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Raising Public Health Awareness in Rural Population Dr. Harish Chandra Shah President Arniko Society Nepal and China are close friendly neighbors since time immemorial. China is one of the world’s most ancient civilization, has recorded history of 4000 years。Our relation cordial, close and cooperative since the establishment of diplomatic relation more than 50 years. Nepal and China enjoy all weather relation in all aspects. Our relation is not only limited to state to state, but extended and deeply rooted at the people’s level. 1. Public Health The term public health came into general use around 1840. It arose from the need to protect the public from the spread of communicable diseases. Now a day it has become wider. It has broad concept. It embraces the non-communicable diseases, social factors and etiological factors of diseases, health law, consumer’s right, justice and equality. So we can describe the public health as a science and art which promotes health status of the people by promoting health determining factors aiming at preventing a disease, restoring health, promoting efficiency and prolonging life. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion and political belief economic and social condition. The right to better living condition and right to health and medical services are vital issues for all human being of the whole world. The role of public health in National health care system of Nepal is gaining more and more importance with the passage of time and very rightly so. It will be being unrealistic to imagine that the health status of Nepalese people may improve without proper public health measures. Health is human’s normal condition. Which has been regarded as his birthright also. It is the result of living in accordance with the natural laws, pertaining to the body, mind and environment. These laws relate to fresh air, sunlight, diet, exercise, rest, relaxation, sleep, cleanliness, right attitude of mind good habits and above all lifestyle. Objective To improve the health status of the population of most vulnerable groups, particularly those whose health needs often are not met, that is that of women and children ,the rural population, the poor, the underprivileged and the marginalized population. To extend to all districts and villages cost effective public health measures and essential curative services for the appropriate treatment of common disease and injury. To provide technically competent and socially responsible health personnel in appropriate numbers for quality health care throughout the country, particularly under-served areas. To improve the management and organization of the public health sectors and to increase the efficiency and the effectiveness of the health care system. To develop appropriate for NGOs ,and the public and private sectors in providing heakth services and To improve the inter-and intra –sectoral co-ordination and to provide the necessary support for effective decentralization oh health care services with full community participation. 2.Dimensions Of Health (1)Physical Dimension: Optimal physical state normally proper functioning of body, cell, tissue, organ and system. (2)Mental Dimensions: Optimal Harmony between both the individual and the surrounding leading to state of non-conflicting situation. (3)Psychological, Emotional and Spiritual Dimension: State of Positive human emotion – kindness, sympathy, love and affection etc. (4)Socio-Cultural Dimension:State of social, Harmonious relationship with the members of the society. 3. Concepts of the awareness and prevention The goals of medicine are to promote, preserve and restore health when it is impaired and to minimize suffering and distress. Awareness and prevention is basically barrier between the source and the host through interventions to block the channel of transmission. Environment plays an important role in this process. Successful prevention depends upon knowledge of causation. Dynamic of transmission, identification of risk factors and risk groups, availability of prophylactic or early detection and treatment measures , removal or elimination of a single may not sufficient to prevent a disease. There has to be a multicultural concerted action, continuous monitoring and evaluation with the time tested technology. Hence, the objective of awareness is to prevent causative agents from its transmission and thereby halting the disease process. Prevention is a part of public health and not a substitution to it. A new concept of Prevention has emerged, as multi-level prevention.Multi-level prevention is a concept of prevention in different levels of disease and its origin in human life since intrauterine life to death. 4. Level of Awareness and prevention (1 )Primordial prevention: Receiving special attention in the prevention of chronic disease. Its effort is also directed towards discouraging children from adopting harmful lifestyles. (2)Primary Prevention :can be defined action taken prior to the onset of a disease which removes the possibility that a disease will ever occur .It signifies intervention in the pathogenesis phase of disease or health problem .it promotes health to protect against special disease agents and the hazards in the environment . (3)Secondary prevention: The interventions of this can be specific or non –specific. The specific interventions are early diagnosis(eg.screening test ,case finding progammes)and adequate treatment which arrest the disease process ,restore health by seeking out unrecognized disease and treating it before irreversible pathological changes have taken place .On specific interventions are nutrition and job load for T.B (4)Tertiary prevention :It signifies intervention in the late pathogenesis phase and the can be defined as all measures available to reduce or limit impairment and disabilities ,minimize suffering cause by existing departures from good health and to promote the patient adjustment to immediate conditions ;modern rehabilitation includes psychological vocational and medical components based on teamwork from a variety of professors . 5. Different model of public health (1)Biomedical model: Addressing health of population through biomedical and technology interventions, eg prevention of disease by vaccines hospitals, equipment and medicine etc. (2) Non-biomedical model of health: Addressing the health of population through political, social, cultural, and behavioral changes. 6. Organized community Efforts (1) The sanitation of the environment. (2) The control of communicable disease (3) The education of the individual in personal hygiene. (4) The organization of medical and nursing service for the early diagnosis and preventive treatment of disease and (5)The development of social machinery to insure everyone a standard of living, adequate for the maintenance of health 7. Prerequistes for health The fundamental conditions and resources for health are (1) Peace (2) Shelter and housing (3) Education (4) Food (5) Income (6) Stable ecosystem (7)Sustainable Resources (8) social Justice (9) Equity (10) Empowerment of women (11) Social security 8. Several Practices under health promotion (1) Adequate Nutrition (2) Provision of sanitary environment safe water supply, facilities for the safe disposal of excreta and others wastes, healthful housing, control of insects and rodents, provision of safe working condition, provision of recreation facilities etc (3)Personal hygiene (4) Health education (5)Marriage counseling (6)Sex education (7)Physical education (8)Improvement of the living standard of people 9.Strategies (1)Building healthy public policy Is to create as supportive environment to enable people to lead healthy lives (2)Creating supportive environment The non-breaking link between people and their environment constitutes the basic for a socio –ecological approach to health. (3)Strengthening community action Promotion work through concrete and effective community action in setting priorities ,making decisions, planning strategies and implementing them to achieve better health .strengthening of community people and making the realize their self-actualization and self –esteem . (4)Developing personal skills Health promotion not only supports the community development but also emphasizes on the personal and social development through information and the skills which help an individual choose the appropriate option conductive to their health, help an individual choose the option conductive to their health (5)Reorienting health services The role of health services must be more increasing in a health promotion direction beyond its responsibility for providing clinical and curative services. 10.Public Health in Nepal。 (1)1949 Small pox vaccine (2)In 1950 insect born disease control unit was established by US/AID (3)In 19956 Establishment of Ministry of Health (4)In 1958 Nepal malaria eradication project started (5)In 1960 Health education unit established (6)In 1965 Leprosy project was established (7)In 1966 T.B.control project was started (8)In 1967 smallpox control pilot project established (9)In 1968 FP/MCH project started (10)In 1972 establishment of Institute of medicine (11)In 1989 new health policy was introduced (11)In 1975-1990 First long term health was implemented 11. Health care delivery system (1)Traditional Health care delivery system: includes Ayurvda,Unani,homeopathic, (2)Modern Health care delivery system: 12. Major health problem in Nepal (1) Problems due to infectious disease: malaria, Cholera, T.B.Leprosy (2)Problem due to Envoronment: Unavailabilty of safe drinking water, No latrines and sewage system, and problem of healthy housing (3) Problem due to malnutrition: Vit.A deficiency, Nutritional anemia, (4) Problem due to over population: hypertension, respiratory infections, Road traffic accident, cardiovascular disease, skin disease etc. (5) Social Problem: unemployment, povery, Theft and Robbery, prostitution, Drug Abuse, Women Violence (6)Problem due to Human resources in Health (7)Problems due to lack of health facilities (8)Drug addiction. !3.Means of Awareness of obtaining optimum health for rural population Management of environment factors Water Disposal of water garbage and house hold refuse Housing Balanced diet(nutrition) Control of infectious disease Vaccination Economic growth Regular exercise Control injuries and accidents Willingness to utilize health services Proper disposal and drainage Substantially better health status and freedom from disability are the goals of public health. All people have an equal opportunity to enjoy good health..