PCH Notes-1 (1) - 1
PCH Notes-1 (1) - 1
PCH Notes-1 (1) - 1
DEFINITION OF TERMS
HEALTH
This is a state of complete physical mental and social, well being and not merely the absence of disease or infirmities [disability]
HYGIENE
This is the practice of keeping one self, one’s way of living and working areas clean in order to prevent disease,
PERSONAL HYGIENE
This deals with the health of the individuals and involves understanding and care of both the body and minds.
PUBLIC OR SOCIETALHYGIENE
This deals with the health of the community and is the responsibility of the community and of both central and local government.
FAMILY[S]
Is a group of two or more people [home] who are united by blood, marriage, adoption and commitment which exist as a family and who are
mixed together as a unity.
COMMUNITY
Is a group of people who live in a specific place or locality sharing common interest and characteristics.
COMMUNAL
PERSONAL HYGIENE
Thisis a science of health that deals with those measures taken by an individual to preserve his/her health. Examples of those measures include;
Cleanliness
The bowels.
Exercise, rest and recreation.
Fresh air and sun light.
Good habits.
Good diet.
Clothing.
This is the health care system that concerns itself with the health of an individual and the community.
To provide, promotive, preventive, curative and rehabilitative health care to individual and community as a whole. I.e. bringing them to a
complete physical, mental and social wellbeing.
Provide nurses with knowledge and skills of maintaining an individual health through health education.
Health being a basic of human right which should be attainable at higher level. This helps nurses to work without discrimination. All
should be treated equally.
It helps nurses to overcome the challenges that may arise during counseling or advising patients, relatives and community members.
Helps nurses to provide good care to patients who are unable to perform since they know the importance.
1
Having good relationship with the community.
Proper planning by the government [MOH].
Emphasis on environmental hygiene.
COMPONENT OF P.C.H♿
P.C.H AS A SUBJECT
This subject includes all matters which affect the health of people either an individual in their own homes or as members of the community such
as villages or towns.
Personal hygiene.
Public or community or social hygiene.
PERSONAL HYGIENE
This includes;
Cleanliness.
The bowel.
Exercise.
Rest and recreation.
Fresh air and sun light.
Good diet.
Good habit.
Clothing.
These include measures taken by the government, health authority, public workers, departments, Agriculture and veterinary departments which
help to improve the health of people by the control and treatment of diseases adequate food production, water supply, etc.
CLEANLINESS
SKIN
This must be kept clean and healthy in order to function well, daily bath is needed to remove dirt and give feeling of wellbeing.
2
FUNCTION OF SKIN
Sebum, sweat, dead skin, cells and bacteria if not removed decomposes and produces an unpleasant smell and irritate the skin.
The pores become blocked and the heat of the body can’t be regulated property.
Dirt favors growth and germs and parasites and may give rise to diseases.
HANDS
FEET
Keeping the mouth and teeth clean is important to maintain good health.
Teeth brushed each morning and before going to bed, nothing should again be eaten after cleaning before sleep.
Brush teeth in up and down movement to remove food particles and prevent decay damage to enamel.
Eat food containing adequate calcium such as dark green vegetables, beans, g.nuts and well water etc. and vitamin D like eggs, sun
light ,milk, cheese,butter,etc.These make teeth healthy.
Mouth should be rinsed after every meal.
NOSE
FUNCTIONS
Warms air.
Filter air entering respiratory tract.
Moisten air.
For these reasons breathing should be done by nose not mouth. The nose should be blown at intervals using handkerchief to remove
accumulated dirt and germs, handkerchief changed daily.
HAIR
Hair should be kept clean and tidy washed with shampoo or soap using warm water.
In hot climate wash hair daily, it should be brushed.
3
Well-kept hair gives a feeling of confidence and wellbeing.
Dirty hair harbors lice this may cause ill health as result of some diseases.
Dirty hair may allow spores of ring worms to develop.
The brush and the comb must be kept clean in a good condition. They should never be shared.
THE BOWELS
The bowel should be opened regularly.The frequency may vary with the amount and the type of food taken but usually it is good to empty the
bowels every day.
CONSTIPATION
The longer the evacuation remains in the colon the water is absorbed and the faeces becomes harden and difficult to expel.
PREVENTION OF CONSTIPATION
EFFECTS OF CONSTIPATION
EXERCISE
Walking.
Swimming.
Dancing.
Gardening.
Netball.
Tennis.
REST
Regular rest is necessary for the body to repair worn out muscles and organs. Sleep is the perfect form of rest .For good health; sleep must be
sufficient and regular in a comfortable and relaxed position and in cool clean dark and well ventilated room.
4
The body should be kept warm during sleep, a warm bath before bed helps promote good sleep. The amount of sleep required varies with age:
This is provided by an activity which is different from ones usual work, it is a time of relaxation and should be something that is enjoyable. It is
important for individuals to have some form of recreation as doing the same thing over and over again leads to depression and nervous
exhaustion .Outdoor games like walking ,swimming, gardening dancing etc .provides both exercise and recreation ,reading ,needle work and
music are also other good forms of recreation}
GOOD DIET
Food is necessary for growth, energy, strength, warmth and body repair. The amount required for health depends on size, sex age, climate,
degree of activity and basal metabolic rate. Our diet should be well balanced one containing all the essential food nutrients that thebody requires
to function normally and stay healthy.
GOOD HABITS
Habit is something we do without thinking about it.Good health can be maintained by forming regular habit, as we continue practicing doing
particular activity,it becomes an habit e.g.going to bed at 10pm; the body will be ready to sleep at that time.
CLOTHING
Provision of privacy.
Promotion of warmth.
Protection from sun heat.
Protection from wind, injuries, germs, rain.
Identification purposes.
Cotton
5
Suitable for hot climates.
Absorbs moisture.
Allow evaporation.
Non- irritating to the skin.
Can be boiled and washed well.
Easy to iron.
Long lasting material.
Linen
Wool
Synthetics
E.g. Nylon, made from chemicals and used mainly for under wares and night clothes;
Clothes should be changed frequently and washed thoroughly in clean soft water and soap. Stagnant water may contaminate it with bacteria and
spores of fungi and lead to infection and itching.
After washing, they should be rinsed well and hanged to dry in a wire line in the fresh air and not put on the ground. When dry they should be
ironed with hot iron to kill any source of infection. In damp climate, clothes should be dried to a void/prevent moulds from growing.
Clothes cupboard should be dry and clean; clothes should be loose and with normal fitting to allow movement and not constrict the blood
vessels/circulation or breathing. In hot climate clothes should be light and of bright color as the dark colors absorbs heat, in cold weather,
heavier, warmer clothing should be worn.
PUBLIC HYGIENE
These are the services provided by the local government central .e.g.
Housing.
Lighting.
Air and Ventilation.
Water.
Sanitation.
IN RURAL SETTING
Main hut.
Children’shut, boys and girls separately.
Visitors hut.
Food store.
Kitchen with raised fire place.
Rest /relaxation hut.
Animal’s hut/birds hut.
A large enough compound.
6
A ventilated pit latrine
A bath shelter.
A drying rack.
A drying wire.
A rubbish pit,
Trees for shade wind breaking.
A nearby water source.
A flower garden.
A wide road from the main road to the home.
IN URBAN SETTING
Main house with master bedroom with water carriage toilet system and a bathroom, sitting room , dinning ,kitchen, three other bedrooms
for boys ,girls and visitors with another toileting system , a store, garage if necessary .
Animals/birds shade or house.
A wide compound.
A drying line.
A drying rack.
Source of light.
Water source, commonly tap water.
A rubbish pit or dustbin.
Compound trees and flower garden.
HOUSING
To protect the health of the community, every country has its laws about housing constructions and other buildings, and also laws regarding the
sites on which the house should be built, itsheight, ventilation and sanitation and the building materials used.
SITE
The place should not be near a swamp because mosquitoes and other insects breed in swampy places.
The site should be slightly raised.
Soil should be porous like gravel and chalk.
There should be no overcrowding to provide enough space for free air circulation.
Some big trees within the site are recommended for the provision of resting shade in hot winter and also act as wind break.
There should be enough space for cultivation.
The site should be near essential services such as school, Hospital, Market, clean water source, policing outposts.
There should be a road within walk able distance from the site but not too near to the home to prevent home accidents.
The attitude of the community in such area should be good.
The security in such an area is important.
The government’s policy concerning the area.
A clean water source for domestic use.
BUILDING A HOUSE
The house should have a good foundation, the depth depending on the type of soil and the size of the house, there should be a separate place for
cooking, eating, sitting/living and sleeping, arrangements for the toilets being water carriage system or pit or dry toilets made.
Enough capital.
Specious land with good quality soil.
7
Slightly raised surface not sloppy.
Nearby source of water for building and other domestic uses.
Adequate man power.
Accessible road for the vehicle which collects the building materials.
The availability of the building materials.
The location of electricity lines in rural areas.
The governments consent to ensure that the land is not affected by future road plans in urban areas.
The security of the place because the building may stop so prematurely.
ROOF
Should be a sound one and projected over the walls to protect the house from rain and wind and to shade the interior from sun rays.The roof may
be made of corrugated iron sheets or thatch, the thatch is good in that it is cheapest and coolest but it harbors mites, ticks, rats and other insects.
Corrugated iron sheets make the house hot and there should be a ceiling between the roof and the room, there should be air space between the
ceiling and the roof protected against bats and the ratsby the wire netting.
THE ROOMS
Rooms should be high and airy and well lit with plenty of window space and air outlets to ensure good ventilation .The windows and outlets
should be protected from thieves, mosquitoes and other insects. Each room should have adequate sun light but not over heated. The wall may be
concrete, concrete or blocks, mud or mud bricks. Mud walls harbors mites and other insects but they are cheap and should be protected from
white ants and kept in good condition. Concrete walls are expensive but last longer.
THE FLOORS
The floor may be made of cement, tiles or mud, mud floor are cheapest .They must be kept in good condition e.g. Cracks harbors mites, ticks and
other insects; they should not be smeared with cow dung as it attracts flies and breeds germs.
THE KITCHEN
The kitchen should be well ventilated and lightened and easy to clean .fire place should be raised of the ground and have chimney to take away
smoke. The kitchen should have adequate clean water, a covered pail for holding waste, there should be table for preparing food and adequate
cupboard for food and cooking utensils, foodcupboard must have a door and be well ventilated.
THE VERANDA
This is formed by the roof projecting over the walls of the house .This keeps the house cool and shades the rooms, it also provides sitting out
place in the evening.
THE COMPOUND
The spread of infectious diseases are more common especially the air bone diseases like Tuberculosis and influenza.
LIGHTING
Good natural and artificial lighting is important in houses and working places.
1. NATURAL LIGHT.
2. ARTIFICIAL LIGHT.
1. NATURAL LIGHT.
This is sun light, it’s the best kind of light and is also important for health.
Sunlight makes the room bright, pleasant and dry showing up dusts and dirt encourages cleanliness of the home.
Good natural light in a home helps reduce home accidents therefore windows should be placed in such away as to provide maximum
natural light.
Natural light provides warmth.
Sunlight acts on ergosterol in the skin and helps in the formation of vitamin D.
It gives a feeling of wellbeing and stimulates the mind and body.
It kills many germs and prevents the growth of others.
To have good natural light, the room should have sufficient window space and windows placed in such away as to give maximum light.
The window should be kept clean.
Walls and ceiling should be painted with light colors to allow good reflection of light.
2. ARTIFICIAL LIGHT
The main sources are electric light, oil lamps and candles.
ELECTRIC LIGHT
This is the best form of artificial light from filament lamps of fluorescent tubes .It gives a good light, it’s clean and has no naked flame, doesn’t
flicker and does not use up oxygen or add carbon dioxide or water vapor to air.
NB. All electric equipment must be switched off before cleaning .It must be kept dry and never touched with wet hands as electricity passes
through water.
OIL LAMPS
These consist of reservoir containing paraffin so and cotton wick .The paraffin soaks up the wick and on lighting produces flame .They are
portable and can be carried from one place to another.
CANDLES
They are made of wax with a wick in the center, they are useful in emergency. Oil lamps and candles give a poor light which is hot and
constantly flickers .They are hazardous as they have naked flames, they also darken the walls and ceiling of rooms, they add impurities to the air
such as carbon dioxide, moisture ,heat and soot formation, they use up oxygen.
AIR
COMPOSITION OF AIR
Oxygen 20%
Carbon dioxide 0.03%
Nitrogen 79%
9
Water vapor {in small amount but varies}
Others gases 1%
OXYGEN
Oxygen is essential for life and for all forms of combustion e.g. breathing, and burning.
CARBON- DIOXIDE
-Decaying organic matter, plants or animals, plants absorb it during day light, they retain the carbon and set free the oxygen.
NITROGEN
This gas forms the bulk of air; it has no effect on man but serves to dilute the oxygen in the atmosphere and checking the rate of combustion.
WATER VAPOUR
-Expired air.
-Evaporation from water surfaces such as rivers and lakes and from moist surfaces such as skin, plants and wet clothes.
The air has a weight and volume; it can support a bird and an aero-plane.
Air pressure falls steadily away from the earth’s surface it is also essential lessened by the heat and moisture so that it rises until in high
altitude it is cooled and descends again, thus we have a constant circulation of air causing winds.
The instrument for measuring air pressure is called a barometer.
Fresh air is cool, it moves a little and is free from harmful germs and other impurities. It allows the body to maintain its normal
temperature by evaporating the sweat and it gives a feeling of wellbeing.
-Where oxygen is reduced and carbon-dioxide, water vapors and germs are increased as in respiration of man and animals.
2. Burning of fuels
-Burning fuels such as oil lamps, candles, charcoal, and fire wood heat add impurities
3. Industrial waste
4. Organic matter
-From animals or planted such as skin feathers, skin, feathers, furs dust from dust forms, Hay or cotton.
5. Inorganic matter
6. Decaying matter
-Decaying matter such bad food, and vegetables excreta, which give rise to bad smell and add germs and other impurities to air.
7. In a Hospital ward
-Organic matter such as dirty linen sluices, specimens and other discharge from wound also contaminates air.
10
RAIN- Wash away impurities.
SUN- Dries and warm the air,kills germs and prevent its growth.
WIND - Dilute and mix the atmospheric gases, impure air rises and cool, fresh air takes its place.
PLANTS- Absorbs carbon-dioxide during the day light and set free oxygen to air.
OXIDATION-Oxygen in the air neutralizes some impurities such as soot, dust,germs and makes them harmless.
VENTILATION
Ventilation is the maintaining of the atmospheric conditions within homes ,work places and places of entertainments, so that air inside is kept as
near as possible to the freshness of the outside atmosphere.
In a well-ventilated room, the air moves gently, it is cool and free from harmful germs and other impurities.
GOOD VENTILATION
This is very important for health, it keeps the air fresh and supplies the oxygen needed for the body.
It also helps to maintain normal body temperature by evaporating the sweat on the skin, it reduces the spread of infections such as common cold,
influenza, bronchitis and pulmonary tuberculosis.
TYPES OF VENTILATION
1. NATURAL VENTILATION.
2. ARTIFICIAL VENTILATION.
1. NATURAL VENTILATION
This is used in most domestic dwellings where air enters through the windows and doors and as the air circulates and becomes contaminated, it
becomes hot and then it rises and escapes through air outlets high on the walls and near the ceiling, meanwhile the fresh air from outside gain
entrance into the room to replace the used up one.
2. ARTIFICIAL VENTILATION
This is achieved by mechanical means by use of fans which keeps the air moving and cool or air conditioning where fresh air is forced into the
building used up air is forced out.
Artificial air is commonly used in operating theatres and large buildings where many people congregate such as cinemas and theatre.
The air from outside must be fresh, the compound must be kept clean with proper disposal of refuse and excreta .Dustbins for waste must
be available and kept covered.
The house should be surrounded by grass so that less sunlight is reflected.
Some shade trees help to provide shade to the house, protecting it from the sun rays and reduce the temperature of the rooms.
Plants, shade trees and grass also absorb carbon dioxide during day light and set free oxygen in exchange.
Animals should not be allowed in the house.
The house must be kept clean and overcrowding avoided.
There must be adequate window space with the windows facing each other to allow cross ventilation, air outlets should be high in the
walls near the ceiling because hot stagnant air rises and is replaced by fresh air.
The ceilings and walls inside and outside the house should be painted with light colors so that less heat is absorbed and the rooms kept
cool.
IN A HOSPITAL WARD
In a badly ventilated room, the air is not moving .It becomes stagnant, full of water vapor, germs and other impurities .The oxygen
becomes less and carbon dioxide increases, the temperature of the air is raised and it becomes hot.
Normally the body is cooled by the evaporation and the body temperature increases where ventilation is poor and no evaporation is
taking place. Therefore where evaporation in inhibited the impacts are great discomfort with sleeplessness, headache, faintness and
nausea.
11
Respiratory infections such as common cold, influenza, bronchitis and pulmonary tuberculosis are more easily spread.
People living in such conditions have lowered resistance to infections; they may also suffer from fatigue and have poor health.
WATER
Definition
Water is the liquid that forms the rivers, lakes swamps rain etc and is the basis of fluids of living organisms, it is essential for life and forms 60%
of body weight.
COMPOSITION OF WATER
PROPERTIES OF WATER/CHARECTERISTICS
1. PHYSICAL PROPERTY
-It is colorless, odorless, and stainless and its boiling point is 100 degree centigrade. It assumes the shape of the container, has a specific gravity
of 1.0.
2. CHEMICAL PROPERTY
-Neutral to litmus paper, is a universal solvent, reacts with hydroxide to form salt, and reacts with nonmetal to form acid.
Severe vomiting.
Severe diarrhea, cholera
Severe sweating.
Severe burns..
Poly -urea following diabetic disease.
Inadequate intake of water.
Prolonged heating by hot sun shine.
USES OF WATER
NB. The body requires an average amount of water of (1½-2) liters a day to replace the lost amount and this maintains good health and
functioning of the body.
It is needed for building all body tissues and is the basis for all body fluids and secretions such as blood, lymph, urine, gastric juices and
respiration.
Provides some mineral salts.
Helps to prevent constipation.
Regulates the body temperature.
Helps in the execration of waste products from the body.
Replaces fluids lost from the body.
Availability of water –People tend to misuse water when there is much supply and economize when there is scarcity.
Climatic factor. People us water during hot condition more often for bathing and drinking.
Distance –Fetching water from far distance is hard and therefore people tend to economize water.
Activities –Grinding mills and irrigation takes a lot of water.
Standard of living- people of advanced standard of living use a lot of water.
Water goes in a cycle, it falls as rain and fall into the ground and some runs off as stream and gradually much of it collects into the rivers
and sea.
From the sea, lakes, rivers, streams and any wet surfaces like forests, plants and respirations of man and animals. The water vapor rises
into the land and as it cools, it condenses and forms clouds and later falls as rain.
SOURCES OF WATER
Rain, Ocean, Sea, Lakes, Rivers, Swamps, springs, Wells, Glaciers {on top of the mountains}.
RAIN WATER
Is a source of water for many people .It may be collected from the roofs by means of gutters and pipes. Rain water is pure but becomes
contaminated as it falls through the atmosphere and collecting places. It should be purified before drinking.
ADVANTAGES
It is pure.
Soft, does not waste soap.
Does not coat saucepan.
It is cheap.
DISADVANTAGES
SURFACE WATER
This comes from rain water and they are –the most common source of water for most people and also most polluted or contaminated by animals’
droppings, defecations, urinations by man, washing of clothes, swimming, children playing in it, leakage from latrines built too near
Rivers.
Lakes.
Springs.
13
Dams.
ADVANTAGES
DISADVANTAGES
Highly contaminated.
Chemicals from industries are deposited in it which can be harmful.
Needs purification before use {expensive.}
Source may be dangerous.
This water is formed from sinking water when rain falls .it can be inform of spring or well.
1. Spring water.
This where the underground water comes to the surface, it may be shallow or deep.
a. Shallow spring.
Is where the rain water is arrested in the first impermeable layer of the soil and comes out as spring where this layer reaches the surfaces.
b. Deep spring.
This is where rain water has passed through at least one impermeable layer of soil and comes out as a spring where deep layer reaches surfaces.
2. Wells.
This is where a hole is dug and water is brought to the surface .It may be shallow or deep well.
a. Shallow well.
Here the hole is dug and water is brought to the surface from the first impermeable layer of soil.
b. Deep well.
This is where the hole is dug through one or more impermeable layers of soil. Water from shallow springs and wells is usually soft but
contaminated; the floor may not be constant during dry season. This water needs purification before use.
Water from deep springs and wells is soft and pure but may be contaminated if the spring or well is not protected. The quantity is good and not
affected by dry season.
HARD WATER
This contains excessive mineral salts such as calcium and magnesium, it is usually found in deep wells and springs, if the well or spring is well
protected is safe for drinking.
14
SHOFT WATER
Is water that contains little or no mineral salts eg rain water, lakes ,shallow wells, springs ,rivers etc.
ADVANTAGES
DISADVANTAGES
By humans - By dirty habits in or near water supply such as urinating ,disposingrefuse, bathing or washing clothes, swimming or
playing and Seepage from latrines built too near tothe water supply.
Animals-Grazing, defecating, urinating or washing in water.
AT HOMES
INDUSTRIES
METALS
NB. Mosquitoes breed in stagnant water and spread the organism of malaria, yellowfever, Dengue fever and filariasis, small black water flies.
Which leaves in water may spread the micro-organisms causing river blindness {onchocerciasis}
15
The water supply must be protected from children playing and animals defecating, urinating, disposing of refuse, bathing, washing
clothes, swimming should not be allowed in or near water supply.
Parts of rivers and lakes used for domestic purposes and spring should be protected and fenced around. Wells should be dug deep and
cemented or bricks to the first impermeable soil to prevent shallow and deep water mixing.If possible a pump should be fitted as a use of
buckets may contaminate the water.
If a pump is not possible, a wall should be built around the well and have a good fitting lid/cover, Ion pipes should be used not lead.
Pipes and pumps should be kept in good condition.
The ground around the well should be cemented with a drain to lead away wasted water.
Latrines, septic tanks or soak pits should be at least 50 meters from the water source.
The water should be kept in clean containers kept covered and raised off the ground.
Hands should be washed before handling containers.
A dipper should be used for removing the water and left floating and dipper not used for other purposes.
Hands should not be dipped in water.
Children should not be allowed near the water places.
STORAGE OF WATER
In homes, water may be kept in clean pots or galvanized irons or cement tanks at the side of the house.
1. WATER POTS.
Water pots must be kept clean, covered raised off theground, no hand dipping in a pot.
2. TANKS.
Made either by galvanized iron or concrete and built at the side of the house. Water is collected off the roofs by means of gutters and pipes
leading to the tank. The tanks should be made in so that a person can enter in it and clean, but to have a tightly fitting lid to keep out insects
and impurities. The openings where the water runs in should be covered with wire gauze to keep out mosquitoes and refuse .The tap for
drawing off water should be atleast 12 cm from the bottom of a tank to avoid drawing off the sediment from the tank.
There should be a drain around the tank to carry away waste water .Arrangement should be made to reject the first rain water as it is highly
contaminated.
3. AT WATER WORKS.
Water is stored at large scale and in a large covered ventilated tanks and pumped the towns, buildings and houses through pipes.
PURIFICATION OF WATER
1.NATURAL PURIFICATION.
When water is moving slowly, solid matter such as mud, sand settle at the bottom.
Water plants absorb carbon dioxide and give out oxygen.
Sun light and oxygen kills many germs and prevent growth of others.
Some germs are eaten by the protozoa; protozoa are eaten by the insects and insects eaten by the fish with their larva.
2.ARTIFICIALLY PURIFIED
I. Boiling.
Kills many germs and destroy in organic impurities .The water is allowed to boil for five minutes, it is then poured into a clean covered container
and allowed to cool
The water filters through the, stones, gravel and sand into clean water pot underneath.
3. Chlorinating.
¼ or four drops of chlorine or lime is added to 16 liters of water and left for ½ an hour ,the water is then safe for drinking .
4. Candle filter
This consists of two containers; the top container has one or two candle filters. The impure water is then poured into this container and then
placed on top of the bottom containers.
This filter through the candle filters into the bottom container .There is a tap at the bottom side for withdrawing the clean water.
One tablet of aqua is dropped into 20 liters of impure water and left for 30 minutes and after that the water is safe for drinking.
Water from the river and lakes passes into the sedimentation tank, large open tanks and stay for three or more weeks where natural purification
takes place by the following process.
a) Sedimentation
b) Sunlight.
c) Oxygen.
d) Natural death of germs as they do not survive for three weeks then water passes for filtration process.
The water passes through a filter bed made up of:
At the bottom are stones.
Above this layer of gravel.
A layer of sand.
A green gelatinous layer of algae made of minute pants forms of top.
This green layer is the real bacterial filter and filters90% the bacteria in the water. When this layer becomes too thick, it is removed and a new
layer is allowed to form. This takes about two days.
Chlorinating
Next the water is piped to the chlorinating house where chlorine gas is added ,this kills germs and sterilizes the water.
Storage tanks
The purified water is piped to large, covered ventilated tanks and from there the water is piped to towns and buildings through iron pipes.
SANITATION
Definition
AIMS
17
It prevents breeding of mosquitoes and other insects.
Prevents contamination of food, water, air.
DISPOSAL OF REFUSE
Refuse are present both in towns and rural areas and they should be disposed of in a proper way.
IN TOWNS
Then the local authority collects the refuse once or twice a week in a closed vehicle where it is disposed of outside the town or city.
METODS OF DISPOSAL
Burying
Incineration
Others like papers and rags reused for other purposes.
Others are reused for feeding animals.
IN RURAL AREAS
In rural settings, refuse not deposed as in town.Here each household is responsible for disposal depending on the type of refuse.
Burning is the most hygienic method of disposal,waste like papers, magazine, etc.And there should be a specific place for it
Burying waste such as broken glasses, bottles,empty tins,etc, a piece of land should be for that.
Compositing.Fruits, vegetables can be poured into a pit and used later for manure.
Waste food.Used for feeding animals or emptied into pit for manure.
Waste water.Watering plants or allowed to soak away into soak pit.
IN HOSPITAL
1. Contamination
-It contaminates/ pollutes air giving bad smell, and also water supply as industrial waste is disposed into
2. Spread of diseases
-Can spread water born diseases like typhoid, dysentery, hepatitis, cholera, and poliomyelitis.
-Due to bad smell, flies can get attracted and breeds there.
4. Home accidents
5. Dirty home
-Rubbish left any how gives the home an uncared for appearance.
6. Poor soils
METHODS
Pit latrines
The flush lavatory
18
NB.Other type of toilets like dry may be risky and needs excreta attention.
A PIT LANTRINE.
UN-CEMENTED FLOOR
Swept daily.
Smear once in a while.
Walls haveno cracks.
Other care as above.
Fills up quickly.
Over flow during rainy season [contamination].
Flies breeds in them.
Children may fall in it as not well protected
Definition
The water carriage system is a process by which the sewage is taken away by means of water through pipes to the sewage disposalworks for
treatment and disposal.
19
COMPOSITION
a. COLLECTING PLACES.
These are places like sinks, hand basins, baths for waste water and flushes lavatory pads for urine and feaces. The water from the
collecting places passes from down into the draining pipes.
Feaces and urine are passed into the lavatory pans and is washed away by flushing the water. The water then enters the pans from
around the rim and washed down at the same time, leaving from clean water in the trap. Traps are found under all collecting places that
are a bend in the pipes and containing water called water seal. This prevents smell from decomposing sewages passing into the house.
b. DRAIN PIPES.
These are pipes that carry water away from collecting places up to sewage works. Rain water pipes carry rain water of gutters of roof
while Soil pipes carry excreta from lavatory pans. These pipes enter the ground and empty contents into house drain. House drains
Underground pipes that slope down wards to inspection chamber. Inspection chamber is where house drain empties. It passes in channel
to enter another pipe a continuation of house drain. The chamber is for inspection, clearage of blockage and disinfection. Each building
has own house drain and all the house drains empty into the sewer. The sewer is a very large pipe underground set in cement and slopes
down ward to sewage works.
C.SEWAGE WORKS
From the sewer the sewage enters iron grid which holds back large objects like papers, rags. They are removed and burnt .Sewage
passes into sediment tanks which is a large sloping tank for storage of sewage for 24hrs for solid to settle. This solid is called sludge and
liquid part is called effluent while in sediment tank bacteria works on it making it harmless and eventually used as manure. Effluent
passes through filter bed made of stones on which green gelatinous layer forms on top. The green layer filters 90% of bacteria. The
effluent purified is then poured into sea, rivers, and lakes but in hospital, effluent drains a way in soak pit. Soak pit is a large hole dug in
the ground filled with stones where effluent part is carried by pipes and drains a way into the ground. A soak pit is also used for draining
waste water from sinks, baths, etc.
Houseflies
Tsetse flies
Tumbu flies
The rat flea
Cockroaches
HOUSE FLIES
Diarrhoea
Amoebic and bacterial dysentery
Typhoid and paratyphoid
Cholera
20
Gastro enteritis
Eye and skin infection
Thoughts to transmit yaws as they are attracted by sores.
The house fly feeds and breeds on feaces, decaying matters.E.g. animals, vegetable.
The female lays eggs and hatch into larva in 1-3 weeks according to climate. After about one week, the larva forms the pupae and the adult fly
emerges from pupae after about 3 days, one week after emerging from pupae, the female lays her first batch of eggs in a batch. The house fly
leaves about 4 weeks during that time, the female lay about 6 batches of eggs so that each female fly lays about 1000 eggs in her life time .The
flies are active by day and rest at night. The bodies and legs covered with hairs. When flies land on feaces or decayed matter sores wounds, the
germs become to the hairs on their bodies and legs and then carry these germs onto human food, skin and eyes when they land on them.
PREVENTIONS
Breeding should always be eliminated by proper building, use and care of latrine.
Refuse bins should not be overfilled and always kept covered.
To avoid attracting flies, home should be kept clean and well ventilated.
Food should be kept covered and waste food placed in covered container until disposal.
Wounds and sores should be covered with clean bandage
To avoid flies spreading diseases, exposed utensil should be turned upside down and food kept covered.
Babies and young children should be protected using mosquito net when sleeping.
Health education to public on breeding and feeding habits of flies, their dangers and prevention.
TSETSE FLY
This is the type of fly that lives and breeds in bushes along rivers and streams.
LIFE CYCLE
The tsetse fly breeds and lives in the bushes. The female lays a single larva at a time and lay about 12 larvae in a life time. She lays the larva in a
worm shady place on the ground usually in swampy areas or vegetable growing along the banks of rivers and lakes.
The larva develops into pupa and after about 3 weeks, the pupa becomes an adult fly.
The adult fly lives for about 3 months. The tsetse fly both male and female carries the protozoon of sleeping sickness, the trypanosome. The flies
bit both man and animals and always attack by and only bit in open. They do not enter the house or other places inhabited by man.
The fly has to bit an infected animal or person and suck up infected blood in order to become infected fly bits a victim the trypanosome. When
the infected fly bits a victim the trypanosome is injected into the body, enters the blood
PREVENTION
21
DISEASES SPREAD BY TUMBU FLIES.
LIFE CYCLE
The female lays eggs on dry soil, sand and Eggs hatch into larva in 2 days and larva develops into adult.
Open the entrance made by the larva and squeeze it out and apply antiseptic to the wound.
PREVENTION
Definition
Epidemiology is a branch of medical science which deals with epidemics and its control.
OR,
Epi,meaning –upon.
Demos, meaning –people.
Logos, meaning –science.
INCIDENCE
-Number of people developing the disease during a defined period of time per 1000 population.
PREVALENCE
-Is the number of people having a disease at a given point of time or during a defined time period per 1000population.
CASE
RATE,
-Is the number of occurrences of an event per unit time expressed per 1000 population.
CARRIER
-Presence of a specified infectious agent in the absence of chemical diseases. A carrier serves as a potential source for further transmission in the
community[temporary carrier state lasts for less than six months but chronic carrier state may last for life longer].
CONTACT
-Exposure to a source of an infection. Transmission due to direct contact may occurwhen the skin or mucous membranes touch as in the body
contact, kissing or sexual intercourse.[also known as contagious disease].
RESERVOIR OF INFECTION
-The natural habitat of an infectious agent where the infections agent may survive or multiply. [May be human or animal or soil].
PATHOGEN
EPIDERMIC
22
-Occurrence of disease in a community area, clearly in excess of what is expected also called an [out break]
ERADICATION
-Termination of an infectious agent resulting in cessation of transmission of infection from given area.
EPIDEMIOLOGY TRIAD/CHANNEL/PROCESS
The disease process demands connection between those conditions for interaction in order to invade and multiply in the body. They are;
Agent.
Host.
Environment.
1. Agent factor
Non-communicable agent -is the one whichdoes not transmit diseases to others and they include the following;
Physical agent.
Chemical agent.
Biological agent.
Nutritional agent.
i. Physical agents, includes; Heat,light radiation etc.
ii. Chemical agents include; Acids, alkaline, metals etc.
iii. Nutritional agent, includes; lack of or excess nutritional factors.
iv. Biological agents, these are disease causing organism that are always transmissible from one individual to another individual and
therefore they are called communicable diseases, and are transferable only through another medium like insects.
2.Environmental factor, Is the aggregate of all external conditions and influences affecting the use and development of an organism.
CLASSIFICATION
i. Physical environment. All those inanimate objects like; water, food, etc.
ii. Biological environment. All those animate objects like; animals, insects and other humans.
iii. Socioeconomic environment. Social and economic factors like housing social group, education, etc.
3.Host factors
This is a condition which determines the outcome of interaction between the agents and host in a suitable environment.
CLASSIFICATION
Age
Extreme age of children and elderly have low immunity making them susceptible to infections.
Sex
Female commonly suffer infectious especially the pregnant ones due to suppressed immunity meanwhile men usually suffer from prostitis or
enlargement of the prostate gland.
Some health habits eg spitting, careless excreta disposalpractice in some communities frequently predispose to epidemics.Some customs like
male circumcision may transmit infections.
Genetic factors
Abnormality in the gene of individuals during cell division may predispose to infections.
23
NATURAL HISTORY OF DISEASE
Every disease has a period before man as involved .This followed later by the interaction between the Agent, Host and Environment.
If the host is to withstand the stimulus, the disease process will not be allowed to progress but if the agent takes the upper hand, the disease
progresses with the tissue and physiological charges in the body.
1 Pre-pathogenesis phase
2 Pathogenesis phase
PRE-PATHOGENESIS
EARLY PATHOGENESIS
LATE PATHOGENESIS
If the signs and symptoms are not recognized earlier and the disease is treated, it may result in to disability, defect or death or may end in
to complete recovery without any disability depending on the host factor and effectiveness of the treatment taken.
SUMMARY OF PATHOGENESIS
Primary prevention
Secondary prevention
3.Tertiary prevention
PRIMARY PREVENTION
Primary prevention means action taken prior the onset of disease and it removes the possibility that the disease will never occur and these
include;
Health prevention through health education, good nutrition, good hereditary and other health promotion activities.
Specific protection through disinfection of food and other particles, immunization.
SECONDARY PREVENTION
This means an action which halts the progress of diseases at its early stage and prevents complications. This can be done through early diagnosis
and early treatment.
TERTIARY PREVENTION
This means the disease process has advanced beyond its early stages but still possible to accomplish prevention. Or can also be defined as all
measures available to reduce or limit impairment and disabilities, minimize suffering caused by existing departures from good health and to
promote the patients adjustment to irremediable conditions.
Disability limitation.
Rehabilitations.
Infection may be transmitted from the reservoir of infection to the susceptible individual in many different ways as follows;
24
1.Direct contact.
This is direct contact from the skin to skin, mucous to mucus of another person eg during touching,kissing,sexual intercourse may spread contact
disease like STDs, AIDs,leprosy,hepatitis B.
2.Droplet infection
This occurs due to contact transmission by infection agent contained in most respiratory secretion expelled during sneezing, speaking, coughing
spitting and may spread disease like TB meningitis etc.
Infection agents are present in soil and can cause disease when the host comes in the contact with the soil and this may cause disease like hook
worm, tetanus etc.
The disease causing agent may be inoculated directly in to the skin or mucosa e.g. by the syringe/needle.
IN THE COMMUNITY
Health education on cause, mode of spread, predisposing factors and prevention of diseases.
Proper domestic waste disposal and management.
Practicing good habit.
Individualized constricting pit latrines and practicing its proper use.
Prevention of water contamination before consumption.
HEALTH EDUCATION
25
DEFINITIONS OF KEY TERMS COMMONLY USED IN HEALTH EDUCATION.
HEALTH EDUCATION
This is the process that informs, motivates and helps to adopt and maintain healthy practice and life styles.
COMMUNICATION
Communication means interchange of thoughts/information between two or more people without alteration of the meaning and a feed back is
given.
EDUCATION
Education is a conscious and deliberate process in which one personality acts upon another in order to modify the developments of that others by
the communication and manipulation of knowledge.
LEARNING
TEACHING STRATEGY
Is a desired method /devise used to impart knowledge and skills that suits the learners needs and abilities using available facilities, environment.
These are teaching aids that can be seen/observed as well as heard used to modify/ stimulate learning.
TEACHING.
Teaching is an intimate contact between a more mature /knowledgeable personality and a less mature one which is designed.
This is a means through which the teacher, thelearner, the curriculum and other variables are organized in a systematic manner to attain the
determined goals and objectives.
HEALTH PROPAGANDA
This is a passive process of propagating the health ideas to the people, while the education is really an active and dynamic process of gaining
knowledge through understanding and bringing the knowledge into practice.
MOTIVATION
Is a transformation in the internal strength of a person which is identified by the zeal or arousal and goal oriented behavior.
5) Participation approach.
Health education aims at promoting community participation in health promotion.
1. Identification
The health educators should identify the community by obtaining the intellectual and cultural identity with the people i.e. should know the
local language used and the culture of the community.
2. Involvement.
He/she should involve the family members during practical demonstrations because this promotes self-reliance and self-confidence.
3. Indigenization.
4. Indoctrination.
It is constant reputations of few simple messages because this influences the health practice and behavior of the population.eg wash hands
before handling of food.
5. Integration.
6. Influences.
The health educator should identify the community leaders to influence the process of health education.
7. Innovation.
Innovation is needed in the art and style of delivering the health the health message to suit every population.
Credibility.
This is simplifying scientific facts into a simple meaning.
Interesting topic and objectives.
The topic should be of interest to both the community ant the educator.
Participation.
Involve the group during demonstration.
Motivation.
Encouragement and positive reinforcement needed.
Comprehension.
Understanding the learning capacity needed for the learners and the educator.
Reinforcement.
Continuous encouragement
Learning by doing.
Encourage permanent learning.
Known to unknown.
Educating starting from simple subjects to more difficult subjects
Setting an example
Appropriate and relevant examples
Good human relations.
Language, eye contact and demonstration skills
Feedback.
Provide the effectiveness about teaching.
Community leader involvement is needed
1. Lecture method.
27
This method is useful in imparting information to group of any size. It is most commonly used formal oral presentation. The preferable
size of the group should be 30-45.
2. Group discussion.
It gives opportunity to exchange ideas and views among health educator and audience. The group leader should control the discussion.It
can be done in formal or informal settings.
3. Demonstration.
It is an important technique of health education. Learning by doing provides more permanent knowledge. The health educator should use
running comments and a discussion. E.g. Oral rehydration solutions preparation (ORS)
4. Role playing.
It is asocial drama in which certain roles are enacted spontaneously by the group to express certain values not only in words but also in
expression and action.
5. Skits.
It is formaldramatized presentation after due presentation and rehearsal. It usually evokes emotion and stimulates thinking process and
discussion.
In this method particular event, health situation or condition is presented in details to a group or participants. The group is then helped to
discussed related problems, factors, suggest alternative solution to deal.
7. Field trip.
Education tour is organized for a group to have first hand information through direct observation.
8. Brain storming.
Participations are asked to throw out there as many ideas as possible on arisen issues or problems or topic.
9. Panel discussion.
A panel consists of 4 to 8 ideas on views on a particular or health topic in front of a large group.
The group of individuals works together the solution of a problem with help of consultant and resource personnel.
Select Educator
Acceptability.
The community health nurse should be friendly to cooperative and sympathetic to the consumers. She should be good listerner,
observer and honest. She should encourage the community in discussion obtain feedback.
Maturity.
The community health nurse should be mature enough across his views on sensitive issues in an objective and dispassionate manner.
She must never lose the creditability and confidence of people.
Conviction.
The community health nurse conviction can add creditability to his health message, his commitment can drive him towards
achieving his education objectives. Lack of conviction and commitment can leads to mistrust on health educator.
Communicator.
Community health nurse should organize and explain the message in very simple language so that it will easily be understood by the
population.
Training.
Community health nurse should have undergone training in the art and science of education and communication.
30