RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE,
KARNATAKA.
“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON PREVENTION OF WORM INFESTATION AMONG PRIMARY SCHOOL CHILDREN AT SELECTED PRIMARY SCHOOL AT BANGALORE.”
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
MS.C.RAJANI.
BANGALORE CITY COLLEGE OF NURSING
BANGALORE-43 KARNATAKA
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,BANGALORE,
KARANATAKA.
RAJIVGANDHIUNIVERSITYOFHEALTH SCIENCES,BANGALORE.
KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECT FOR SYNOPSIS
1 / NAME OF THE CANDIDATE AND ADDRESS / C.RAJANI160,CHELEKERA MAIN ROAD,BANASWADI OUTER RING ROAD,KALYAN NAGAR.
2 / NAME OF THE INSTITUTION / BANGALORE CITY COLLEGE OF NURSING, BANGALORE.
3 / COURSE OF STUDY AND SUBJECT / I YEAR M.SC.(N)
COMMUNITY HEALTH NURSING
4. / DATE OF ADMISSION
TO COURSE / 18-O4-2011
5. / TITLE OF THE TOPIC / “A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON PREVENTION OF WORMINFESTATION AMONG PRIMARY SCHOOL CHILDREN AT SELECTED PRIMARY SCHOOL AT BANGALORE”.
6. BRIEF RESUME OF INTENDED WORK
INTRODUCTION
‘Unless the investment in children is made, all of humanities most fundamental long term problems will remain fundamental long term problems’.
State of World’s Children(1991)
Children constitute a large sections of the population in India. It is a great challenge to the nation to provide health, education and food to the children below 15 years who are the dependant, unproductive section comprising 40% of the total population of the country (Census 2006). This is the section of population with great potential. “Children are the wealth of tomorrow. Take care of them if your wish to have a strong India, ever ready to meet various challenges” said Jawaharlal Nehru.
The formative years of childhood has greater risk for morbidity and mortality. In most cases, the manifold childhood problems are interrelated and affect the growth and development of children, the most common ones being infections, parasitic infestations and malnutrition. Worm infestation has a close relationship with the socio- demographic and ecological factors like poverty, illiteracy, poor personal and environmental hygiene. Children are at special risk due to their activities like play and lack of importance to personal hygiene. From the children, the entire family may get worms and suffer. Therefore any interventions with short and long term goals should be carried out aiming at children specifically.
The school has the advantage of having a single roof providing systematic education for development of children. The UN declaration of the rights of children (1959) gives the child pride of place and also makes the people aware of his / her rights and duties towards self and others. India being a signatory to this UN declaration has ensured education as one of the fundamental rights. With the universalisation of primary education, it has become easier to penetrate larger, needy sections of society through schools. Therefore in this modern age school can effectively become an agent of change.
6.1. NEED FOR STUDY
‘The day will come when nations will be judged not only by their military or economic strength, not by the splendor of their capital cities and public buildings, but by the wellbeing of their people: by their level of health, nutrition and education
- Progress of Nations
Health education, an effective tool which aims at promoting health should therefore be given at
a young age when habits are formed in the childhood and the child is in the process of being educated to lead a civilized life taking responsibilities in society. Schools, where the children spend most of the time of their formidable age is the place best suited for imparting health messages. A comprehensive, continuous and interdisciplinary health education offering information, motivation and skills is vital to the improvement of the health of all citizens forever.
And the time has come, Health, nutrition and education are the most important issues related to the children. These issues are very closely interrelated, and an unhealthy, malnourished child of today will only contribute to unhealthy future of the country. Therefore most countries of the world recognize this urgent need of providing health, nutrition and education to children. The significance of giving first priority to the children’s needs can be understood by these words. “We are guilty of many errors and many faults, but our worst crime is abandoning the children, neglecting the foundation of life. Many of the things we need can wait. The child cannot. Right now is the time his bones are being formed, his blood is being made and his senses are being developed. To him we cannot answer ‘tomorrow’. His name is
WHO advocates the use of energies of young people and children towards health promotion. Child-to-child programme conceived by the Institute of Child Health in 1979 is such an effective, economical and active way of improving the health status of the community. Now the scope of child-to-child has widened from ‘sibling care’ to ‘child power’. Child-to-child programme is based on the principle that children learn better by doing; they interact with each other to learn, they influence adults, they are equal partners in education. It focuses on issues of health; and not mere absence of disease but the importance of happy relationships. It addresses issues of learning and links what is learnt now and what children know already. It links what is learnt in the classroom with what we do out of the class and at home.
The fundamental changes in primary education towards an activity oriented learning helps children to acquire knowledge and an liquidity based attitude. Child-to-child programme makes learning easier through activity and fun. It can be of particular relevance to India as children take back the message to parents who in most cases are less literature that their children, these words are best suited for child-to-child programme; “A small body of determined souls fired by an unquenchable faith in their mission can alter the course of history” (Mahatma Gandhi, 1946).
Health education is the most effective weapon to prevent and control illness. It promotes health, prevents and reduces suffering, prolongs life with quality with less cost. Timely health education provided at frequent intervals help all individuals to achieve good health by their own action and effort. Primary School age being a mouldable period is the most appropriate age to provide health education. The messages and lessons learnt at this tender age is easy to practice when they grow up in society. Children can also as messengers of health, to spread health messages in their families, friends and community.Child-to-child approach to health education is an
innovative, simple, costEffective and participatory approach that makes use of the potentials of Children to the maximum to spread health messages.
The investigator came across the problems of environmental sanitation and poor hygiene in communities during the field experience. It was identified that children and their families do not possess basic knowledge on worm infestation, though it is a preventable condition. However they knew that the worms live in the gastro-intestinal tract. Hence the investigator felt that there was a strong need to educate children and their families with minimum costs, within a short time with maximum effectiveness regarding worm infestation and its prevention.
6.2. REVIEW OF LITERATURE
Literature review refers to an extensive, exhaustive and systematic examination of publication relevant to the research study . In this study review of literature was done under the following headings.
Studies related to:
1. A studies releted to worm infestation.
2. Studies related to the effect of worm infestation among children.
3. Health education in school children.
1. Studies related worm infestation
Ramamani and Sharma (2000) conducted a survey in 32 slum clusters and eight colony houses in Delhi. Findings showed that 12.1% had intestinal worms, 25.9% had fever, 18.8% had respiratory infections in the 0-14 years age group due to poor environmental sanitation.
Awasthi and Pande ( 1996) studied the point prevalence of intestinal parasites and their association with nutritional parameters in Anganwadi centre under the integrated Child Development scheme ( ICDS) in Lucknow, India, using a cross sectional survey design.
Thirty two out of were girls and 51.7% were boys, between the age group of 1.5 to 3.5 years. Baseline information on socio-economic status of the family and history of passage of works in the proceeding one month were collected by personal interview. Height, weight and haemoglobin level were estimated. Mothers were instructed to collect fresh fecal specimen of the child and within eight hours direct fecal examination was done. Parasites were detected in 17.5% of children by a single direct fecal smear examination. Of these 124 (68.1%) were Ascaris lumbricoides and 60 (32.9%) were Giardia lamblia. There was no association between weight or height and parasitic positivity. The mean haemoglobiin levels for children who were smear positive vs smear negative for ascaris or giardia were 9.1 g/dl and 9.6g/dl. The study emphasized on the urgent steps needed on community basis to improve their nutritional status and
control parasitic infestation. It also suggested the need for studies with larger sample size of asses the effect of control of parasitic infestation on improvement of haemoglobin levels.12
Sharma, Gautam and Gupta (1993) conducted a study to assess the health and welfare status and rights of children below 15 years in slums of Agra City. Baseline information revealed that the health and living standards of children, socio-economic and educational profiles were very low and mortality and morbidity was very high. Personal hygiene was poor in 73% of children, nails were not trimmed in 75% took bath irregularly, in 85% teeth was dirty and showed poor personal hygiene was predisposing to gastrointestinal and parasitic disorders. 25
Bhandari, Gupta and Mandowara ( 1985) conducted a study to findout the prevalence rate of intestinal parasitic infestation and its correlation with social class, literacy status of mother, defecation habits, housing conditions and personal hygiene in Udaipur city. Detailed history regarding gastrointestinal symptoms,
socio- economic information of family, literacy of parents, housing condition and defecation habits of each child were noted. With appropriate instruction and demonstration parents collected morning stool specimen and scotch tape was used to identify the eggs of Enterbius vermicularis. All the children were examined for signs of nutritional deficiency and nutritional status was graded according to the recommendations of Indian Academy of Paediatrics (IAP). Of the 1022 children below 15 years, 45.5% showed the presence of parasitic infestation. There was a negative correlation with low socio-economic strata, illiteracy of the mother, in sanitary and inadequate means for disposal of human excreta and poor hygiene. Study concluded the need for political commitment and adequate resource mobilization. It also advocated the possibility of periodic administration of antihelminthic drugs.14
..Subbannayya, Kumar, Rao and Shivananda (1984) conducted a study in Udupi to find out the incidence rate of parasitic infestations in primary school children of six to
fourteen years and to compare the incidence with two different environments – urban hostel and rural non-hostel based on individual hygiene and availability of sanitary facilities. The sample included 366 children of whom 77 were urban hostel residents and 289 were rural non-hostel residents. Students collected the morning fecal specimen after specific instructions. Information on sanitary facility, food and walking habits, defecating place and economic status were obtained. The results showed Ascaris lumbricoides (70.4%) and Enterobius vermicularis (2.1%) . Incidence of ascaris was 52 (67.5%) and 206 (71.2%) and that of Enterobius vermicularis was one (1.2%) and seven (2.4%) in urban and rural areas respectively. Therefore the study recommended the need to insist on using foot wears, developing disciplined food habits, treatment of the infected cases and provision of better sanitary conditions. 26
Veerannan (1977) conducted a study to estimate rate of parasitic infestation in relation to age, Sex, diet, environmental hygiene and economic status around Madras city. Baseline information were collected. Faeces samples of 348 persons were tested. The study revealed 37 (10. 62%) had Ascarice lumbricoids, 24( 6.89%) had Aanchylostoma duodenalble, 9 (2.58%),had enterobius vermicularis . Ascaris had the highest incidence 11(23.87%) in zero to ten years Anchylostoma duodenable 9 (8.28%) in 11-20 years and enterobius vermicularis 2 ( 4.34%) in zero to ten years. Ascaris lumbricoided was comparatively higher in females & in non vegetarians . The study revealed that the provision of latrine would significantly lower the incidence of intestinal parasites. Surprisingly the prevalence rate was higher among the members using tap water than those who were using well water. The findings indicated that economic status was also an important factor governing the prevalence of parasitic infestation. 28
2.Studies related to the effect of worm infestation among children.
SowbhagyaRatna (2001) studied the effect of worm infestation among primary school children in Yelahanka, Bangalore. Quasi experimental approach with pretest-posttest without control group design was used. Purposive sampling technique was used to select 238 children of class V, VI, &VII. Tool consisted of personal data and 33 items related to prevention of worm infestation. Pretest was conducted and a structured teaching of 45 minutes was implemented on selected 25 children. After a week’s child-to-child education, posttest was conducted. The mean posttest scores were found to be significantly higher than mean pretest scores indicating that child-to-child programme was effective in increasing the knowledge of children regarding worm infestation. 2
Shirley (1997) conducted a study to assess the effectiveness of planned health education using child,
approach on the knowledge of vitamin B2 (riboflavin) in selected schools of Chennai. The sample included 133 peergroup members and 19 change agents of class VII selected by simple random sampling. The tool had 13 items and a total score of 40.
The learning module and audiovisual aids were used in health education. The results showed that the health education was effective. However there was no significant association between variable like religion, education of parents, exposure to television etc. There was a significant association with other variables-sex, income and academic influence of the peergroup at 0.05 level of significance. The study concluded that children can act as effective change agents in the society. 1
Patil, Solanki, Kolwi, Naik, Bhalerao & Subramaniam (1995) conducted a long term follow up of child-to-child programme. Fifty children were interviewed five years after they had completed a school based programme on anaemia, diarrhoea and