These are some types of vaccines that are often used:

1. Live vaccines e.g. BCG, measles, oral polio vaccine.

2. In live or dead vaccines like Pertusis, for example.

3. Toxoids, like those that cause tetanus or diphtheria.

4. Combination vaccines e.g. DTP.

5. Immunoglobulins and antitoxins passively immunise. We'll use vaccinations better if we understand the national immunisation programme.

Q3) Primary Prevention of Disease

Ans) The pre-pathogenic period is when primary prevention takes place. The main parts of primary prevention are promoting health and protecting people in specific ways. Primary prevention can be done in a number of ways, such as by taking steps to improve the health of the whole population, protecting an individual from disease agents, or putting up barriers in the environment to keep agents out. They stop the agent and the host from being able to talk to each other. Health promotion is the most important way to keep people from getting sick. It includes social, economic, and political actions that make life better. Specific protection includes all the things that are done to stop a disease in the usual way.

Q4) Sanitation

Ans) "Sanitation" refers to all things that affect health, especially dirt and disease, and more specifically to how sewage and trash from homes are drained and thrown away. Sanitation is the whole field of controlling the environment to keep people from getting sick and to improve their health. Sanitation is the quality of life that is shown by a clean house, neighbourhood, and community. The WHO Expert Committee on Environmental Sanitation said that environmental sanitation is a set of activities that include controlling community water supplies, getting rid of faeces and wastewater, getting rid of trash, getting rid of disease-carrying insects, making sure there is enough food and how it is handled, making sure the air is clean, and making sure the workplace is safe.

Q5) RAHA

Ans) In 1969, RAHA started in two districts in the east of the state of Madhya Pradesh. The most unique part of RAHA is the Medical Insurance Scheme (MIS). In 1980, the programme began. There are two different types of Medical Insurance Scheme. At the health centre level, people in the area run the local insurance fund, which is called "SAMARIT AN FUND." The "CENTRAL FUND," which sends people to hospitals, is run from one place. RAHA keeps a close eye on the system to make sure that this new and different plan works well on many different levels. This system is simple, cheap, and does more than just provide insurance. It gets people involved and brings them together. The model was easy for other NGOs to copy or change to fit their own needs.