PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

MS. LINA DEBBARMA

1ST YEAR MSC NURSING

COMMUNITY HEALTH NURSING

YEAR 2008-2010

PADMASHREE COLLEGE OF NURSING

GURUKRUPA LAYOUT, NAGARABHAVI,

BANGALORE-72

RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. / NAME OF THE CANDIDATE AND ADDRESS / MS. LINA DEBBARMA
1ST YEAR MSC NURSING
PADMASHREE COLLEGE OF NURSING,
GURUKRUPA LAYOUT, NAGARABHAVI,
BANGALORE-72
2. / NAME OF THE INSTITUTION / Padmashree college of Nursing,
Bangalore
3. / COURSE OF THE STUDY AND SUBJECT / 1ST Year MSc Nursing,
Community Health Nursing
4. / DATE OF ADMISSION TO THE COURSE / 2/6/2008
5. / TITLE OF THE STUDY: / To assess the knowledge, attitude and practices of mothers regarding domestic methods of water purification in selected rural area, Bangalore.

6. Brief resume of the intended work

6.1 INTRODUCTION

Water is one of the very crucial natural resources.It is available abundantly on the surface of earth .There is about 1.4 billion cubic kilometer of water on the earth which comes about 71percent of the earth’s surface.About 97 percent of the water on the earth is in the oceans.The ocean water is salty and is not suitable for human consumption.The remaining 3 percent of the total water is available in the form of ice sheets,clouds,river,lakes,ponds,well and springs.Only 1-1.6 percent of the 3 percent of water,is useful for human consumption.

The water on the surface of earth has its own journey.The water from the ocean gets evaporated by the sun’s heat.Evaporated water,rises up into the air and forms clouds and later fall onto the earth in the form of rain and snow and flows on the earth as streams, lakes,rivers which ultimately fall in the oceans like air,water is also very essential for man to survive.But unlike air,man can live without water for about a week or so.The water which is required for human consumption should be palatable and free from any kind of impurities so that it is safe and suitable for daily activities1.

One of the essential public health care element is safe drinking water and sanitation.In 1990, more than1 billion people in developing world lacked access to safe drinking water and nearly 2 billion people lacked on adequate system for disposing off their excreta. Faeces deposited near homes,contaminated drinking water,fish from polluted rivers and coastal waters, and agricultural produce fertilized with human waste are all health hazards.Water quantlity is as important as water quality.Washing hands after defecation and before preparing food is of particular importance in reducing disease transmission,but without abundant water in or near home,hygiene becomes difficult or impossible.The lack of water supply and sanitation is the primary reason why diseases transmitted via faces are so common in developing countries.The most important of these disease,diarrhea and intestinal worm infestations,account for 10 percent of the total burden of disease in developing countries.

The National Water Supply and Sanitation Programme was launched in 1954 by the govt. of India as part of the health plan to assist the states to provide adequate water supply and sanitation facilities in the entire country.Provision has been made in the successive 5yrs plans to improve the water supply.In 1972 a special programme known as the Accelerated Rural Water Supply and Sanitation Programme. During 5th plan, rural water supply was included in the minimum needs programme of the state plans.The central govt. is supporting the efforts of the states in identifying problems villages through assistance under Accelerated Rural Water Supply Programme.A “problem village” has been defined as one where no source of safe water is available within a distance of 1.6km,or where water is available with in a distance or depth of more than 15meters,or where water source has excess salinity,iron,fluorides and other toxic elements ,or where water is exposed to the risk of cholera.

The Govt. of India launched the International Drinking Water Supply and Sanitation Decade Programme in 1981.Tergets were set on coverage-100% coverage for water,both urban and rural,80% for urban sanitation and 25% for rural sanitations.

Swajaldhara was launched on 25thdec.2002 sajaldhara has certain fundamental reform principles, which need to be adhered to by the state govts. And the implementing agencies.Swajaldhara is a community led participating programme,which aims at providing safe drinking water in rural areas,with full ownership of the community,building awareness among the village community on the management of drinking water project including better hygiene practices and encouraging water conservation pratices along with rain water harvesting2.

6.2 NEED FOR THE STUDY

Water is nature’s most abundant resource which man has always been taking for granted.Studies indicate that less than 1% of the world’s water is available in the form of rivers,ponds and lakes for human use. But today,because of the rapid decline of ground water levels and over exploitation of the surface water there is acute shortage of fresh water.This serious situation can be reactified through on age old practice called rain water harvesting.

Man’s health affected by the ingestion of contaminated water either directly or through food:and by the use of contaminated water for purpose of personal hygiene and recreation.The term water-related diseases include the classical water-borne diseases.Developing countries carry a heavy burden of water-related diseases,the heaviest being the diarrhoeal diseases.

In India,water pollution is becoming a serious problem.To protect water from being contaminated,Parliament in 1974 passed the water (prevention and control of pollution)Act.The Act seeks to provide legal deterrent against the spread of water pollution.The Act is a comprehensive piece of legislation.It provides for the constitution of Central and State Water Boards and Joint Water Boards endowed with wide powers for controlling pollution.

Much of the ill-health which affects humidity,especially in the developing countries can be traced to lack of safe and wholesome water supply.Water that is easily accessible,adequate in quantity,free from contamination, safe and readily available throughout the year .There can be no state and positive health and wellbeing without safe water.Water is not only the vital environmental factor to all forms of life,but it has also a great role to play in socio-economic development of human population.Each country should develop its own water resources,exploitation and hydrogeology.In 1980,the United nations general assembly launched the International drinking water supply and sanitation decade,1981-1990 the aim being to provide all people with adequate supplies of safe water and sanitation by 1990.In 1981,the 34th World Health Assembly in a resolution emphasized that safe drinking water is a basic element of “primary health care” which is the key to the attainment of Health for All by the yr 2000 AD.Water is also integrated with other PHC components because it is an essential part of health education,food and nutrition and also MCH.

When community is provided drinking water by a water supplier, the water provider is responsible for testing the water according to Environmental Protection Agency(EPA) standars.The results of their testing must be reported to those who purchase the water,in the form of a consumer confidence report(CCR).Community health nurses should review consumer confidence reports,sometimes referred to as right-to-know reports,to determine what pollutants have been found in the drinking water.If the

drinking water poses an immediate health threat, the water provider must send emergency warnings to the community via the local newspapers, radio and television.3

To ensuring access of safe drinking water is a major public health concern.The outbreaks of disease from water-borne pathogens in communities like Walkerton and North Battleford alerted the federal Govt. to the need for a standardized multi-barrier approach to managing public drinking water distribution systems.Although many provinces and territories have adopted such an approach,there are problems with water quality throughout Canada. The conducted community health needs and resources assessment study in Newfoundland and Labrador to assess health beliefs and prac tice.,satisfaction with health and community services and concerns in relation to community health.The results indicated that the quality of drinking water was a series concern.The finding and implications for nursing practice in relation to developing healthy public policy and population health initiatives.4

A study was carried out gastroenteritis associated with contaminated grey water . 921 exposed household had(A) a higher attack rate for diarrhea(54.1%) than a non exposed 1529 household from an adjacent area(B).Household water score showed a dose-response with illness,in both area A and B.For each 1000 inhabitants, 19.8 cases in area A,7.0 cases in control area B and 3.3cases in a more distant control area C were diagnosed with gastroenteritis by their general practitioner.A gastroenteritis outbreak associated with consumption of contaminated drinking water was observed in the exposed area.The use of grey water was banned with the exception of rainwater use for flushing toilets.5

A pilot project was done to prevent diarrhea in a rural .The project is done to improve drinking water quality using geavity-fed,household based,ceramic water filters.It is done among 60 households in the community.Water filters eliminated thermotolerant(faecal) coliforms from almost all intervention households and singficantly reduced turbidity,there by improving water aesthetics.After adjustment for household clustering and repeated episodes in individuals and controlling for age and baseline diarrhea,prevalence of diarrhea among the intervention group was 51% lower than controls,though the protective effect was only borderline significant.The study concluded that water samples from all regularly used filters were free of thermotolerant coliforms.6

The destroyed drinking water infrastructure, placing over 500000 displaced and increased risk of waterborne disease. The water handling behaviours to household water quality in three districts In the 21 communities 1127 households are tested and stored water.Factors associated with a reduced likelihood of having contaminated stored drinking water included obtaining water from improved sources,using clorine solution and having free clorine in stored water.Repeted boiling,even among those who could describe correct practice,was not associated with improved water quality .Water source improvement and household water clorination appear to be useful strategies to improve household stored drinking water quality in post-disaster situations.7

Using contingent valuation survey data for about 2700 household in rural Bangladesh and applying a multinomial logit models,the paper estimates the value of arsenic-free drinking water to the rural people .The estimates indicate that the rural people in arsenicpaffected areas of Bangladesh place a low value on arsenic-free drinking water .It is about 10 -14% of the amount they are willing to pay for piped water and only about 0.2-0.3% of the average household income.The implecation of the result is that robust but costly arsenic reduction technologies such as activated alumina technology may find little social acceptance,unless heavily subsidized.8

6.3 STATEMENT OF THE PROBLEM

A study to assess the knowledge, attitude and practices of mothers regarding domestic methods of water purification in a selected rural area, Bangalore.

6.4 OBJECTIVES OF THE STUDY

  1. To assess the level of knowledge of mothers regarding domestic methods of water purification.
  2. To assess the attitude of mothers regarding domestic methods of water purification.
  3. To discuss the practices of mothers regarding domestic methods of water purification.
  4. To find out theassociationbetween knowledge, attitude and practices of mothers regarding domestic methods of water purification with selected demographic variables.

6.5 OPERATIONAL DEFINITION

  1. Knowledge- Knowledge is referred to level of understanding and awareness of mothers regarding domestic methods of water purification.
  2. Attitude- Attitude is referred to a way of thinking or feelings expressed by mothers regarding domestic methods of water purification.
  3. Practices- It refers to methods adopted by mothers for domestic water purification.
  4. Mothers-In this study mothers who are married housewives having under five children.
  5. Domestic methods of water purification-It refers to a process of purifying water at home level by domestic filtering and boiling.

6.6 ASSUMPTIONS

  1. Mothers may have inadequate knowledge regarding domestic methods of water purification.
  2. Mothers may have negative attitude regarding domestic methods of water purification.
  3. Mothers using contaminated water lead to water borne diseases such as typhoid, dysentery, and diarrhea in under five children.

6.7 HYPOTHESIS

H1 There is a significant differences between knowledge, attitude and practices among rural mothers regarding domestic methods of water purification.

H2 There is a significant association between knowledge, attitude and practices among rural motherswith selected demographic variables.

6.8 REVIEW OF LITERATURE:

“A review of literature in the research topic makes the researcher familiar with the existing studies and provides information which helps to focus on a particular problem and lay a foundation upon which to base new knowledge. It creates accurate picture of the information found on the subject” (Polit and Hungler; 2000).

The investigator carried out on extensive review of the literature on the research topic in order to gain in deeper insight into the problem as well as to collect maximum relevant information for building up to study.

The study was done for chlorination and safe storage of household drinking water in developing countries to reduce waterborne disease. The use chlorination and storage in special plastic containers of gathered household water for improving microbial quality and reducing diarrheal illness. Community families were recruited and randomly divided into intervention and control households. Microbes in stored household water were extensively inactivated by 1-5mg/L doses of hypochlorite. Escherichia coli level in stored households water were<1/100ml in most intervention households but readily detectable at high levels in contral households. The intervention reduced household diarrheal illness.9

A study was conducted to reduce fecal contamination to improve the microbiological quality of market-vended beverages with a simple system consisting of dilute bleach(4.95% free available chlorine)for water purification.The narrow-mouth plastic vessels with spigots for disinfecting and storing water and for preparing and storing beverages,handwashing soap and education in using the system.The intervention trial among 41 vendors and 42 control vendors,comparing total and fecal coliform bacteria and Escherichia coli contamination of market-vended beverages,stored water and vendors hands.It was obtained at baseline and at each of six weekly follow up visits.The fecal coliform bacteria were found in 40 (48%)market-vended beverages and E.coli in 14(17 %). When compared the sample it decreases the total coliform (p<0.001)and fecal coliform(p<0.001) from stored water and beverages. .10

A study was conducted to examine bacteriological quality of drinking water and Store household water. The main sources of water are springs, rivers and wells during the rainy season, there was a considerable contamination of drinking water and during household storage which mirrored the unhygienic environment. To improve water supply system consisted of piped,untreated surface water from an unhibited mountain area. Technical interventions aimed to improve water supply in rural areas of become effective combined with comprehensive health education programme for population concerned.11

A study was conducted to improved for safe drinking water in rural areas of Bangladesh, through drinking water high rates of diarrheal decease morbidity indicate that pathogen transmission continues through water supply. 200 and 70 tube - well water samples and 300 water samples from household storage contains were tested for fecal coliform (Fe) concentration. The contamination rate for water samples from covered household storage contain s was significantly lower than uncovered containers. It is shown that safe drinking water was achieved by the combination of a protected and high-quality sources at the initial point and maintaining quality from the initial supply point.12

The study was conducted to improve hygienic practices of the rural and community among housewives. The study was conducted in two villages where the chemical and biological water quality was analyzed by some hygienic practices. After three months to water quality of the houses was tested to ensure the quality aspects of the hygiene practices. Based on the findings, the chosen methodology was able to promote a real change in improving to water quality on household taps and in improving hygienic practices and knowledge.13

The study was conducted among HIV affected household in rural area to safe water systems (S. W. S.) and to reduce diarrhea and death. It is a home based health care package that included rapid diarrhea diagnosis treatment of 196 households with relatively good water and sanitation coverage. The high SWS cost per DALY gained was probably caused by a lack of mortality benefit in a trial designed to rapidly treated diarrhea. SWS is an effective intervention whose cost effectiveness is sensitive to diarrhea related mortability, diarrhea incidence and effective clinical management.14

The study was conducted to improve the practice on storing water in, and handling water from storage containers at home. The practice had to the deterioration of the microbiological quality of the water in domestic storage containers. Results indicated in significant improvements in practices. This was supported by insignificant improvements in the microbiological water quality, that was still above health - safety limits. It is suggested that some negative water hygiene habits may readily change, while behaviour of a more personal nature, such as hand -washing, was not easily changed.15