Narrative Report of Training of Co-ordinators in Health and Developmen
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- Title
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Narrative Report of
Training of Co-ordinators
in Health and Developmen - extracted text
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Narrative Report of
Training of Co-ordinators
in Health and Development
(For the period of 3 months - 10th July 2002 to 9th October 2002)
Report written by
Ms. Seema Deodhar
Dr. Prasad Johnson
Ms.Meenal Jagtap
Ms. Vaishali Gaikwad
Ms. Ashwini Patil
The Foundation for Research in Community Health
Pune / Mumbai
2003
THE
FOUNDATION
FOR
RESEARCH
IN
HEALTH
COMMUNITY
3-4, Trimiti-B Apts., 85, Anand Park, Aundh, Pune-411 007 INDIA
(020) 5887020
Tel
\\ 3
Trustees :
Fax : (020) 5881308
Dr. N. H. Antia (Chairman & Director)
E-mail : frchpune@giaspn01.vsnl.net.in
Q
Dr. N. F. Mis try
Dr. Armaity Desai
Dr. R. C Awasthi
Dr. M W. Uplekar
27th June 2003
Mr. Pankaj Ballabh
Sustainable Development Coordinator,
Shell, Hazira Gas Pvt. Ltd.,
101- 103,Abhijeet II,
Mithakali Circle,
Ahmedabad - 380006
Dear Mr. Ballabh,
Enclosed herewith please find the Narrative Reports for the periods - 21st October
2002 to 31 st December 2002 and 1st January 2003 to 31st March 2003.
Please acknowledge receipt.
Thanking you,
Yours sincerely,
Dr. Merges Mistry
Joint Director & Trustee
Encl: Two Narrative Reports
Mumbai Office
> ft
NG A
84-A, R G Thadam Marg, Wodi, Mumbai-400 018. INDIA. Tel. : (022) 4934989. Fax . (022) 4932876. Email
frchbom@bom2.vsnl.net.in
The Foundation is registered under the Bombay Public Trusts Act of 1950 [Regd. No. E. 6007 (Bom.)] Covered u/s 35 (i) (ii) of the Income Tax Act.
19€ 1 vide Notification dated 12-5-94
Narrative Report of
Training of Co-ordinators
in Health and Development
(For the period of 3 months - 10th July 2002 to 9th October 2002)
Report written by
Ms. Seema Deodhar
Dr. Prasad Johnson
Ms.Meenal Jagtap
Ms. Vaishali Gaikwad
Ms. Ashwini Patil
Wi
The Foundation for Research in Community Health
Pune/Mumbai
2003
Team members
Name
1.
Ms. Vasanti Purandare
2.
Dr. Dhananjay Kakade
3.
Mr. Appasaheb Ghadge
4.
Ms. Madhavi Gharmalkar
5.
Ms. Meena Roman
6.
Ms. Prabha Dudhal
7.
Mr. Raju Inamdar
8.
Mr. Santosh Jangam
9.
Mr. Avinash Gurav
10.
Mr. Sachin Gondhali
11.
Mr. Amol Bamishte
Team members associated with the Project
Name
1.
Ms. Tripti Prakash
10'h July 2002 to 16th August 2002
2.
Ms. Neelima Joshi
10th July 2002 to 10th August 2002
3.
Mr. Gopal Kamble
10th July 2002 to 25th August 2002
INTRODUCTION
BACKGROUND
The Foundation for Research in Community Health (FRCH) established as a public
trust in 1975 is recognized by the Dept, of Science and Technology as a national
scientific research institution.
In the 70s FRCH undertook a study of the health problems of a rural area in Alibag
district of Maharashtra (popularly known as the Mandwa project). In the absence of
effective public and private sector health services, FRCH demonstrated that local
village women provided with simple existing knowledge and technology could achieve
many of the set health and medical targets in a 30,000 population. This was in the late
70s, which the government hoped to achieve by 2000 AD. This demonstrated that for
most of the prevalent health problems of our country, remarkably simple, safe, cheap
and effective knowledge and technology could be used very effectively and that semi
literate village women had the ability to acquire and use this knowledge effectively for
control of several common diseases. This also includes National Programmes such as
ORT, leprosy, tuberculosis, ARI and even Family Planning. This was due to their strong
social commitment, constant availability and accountability to their extended family and
friends in the community.
In the past 5 years FRCH has demonstrated in the valley of Parinche in Pune district
that village women can undertake a variety of non-medical health as well as medical
functions within their village. Within the period of a year they have also proved to be
effective teachers and trainers in other districts of Maharashtra on a project supported
by the WHO.
During the past two years several organizations and institutions have deputed their
women, including trained ANMs for training such as Catholic Health Association of
India (CHAI), Kerala Shastra Sahitya Parishad (KSSP),
and a rural adivasi
development centre in Bihar. A well-defined course for hands on training of such a
functionary at our center together with a Distance Education Programme with its
training material in Hindi and Marathi is now available. The National Institute of Open
Schooling, New Delhi (NIOS) accredited FRCH for preparing and conducting a course
for the training of Gram Sakhi (1 year) and Sahyogini( 2 years) in the Distance
1
Education mode for rural health functionaries. Upon successful completion a
certificate/diploma will be awarded by the NIOS.
The recently released book by FRCH Health and Medical Care: A People's Movement
provides in greater detail the implementation of the ICSSR/ICMR Report Health for all:
An Alternative strategy of 1981 which visualized Health for All in a far wider
perspective, encompassing nutrition, employment, education, improved women’s
status, water, sanitation and environment, as well as the overall approach and strategy
to be employed and the cost of such an alternative strategy. It explains how several
problems of the existing public and private sectors, training, motivation and
accountability to the people can be overcome using an appropriate mix of social,
technological and professional inputs at each level.
This would not only be more socially and culturally acceptable to the people but also,
empower women functionaries and also provide large-scale employment to women
within their own community.
Such a new approach, which is rational and logical, needs to be demonstrated on a
larger scale and FRCH would be pleased to help if the necessary support is provided.
We feel that this would help to achieve the requirements for most National Health
Programmes and especially for Family Planning and Welfare, which requires a highly
sensitive approach, provided within the community by their own functionaries. The
functioning and accountability of such functionaries at much lower cost, would be more
a social and community function with transparency being evident and accountability
assured.
EXTENSION AND DISSEMINATION OF A PEOPLE-BASED HEALTH CARE
SYSTEM:
FRCH believes that the eventual acceptance of a people-based health care system will
materialize only through several demonstrations of its effectiveness at the grassroots
level in various parts of the country. However being an organization with limited
resources, FRCH cannot undertake such demonstrations on a large scale over long
distances without additional financial support. Hence the approach for linking local
capacity building with local realities and support structures needs to be considered for
achieving a sustainable extension of the Community Health Care System (CHCS). The
2
core strategy envisaged here for dissemination is the creation of a cadre of
locally drawn facilitators who will by definition develop and provide functional,
administrative and most important social support to local level health
functionaries as envisaged in the CHCS unto the 5000 population level. The
facilitator should be capable of moulding the system to suit local needs and
norms. This will be reflected in training and support, evaluating the program
from time to time and ensuring smooth and effective functioning at all levels. The
facilitators can serve as important resource persons for extension of this method
of training for the State/Panchayats after the termination of this project.
SPECIFIC OBJECTIVES
1.
Building local support for a people-based health care system in 3 states.
2.
Assessment of the impact and functioning of such a village based Community
Health Care System (CHCS).
Selected Area:
FRCH has attempted to replicate its community health care model in different areas to
test the feasibility and to make necessary modifications.
The areas selected were:
1. Hazira in Gujarat
2. Phulbani in Orissa
3. Bankura in West Bengal
4. Chandrapur in Maharashtra
Four areas selected represent distinctive features.
1. Hazira
Highly industrialised, close to a major city
2. Phulbani
Tribal, non-industrialised, access
problems, poor transport facilities, hilly areas
3. Bankura
Political decentralisation has occurred,
strong political will.
4. Chandrapur
Tribal & non-tribal groups, adopted by
industry.
3
FRCH will extend its work in Hazira. While in West Bengal, Ex-Health Minister
Mr.Partha Dey and his team will be involved in replicating the model, in Phulbani, two
NGOs NIPDIT and Agragamee (For Background
See Annexure 1)have
undertaken the responsibility for replicating the people based health care model.
APPROACH
FRCH has trained these facilitators intensively for a 3 month period at Parinche/Pune.
This will be followed by continual support for two years by FRCH's extension and
training teams with the help of distance education. These facilitators will in turn select
and train local functionaries over a year as master-trainers (Gram Sakhi) using the
distance education material developed jointly by the FRCH and the NIOS. A certificate
will be awarded to the Gram Sakhi by the NIOS after successful completion of the
course.
TRAINING PROCESS
The training of facilitators was divided into five major groups:
1.
Health and Development
2.
Clinical
3.
Research
4.
Training and Communication
5.
Management
The percent(%) of hours utilized in above mentioned groups is as follows :
Topicwise % of Hours of Training
3%
15%
34%
□ Health &
Development
■ Research
□ Clinical Training
30%
18%
□ Training &
Communication
■ Management
4
For details of the topic covered (See Annexure 2 Syllabus)
The above mentioned subjects were chosen, as the role of facilitators envisaged is :
1.
Selection of grassroot level functionaries
2.
Training of grassroot level functionaries
3.
Liasioning with community and local authorities
4.
Monitoring, documentation and evaluation
5.
Improving and modifying the training
It was decided to impart training in wide issues as to make coordinators aware of
various factors which may affect their work.
The objective of training of the major group :
Health & Development :
•
To know different factors affecting health.
•
To know relationship between different factors.
•
To know symptoms of common illness, general plan of
Clinical:
treatment and referral.
•
To maintain health information.
•
To create tools relevant to their work, such as needs
Research :
assessment.
•
To assess the impact of their work and make modifications
as and when required.
Training & Communication :
•
To learn how to impart training
•
To be able to plan the project work.
Management:
5
The number of hours planned under each major topic and utilized is given below:
Planned & Actual Hours of Training Toplcwlae
250 t223
j
202
200
!
r|
150
■
136
e
I
116
H
123
■
100
I
.<
i
97
I
I
66
H
50 ■
Planned
Actual
I
36
|B|
0 ----Health &
Development
Research
Clinical Training
Training &
Communication
Management
Topic
A total of 153 hours (19 days) extra were utilized. Hence holidays could not be given
to trainees.
The topics, which could not be covered, are:
1. Legal issues relating to gender, land and water
2. Soil testing
Extra hours were utilized for training than planned because :
1. Seven out of eleven had worked in development field; four of them were
totally new to the field. Four of the trainees had come from a highly
industrialized belt while seven of them were from non-industrialized belt. Thus
such heterogeneity in the trainees' background required lot of discussion.
2. Only two of the trainees were aware of women’s participation in development
process.
3. The group from the tribal area wanted to know more about preserving
biodiversity and forest.
4. No trainee had any previous clinical experience or understanding of health
issues.
6
Training Method
Training method used was integrated and participatory. The different methods used
were:
\
1. Lectures
2. Discussion
3. Activities and hands on training
4. Visits
5. Audio/Visual Aids
1.
From the following graph it is clear that lecture method was used only for 104
Hrs. Its very selective use was based on necessity.
Training Method
Total Hours
Discussion activity
321
Hands on training and Visits
240
Lectures
104
For e.g. In clinical training and research, trainees had no previous experience. Thus
the lecture method was supplemented with activities or hands on training.
Time Distribution
140
120
120
100
■
80
□
O
X
3
75
67
60
40
ODrecussKxi activity
■Hands on training and visits
so
□ Lectures
V;
3
20
0
Research
Ctaical TranrKj
Traong & Communication
Marta gemert
Topic
2.
External lectures and field visits were arranged. This was done to help the
facilitators understand different viewpoints about development. The following
list shows the arranged visits and external lectures (Annexure 3&4).
7
3.
The trainees were asked to explain or take sessions whenever necessary
keeping in mind their experience in particular field.
4.
Sanjay (Phulbani)
•
Statistics
•
Mental Health
Alpa (Gujarat)
•
Development
Digal (Phulbani)
•
Education
Sanjay (Phulbani)
•
Development
Vijay (Chandrapur)
-
Discussion was the prominent method utilized, since nine of the trainees had
worked in their respective fields for more than 2 years.
5.
Hands on training and activities were used to learn skills as well as provide an
opportunity for experimental learning. This then equipped the trainees for
discussion.
6.
Films were used as a training tool to address certain issues (Annexure 5).
For eg. :
1.
Gaon Nahi Kisi Panch Ka, Sanshodhan -
2.
Astitva, Daman, Mother India
3.
Sanshodhan
Health Worker
4.
Neem and Haldi
Herbal Medicine
5.
Lagaan
Management Technique
-
Development
Gender
Sharing sessions with FRCH’s health workers were planned. These sessions
gave the facilitators an idea of;
1) Scope of the work that could be done by health workers
2) Problems faced by grassroots level functionaries
3) Limitations and the need of support services
8.
Trainees were given reading material with different viewpoints so that
discussion could stimulate their thought process (List of reading material Annexure 6)
The training process utilized for major heads was as follows (For details of the
training See Annexure 7 Process Documentation)
8
Training in Health and Development
Developmental issues were discussed in detail based on the premise that health is
not possible without development. A total 223 hrs. were utilized for Health and
development.
Sr.No
Date
Topic
Hours
FRCH Philosophy
Film - Chhipe Angare, Chakori
Development concept, Film_______
Globalisation___________________
Visit to Mahur___________________
Economic Development, Film Gaon Nahin Kinhi Ranch Ka &
Bhumi Putra_________ _
Rural Development ,
Film
Sanshodhan
Conceptual
framework
of
development________
Gender, Development
Environment________
Environment, Gender
Development,
Decentralisation,
Globalisation____________________
Rural development
Environment, Development, Film Daman_______________________
Social, political, development, visit
to Veer
Film - Astitva
Political development
Film - Mother India______________
Rational drug theory
Rural development - Visit to
Satalwadi, visit to Pangare for
public information, Film - Lajja
Film - Animal husbandry__________
Development and environment
Visit to Mandhar
Development - Post test
Development- Attitudinal change
presentation
Visit to Satalwadi
Present
health
system
and
globalisation___________________
Rural technology and development
7.30
1.
10 July 2002
2.
3.
4.
5.
11 July 2002
14 July 2002
15 July 2002
16 July 2002
6.
17 July 2002
7.
18 July 2002
8.
9.
10.
11.
19 July 2002
20 July 2002
21 July 2002
22 July 2002
12.
13.
24 July 2002
27 July 2002
14.
29 July 2002
15.
16.
17.
18.
19.
30 July 2002
31 July 2002
1 August 2002
3 August 2002
5 August 2002
20.
21.
22.
23.
24.
7 August 2002
20 August 2002
25.
26.
26 August 2002
28 August 2002
27.
11
September
2002
23
September Nai Talim/Development - Revision
2002
_
24 & 25
Feedback, Revision, Activity
September 2002
28.
29
8 August 2002
12 August 2002
19 August 2002
4
4
3
11
10
6
5
2
3.30
5.30
10
5.30
8.30
3
4.30
3
3
11
3
11
3
10
5
3
5.30
10
4
22
9
Sr.No
30.
31.
32.
33.
Date
Topic
27
September Development and water, Film 2002
__
Chandni Bar_____
1 October 2002
Visit
to
Pabal
for
Rural
2 October 2002
3 October 2002
development_____
Development and microplanning
Development and air
Hours
9
10
6
6
Training Process
The process of training was participatory. Trainees were provided with reading
material, shown films related to development and shared their own experiences in
the development field
After this, discussion were held regarding their observations.
This process raised various issues such as :
1.
Privatization and the public Sector
2.
New technology and rural technology
3.
Government and non-government / Anarchy
4.
Decentralization and centralization
5.
Freedom and equity
6.
Choice and compulsion
7.
Service and employment
8.
Liberalization and total control
9.
Development and environmental protection
10.
Consumerism and need based use of material
These issues were discussed. Different view points were presented through external
lectures and visits. Following this, various community based experiments and
movements were discussed. They were analyzed critically. Subsequently, success
stories of individuals and community based organizations were discussed. This
helped them to develop their own perspective in development as well as strategies to
be utilized.
At the end, development and its relation to health was discussed. Trainees were
allowed to list down factors affecting health. Thus the emphasis on development for
health was brought out clearly.
10
CLINICAL TRAINING
Clinical training was planned from 7th August to 28th August 2002. However actual
clinical training commenced from 22nd August to 15th September 2002. The clinical
training was postponed, as gender issues, political systems and poverty related issues
were covered during this period. A total of 21 days (186 hours) was planned within
which to complete the clinical training. But 23 days (202 hours) were required to
complete the designed syllabus (For details - Annexure 2)
The facilitators have worked with various issues related to health. One of the facilitators
(Ms. Sugatha Panigrahi) had worked with grassroots level health functionaries but her
role was limited to organizing camps and training programmes. Another facilitator had
worked in a de-addiction centre and as such, her knowledge of health and related
issues was narrow (See Annexure C1 -Biodata of Facilitators).
The objectives of imparting clinical training were :
1. To identify commonly occurring illnesses and treat them.
2. To recognize danger signals and make timely and appropriate referrals.
3. To integrate different systems of medicine.
4. To conduct health check ups.
5. To conduct a clinic in a home or village setting.
Process of Clinical Training :
The human body as a whole and its relationship with the mind was explained.
Furthermore various factors affecting health were revealed. All systems were explained
with the help of models, body mapping and black board illustrations.
While a particular body system was taught, common diseases relating to that system
were explained. The signs and symptoms, cause of illness, treatment, advice and when
to refer was told.
Simultaneously bi-weekly clinics were conducted in different hamlets (See Annexure
C2). A total of 15 clinics were conducted. The objective of conducting such clinics was
to give them hands on training vis-a-vis examination and treatment of commonly
occurring illnesses. A list of illnesses seen is attached (See Annexure C3)
11
School Health programmes were conducted concurrently with the training. A total of
308 students were examined (See Annexure C4). This was done with the objective of
refining their skills in general examination and in developing their ability to understand
what is normal. Two days were utilized to clear their doubts and answer their queries
which was more than planned for (Annexure C5).
List of Yogasanas and exercises taught are attached in (Annexure C5). List of
medicine taught to them are attached in (Annexure C6).
TIME TABLE OF CLINICAL TRAINING
TOPIC
HOURS
Introduction
5
Digestive system
5
Respiratory system
21
Pains & Aches
18
Reproductive system
11.5
Orthopaedics
10
Fever
10
Emergencies
4
Skin, Ear & Eye
3
Nutrition
5
Herbal Medicine
5
Mental Health
17.5
Queries
10.5
125 Hrs
(15 days)
12
TRAINING IN RESEARCH
Though a total of 116 hours were devoted, but 123 hours were required. The objectives
of conducting training in research were
•
To develop analytical attitude
•
To be able to develop their own tools for study
•
To be familiar with quantitative and qualitative methods
•
To know the basics of epidemiological research
Process of training :
The training started with the discussion on "What is Science?". Trainees responded as
follows:
1.
Physics
2.
Industries
3.
Chemistry
4.
Laboratories
5.
Biology
A discussion was conducted on the difference between science and technology. The
objectives of science were explained. It was also explained that science is not a
general or any particular body of knowledge; science is distinct because of its
methodology.
Approaches to knowledge
: The word science is derived from the latin word "to
know". Throughout history, knowledge has been acquired through many ways. The
modes which have been used to acquire knowledge are
1.
Authoritarian mode
2.
Mystical mode
3.
Rationalistic mode
4.
Scientific mode
A major distinction among these modes is the way in which importance is given to the
source or producer of knowledge (who says?), the procedure by which knowledge is
produced (How do you know?). The scientific approach is grounded on a set of
fundamental assumptions. These assumptions are unproven and unprovable.
13
1.
Nature is orderly.
2.
We can know nature.
3.
Knowledge is superior to ignorance.
4.
All natural phenomena have natural causes.
5.
Nothing is self-evident.
6.
Knowledge is derived from the acquisition of experience.
The ultimate goal of social science is to produce an accumulating body of reliable
knowledge. Such knowledge would enable us to explain, predict and understand
empirical phenomenon that interest us.
The components of science are
.
explanation
prediction
understanding
1. Explanation
Scientific explanation: aims to provide general explanation to 'Why". For e g. Why a
given event or behaviour has taken place? A systematic and empirical analysis of the
factors responsible for the occurrence of the event or behaviour is required. Two basic
types of explanation are used:
Deductive explanation
Inductive/Probabilistic explanation
2. Prediction
The ability to make correct predictions has been regarded as one of the foremost
qualities of science.
3 Understanding
After this, conceptual mapping and process documentation was explained.
Trainees were asked to suggest some of the research questions they would like to
investigate.
14
The research queries, which were listed, are
Studying in vernacular medium verses English medium
The outcome if the fish population has reduced in one particular lake
How to measure the impact of work of a health functionary
How they could measure the impact of savings and credit groups
How to measure the impact of a journal
How to measure the impact of communication.
From the problems posed, they were asked to divide the main problem into small
problems and to
Write a hypothesis
List the variables
This gave them the basic concept of “variables, objectives and hypothesis”. Then the
trainees were taught the importance of "Operational definitions". This was explained
with the help of few concepts such as "anger", "power". Every one was asked to
describe the above two mentioned terms. It came out very clearly that every one had a
different concept. Thus defining of terms or concepts used was very important and was
stressed upon.
The difference between qualitative and quantitative methods was told.
For qualitative research; five methods were explained. They were :
Focus group discussions
Focus interviews
Process documentation
Pile sorting
Case studies
The validity and reliability of data was explained.
Trainees were asked to perform process documentation of two days training.
They were asked to analyze one Focus group discussion. Whilst one discussion was
conducted by them at the community level
another.
they played the role of participants in
Few exercises were given to classify data both in quantitative and qualitative terms.
Different types of measures were taught:
•
Rates
•
Ratio
15
•
Proportion
Sampling procedures were discussed.
Test of probability and significance was explained.
Their own projects were discussed in detail. Impact indicators were listed. Base line
tools for community and village health functionary was prepared by trainees
(See
Annexure R1).
For details of research training (See Annexure R2).
Epidemiology was focussed on for health research. The trainees were taught about the
basics of epidemiology.
The formulation of questions for understanding the dynamics of community based
disease was taught as an entry point. For example :
Who has the disease?
What has caused the disease?
Where has it occurred?
Why has it occurred?
How has it occurred/spread?
When has it occurred?
These basic tools were explained with the importance of each one being highlighted.
Following this, other tools like rates, ratios and proportions were explained in detail
using examples like infant mortality rate, prevalence rate, incidence rate etc.
Basic principles of sampling were explained.
Types of epidemiological studies were explained in brief.
i.e.
Analytical----------- ► Case control study
Cohort study
Descriptive
Experimental
They were also told about the dynamics of disease causation, i.e. the relationship
between agent, host and environment.
Epidemic surveillance as an important research tool was explained. At the same time a
practical activity was carried out to investigate an outbreak of Hepatitis in one village.
(See Annexure R3)
16
TRAINING AND COMMUNICATION
A total of 66 hours were devoted to the above-mentioned component in the syllabus. A
total of 97 hours were required. Except for three facilitators, others had experience in
training and communication.
The objective of the training were :
1.
To know different approaches in health training.
2.
To plan and conduct training for their own projects.
Thus it was decided to have a discussion on training methods and different educational
experiences. To learn from other grassroot level experiences a two day workshop was
arranged. During this workshop five different organizations presented their approach to
training in health, scope of health functionaries, impact of training and legal issues
related to grassroots health functionaries.
A discussion of different experiments in education conducted by Shri Rabindranath
Tagore, Shri Aurobindo, Mahatma Gandhi and Shri J.K. Krishnamurthi was held. The
group was interested in Mahatma Gandhi's experiment ("Nai Talim") and the method
propagated by Mr. J. Krishnamurthi.
"Nai Talim" as a method propagates life skill education, learning from the surrounding
environment and develops a social commitment while J. Krishnamurthi's approach
denies discipline of any kind, learning what one is interested. Facilitators felt that they
will use a combination of these two approaches.
The participatory approach advocated by FRCH was demonstrated in the following
activities followed by discussion :
Children
Khelwadi
Children
School Health
Adults
Films
Adults
Notice board
1.5 hrs.
Adults
Saving and credit group meeting
4 hrs.
Adults
Organizing community
Adolescent girls
and discussion about problem
4 hrs.
Health education
2 hrs.
17
Different types of communication like - Dialogue, negotiation, counseling, confrontation,
ignoring and Satyagraha were discussed.
Later on, a discussion on syllabus, curriculum was held. Trainees were asked to
prepare syllabus, which they would be utilizing for training of their own functionaries.
The basics of writing of training modules was taught. Evaluation of training and
communication was based on the syllabus proposed and their participation in training.
Of the 11 participants, 3 were unable to contribute in any way to the session. Of the
three one had language problem since she could not speak in Hindi or English.
18
MANAGEMENT
A total of 36 hours was devoted to this component of training. Since the trainee co
coordinators had been working in the field as supervisors for at least two years only a
total of 20 hours of training was required.
The objective of the training was
:
To inculcate planning and training of their own programmes
Thus discussions were held where supportive monitoring was demonstrated.
Topics discussed in this area included :
•
Planning their own programmes
•
Project proposal writing
•
Report writing
•
Minute writing
•
Supportive monitoring
•
Management techniques
•
Basics of account keeping
Basic management techniques were explained through a viewing of the film 'Lagaan'
There was no evaluation conducted for this part of the training.
Discussion
10 hrs
Field visit
3 hrs
Lecture
4 hrs.
Film
3 hrs.
Lecture
4 hrs.
Discussion and activity
16 hrs.
Total
40 hrs
19
EVALUATION
Evaluation of any training programme is necessary. Different evaluation methods
described below were used, as the topics required different tools.
1. Health Development
1) Pre-Post test, Process Documentation,
2) Focus group discussion
2. Clinical Training
1) Spot checking of skills, multiple
choice questions
3. Research
1) Tools prepared by the trainees for e g,
FGD
questionnaire,
Baseline
questionnaire, Code list
prepared for
disease
data,
analysis
of
FGDs,
parameters identified.
4. Training & Communication
1) Syllabus prepared for trainee’s health
functions.
2) Participation in training
No formal evaluation was done for the section on Management.
A)Development
1.
Development of an attitudinal change was reflected in the conceptual
mapping, pre-test and post-test.
20
Sr. No
1.
Development
Factors_____
Health
2.
Economic Development
3.
Social Development
5.
Education
Higher education, big
colleges, schools, multi
linguistic
6.
Gender
No dowry deaths and
exploitation of women
7.
Environment
Proper utilization of
land, forest and labour.
Pre-Test
Post-Test
Big hospital, expensive
medicine, no disease,
Health
Doctor,
medicine is the only
solution to disease, trust
only on Allopathy, lab
test.
Affordable, accessible and effective
medical treatment, believe in our own
body- to cure minor illnesses, and
consult the doctor only in case of major
illnesses .increasing faith in home
remedies, Ayurved and Homeopathy,
balanced diet, preventive measures as
clean surrounding is also important,
adequate nutrition.________
Fulfillment
of
basic
needs,
decentralization
of
technology
Swadeshi, not only industries but
agriculture also is the way of economic
development, globalisation, surplus
export.
Development
means
only
economic
development.
Multinational companies
means
development,
full
time
job
employment,
western
lifestyle,
High bank
balance,
industrialization,
Modern
technology,
Information Technology,
luxurious
lifestyle,
travelling
abroad,
communication
Equal distribution of resources, peace,
entertainment,
rural
development,
utilization of manpower, respect to our
own culture, reduce in crime rate, use of
local resources, de-addiction, sense of
belonging.________________________
Primary education, priority to education,
women's education, education for all,
parents meetings, number of school
dropouts should reduced.____________
Gender equality, participation of women
in gram sabha and social activities, self
image, education for women._________
Balance between cash crops and food
grains,
ecological
development,
watershed development, development
through minimum degradation of
environment, environment protection,
protection of traditional seeds and
technology.
21
B)Evaluation of Clinical Skills
Evaluation of clinical training was done by
1)
i)
Spot checking of the skills
ii)
Their ability to conduct physical examination
iii)
Multiple choice questions were given to evaluate their knowledge.
iv)
Focus group discussion
Spot checking of the skills acquired during school health programme revealed
that all the trainees were competent in general examination including vision test.
Skills learnt were
1.
Weight measurement
2.
Height measurement
3.
Vision checkup
4.
Counting pulse rate
5.
Counting respiratory rate
6.
Detection of anaemia
7.
Detection of cataract
Skills requiring more practice were identified viz:
1.
Measuring blood pressure
2.
Haemoglobin estimation
3.
Detecting heart sounds
4.
Straight leg raising
5.
Counting pulse in children
C) Research :
The following tools were prepared by trainees:
1.
Baseline Survey
2
Questionnaire for focus group discussion
3.
Listing code for diseases
Grades were assigned on the quality of the above mentioned tools prepared by the
trainees.
2
D) Training and Communication :
1.
Syllabus for their functionaries was prepared by the trainees. (See
Annexure E1).
Grades were given for the syllabus prepared.
2.
Eight out of eleven candidates were able to take part in the training
session on which they were also evaluated.
Following is the performance of the trainees :
Sr.
No
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Trainees
Alpa Joshi
(Gujarat)_______
Manoj Patel
(Gujarat)_______
Niranjan Patel
(Gujarat)________
Shailendra
Khalashi (Gujarat)
Joyita Sarkar
(West Bengal)
Sanchita Sarkar
(West Bengal)
Ramashish
Mukherjee
(West Bengal)
Jerimio Digal
(Orissa)________
Sugatha Panigrahi
(Orissa)________
Pramila Konhar
(Orissa)________
Sanjay Bhol
(Orissa)
2)
Health
Development
6
40%
Research
C+
Clinical
Training
13
43%
Training &
Communication
4
40%
8
53%
C+
12
40%
4
40%
5
33%
D
9
30%
3
30%
4
27%
D
12
40%
5
50%
7
47%
B+
13
43%
7
70%
5
33%
Oh
io
33%
6
60%
3
20%
C
8
27%
4
40%
D
6
40%
D
11
37%
5
50%
6
40%
B+
13
43%
4
40%
6
40%
B
8
27%
5
50%
For evaluating knowledge, multiple choice questionnaire was prepared.(See
Annexure E2). Result of multiple choice questionnaire were:
23
Gujarat
%
1.
Alpa Joshi
64
2.
Manoj Patel
59
3.
Niranjan Patel
60
4.
Shailendra Khalasi
51
West Bengal
%
1.
Joyita
72
2.
Sanchita
62
3.
Ramashish
59
Orissa
%
1.
Sanjay
66
2.
Digal
66
3.
Pramila
59
4.
Sugatha
45
An evaluation of the training programme by Facilitators :
Evaluation of training programme by Facilitators
A) About Content
1.
Broad content (Macro view of issues)
2.
Wide exposure
B) Method of Training
1.
Interactive and co-operative
2.
Relationship between trainees and facilitators was warm.
3.
Participatory
4.
Very practical
5.
Group discussions were important
6.
Integrated training
24
7.
Changes made in syllabus according to our feedback
8.
Use of many examples has helped to learn
9.
Various views were taught
10.
Working with health workers has helped to learn practical concerns
C) A) Impact of training as perceived by trainees :
1.
Self analysis has increased.
2.
Learnt that most issues are multidimensional and have learnt to
link various issues.
3.
Learned the importance of using local resources.
4.
Learned to look at problems from various angles and to look for
multiple solutions.
5.
Learned to work individually and in groups.
6.
Learned how to conduct training.
7.
Improved communication.
8.
Learned about gender equality.
9.
Learned to utilize home remedies.
10.
Aware of limitations in self.
11.
Helped to build our own perspective.
12.
Attitude about health has changed, from doctors and medicine to
exercise, diet, education, gender and environment.
13.
Confidence level has increased.
14.
Helped in an accident situation.
15.
Preventive measures like quality of water, exercises have
become important.
16.
Body also has a defence system.
B) Future plans as envisaged by trainees :
1.
Work of Mr. Anna Hazare and Mr.Popat Rao will be presented
to their community.
2.
No consumption of medicines for common minor illnesses.
3.
Information learnt will be told to relatives and community
members.
4.
Preventive measures will be taken along with community
involvement.
25
SUGGESTIONS BY TRAINEES
A) Time Schedule
1.
Content of development issues need to be reduced
2.
More time to be spent on clinical training
3.
More practical field oriented experience
4.
Need for annual feedback sessions
B) Sequencing of the syllabus
1.
Water purification, veterinary training at the beginning of the
syllabus
2.
Mental health also at the beginning of the syllabus
3..
Project management in the middle of the period
4.
Human health at the end of syllabus
C) To be included in next programme
1.
Visit to milk dairy
2.
Soil testing
3.
Community mobilization
26
ANNEXURE 1
About NIPDIT
National Institute for People's Development Investigation & Training shortly known as
NIPDIT, literally means THE OPPRESSED. It is a non-profit making, non-political, non
religious, non-govemment, Voluntary Organisation working since 1983 in the field of
Tribal & Rural development. The head office is located in Phulbani of Kandhamal
district. Project offices of different operational districts are located at Block/Gram
Panchayat Head quarters of Bolangir, Kalahandi and Keonjhar.
NlPDITs intervention is towards fulfilling the basic need of THE OPPRESSED.
Developing human and material resources among weaker sections, empowering them
by creating self-confidence with appropriate leadership qualities is the main mission &
vision of NIPDIT. The important tool with NIPDIT is to create awareness among the
focal groups for their socio-cultural & economic change.
Programmes by NIPDIT
The major programme areas covered by NIPDIT for integrated development are
•
Forest & Environment
•
Community Health
•
Gender Development
•
Organization Building
•
Land & Agriculture
•
Entrepreneurship Development
•
Lobbying, Advocacy & Networking
AREAS OF COVERAGE
NIPDIT covers 7 Developmental Blocks, 35 Gram Panchayats and 440 villages
covering a total population of 1.5 lakhs of Kandhamal, Bolangir, Kalahandi, Keonjhar &
Mayourbhanj districts.
27
TRAINING INFRASTRUCTURE
Four well-equipped training centres are being run by NIPDIT. Three of these are in
Kandhamal district with one in the H.Q. another two are at 10 Km. & 50 Km. away from
Phulbani whereas one is in Bolangir district which is 100 Km. from district H.Q. The
infrastructures serve the requirements of NIPDIT as well as other organizations on
request.
PRESENT STAFF POSITION
At present 50 full time young, dynamic, dedicated, qualified and trained professionals
are working in different project areas. 200 local animators are also actively involved
with NIPDIT in different operational districts; some are part timers and some are
working on purely voluntary basis
28
ABOUT AGRAGAMEE
Agragamee - meaning "marching forward" - is a group of professionals, activists and thinkers
working with marginalized and underprivileged communities in the tribal Districts of Orissa, India. Our
efforts at initiating a people centred development have combined an issue-based approach with
programmes for socio-economic development
Agragamee works in 10 Blocks in 7 districts of Orissa, mostly in remote areas. Agragamee has
received support from the Government of India & Orissa, as also from International agencies, such
as GAA, HIOVS, UNDP, UNICEF, WFP, Action Aid, etc.
Agragamee's current Mandate is :
To promote throughout India all aspects of tribal development and in particular to adopt an
integrated approach to help the tribal communities in mobilising for self-sustaining development
organisations and to build up an institutional base for training of tribal youths as well as young
educated professionals.
Agragamee has also taken up action research in several areas of work, which have helped in
making effective policy intervention, and ensured attention to and mainstreaming of issues of
survival and human rights in the tribal regions. These efforts taken up through participatory
techniques have helped establish effective methodologies while also enabling in-depth exploration
of the different situations and aspects of the tribal socio-economic situation, and the forces that
affect it.
Agragamee s concerted and systematic efforts have had significant impact in addressing some of
the fundamental causes of poverty which include debt and bondage, and acute food shortage
during the monsoon months. Along with tribal communities, hitherto downtrodden and repressed
have also developed the ability and confidence to form successful grassroots organisations for
sustainable development action which has caught the attention of state and national governments
as also the media. Thus villages with strong people’s organisations have been able to make
effective use of natural resources to build up buffer stocks in the community grain banks which
helps them tide over periods of low food stocks, and also dialogue with the instruments of local
governance and administration for effective delivery.
Agragamee s areas of action research have indicated that there is much potential as well as need
for improved production, and better natural resource management systems in the tribal regions.
29
Annexure 2
Syllabus for Co-ordinator
S.NO.
1.
TOPIC
Development
4.
Various definitions of development;
Components of development; Factors
affecting development; Role of State
individuals; NGOs in the development,
History of development in India, Emerging
issues in development____________________
Governance
Different Political and Economic Systems;
Communism, Capitalism, Socialism,
Dictatorial. Panchayat Raj: Historical review,
Gandhi's vision of Gram Swarajya Concept,
Components, Factors affecting Panchayati
Raj, People's role is Panchayati Raj,
People's role in Panchayati Raj, Concept of
decentralization : Political, Economic,
Technical________________________________
Parameters to assess development
Economic, Agriculture, Gender, Political
Decentralization, Self Governance, Access to
health, education and other amenities, social
security._________________________________
Infectious diseases; its relation to poverty and
5.
Epidemiology
6.
Quantitative Research Methods
Base line Survey_____________
Documentation
2.
3.
7.
8.
9.
10.
11.
12.
Qualitative Research Methods
FGD, Focus Group Interview, Pile sorting
Science : What is science, objectivity,
scientific thinking and its impact.__________
Know your body various systems, Minor and
common illnesses, Disease classification,
why diseases happen, Morbidity patterns,
Pattern of morbidity in developed countries
and developing countries. Diseases of
Poverty, Diseases of affluence.___________
Common diseases of Digestive system,
Respiratory system, Reproductive system,
Fevers, Skeleton:
Detecting emergencies, treatment, advice,
follow up and referral
Telemedicine : Concept, its need, use of
computers
S.NO.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
TOPIC
Nutrition ; well balanced diet,
Malnourishment: detection, measures to be
taken, special diets, kitchen diets__________
Land : Quality of land, Soil testing, Land
holdings, Land reforms, Legal issues,
Cropping pattern, Multiple crops, Agriculture,
Insecticides and pesticides.________________
Water: Water Purification, Measuring of well,
Water testing, Watershed Management
Microplanning
Air: Air pollution, why it occurs?
Industrialization, rules and regulation, Green
house effect,
Forestation etc.___________
Environment and Health: Protection of
environment, culture of protecting
environment, Environment laws.____________
Poverty : various definitions of poverty,
Reason for being poor, Approaches used by
Govt, to eradicate poverty, equity and
equality, different schemes of govt,
opportunity loss, vicious cycle of poverty and
illness, steps taken in other countries,
Gandhi’s concept of simple living.___________
Globalization, Liberalization, Privatization
What does it mean; how it will impinge on
Health , Education, Agriculture, Natural
Resources, Sovereignty of state, subsidy,
Patent act etc, and environment.____________
Health as a development issue :
Understanding Health; Various definitions of
Health, illness and disease, People’s
perception of Health, illness and disease, and
importance of knowing people’s perception.
Factors affecting health.___________________
History of Health System in India; Health
system of various countries; National Health
Policy, Various Health Committees
National Health Problems and Programmes
Distribution of Resources, vertical
Programmes Centre and State relationship,
Role of Panchayat in Health_______________
Grassroots level Projects strengths and
weakness, community financing, Role of
CHW, Role of community in taking care of
their own health.
Sustainability.
Participatory learning: Method, Education, its
impact, Nai Talim, Concept, Components
practice each candidate
Communication skills, Media, Audio-Visual
skills, Counselling
31
S.NO.
27.
TOPIC
28.
Khelwadi, Street play, Role plays, Story
telling___________________________
Culture and Health
29.
Monitoring, Support and Guidance
30.
Evaluation of different programmes, projects
and trainees___________________________
Mental health; Factors affecting mental health
common mental disorders, classification,
detection Stress management, Gender and
Mental Health, Domestic violence, counseling
Different systems of medicine: Ayurved,
Homeopathy, Yoga, Reiki, Acupressure,
Allopathy_____________________________
Identification of Herbal medicine, Preparation
of Herbarium_________________________
Planning of their own programmes
31.
32.
33.
34.
35.
37.
Project proposal writing. Funding Agencies
and their focus: Govt., private, International
Basics of account keeping, petty cash, audit,
budgeting____________________________
Human values and relations
38.
Management techniques
39.
41.
Legal aspects related to Health and
Development and Gender and use of
paramedical workers.________________
Role of Information, various methods of
collecting information, dissemination- why
and where, Internet__________________
Religion, spirituality, its impact
42.
Feedback, Evaluation, Examination
36.
40.
32
ANNEXURE3
LIST OF VISITS
1. Ralegan Siddhi
2. Sustainable Ecosystem Development at Panshet.
3. Rural Technology at Pabal.
4. Rural Technology at Phaltan
5. Goatry - Phaltan
6. Leprosy Rehabilitation Colony - Mandaki
7. Water Shed Development - Satalwadi.
8. Dairy - Kaldari
33
ANNEXURE 3
KHELWADI
24/07/02
Pangare
07/08/02
Parinche
08/08/02
Mandhar
14/08/02
Veer
21/08/02
Khengrewadi
28/08/02
Mahur
11/09/02
Hargude
34
ANNEXURE 3
PUBLIC INFORMATION
VISITS
15/07/02
Mahur
29/07/02
Veer
05/08/02
Pangare
12/08/02
Mandhar
26/08/02
Satai wadi
35
ANNEXURE 4
EXTERNAL LECTURERS
1)
Rajiv Sane (M.A. (Sociology), B.E.(Electrical))
Member of Option Positive Group
Consultant for different labour unions
2)
Arvind Shotri (MSW)
3)
Prakash Gole
Environmentalist
Project in 'Panshef ,Pune for development of Forest ecosystem
and Water ecosystem.
4)
Popatrao Pawar (B.A)
Ex-Sarpanch of village - Hivare Bazaar (Model Village),
Dist.Ahmednagar, Maharashtra.
5)
Aruna Deshpande (MSc.(Statistics))
Biostatistics
6)
Nagmani Rao (M.S.W)
Lecturer in Karve Institute of Social Sciences
7)
Devrajbhai Chauhan ( M.A. Economics)
8)
Dr.Vishwas Rane (PhD in Pharmacology)
Worked with 'Rational Drug Movement1
9)
Pankaj Saxeria
Environmentalist
Working with "Kalpavriksha" - an NGO
10)
Anti Naik ( B.Sc in Physiotherapy)
Working in 'Yogesh Hospital1
11)
Gopal Kadam
Ex-Sarpanch of Satalwadi (Model Village), Dist. Purandar,
Maharashtra
36
ANNEXURE 5
VIDEO FILMS
Subject: Development
11/07/02
Chhipe Angare, Chakori
16/07/02
Gaon Nahi Kinhi Ranch ka Bhumiputra
27/07/02
Daman
30/07/02
Astitva
01/08/02
Mother India
07/08/02
Animal Husbandry
27/09/02
Chandni Bar
05/08/02
Lajja
Sanshodhan
Subject: Management
04/10/02
Lagaan
Entertainment
Nayak
Rahul
Raju Chacha
Baby’s Day Out
Devdas
37
ANNEXURE 6
MATERIAL PROVIDED
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28?
29.
30
31.
32.
Centrally sponsored schemes for Rural
Development - Devraj Chauhan_____________
Basic Statistical Concepts - Caluin F.Schmid
Yogesh Hospital (Exercise chart)_____________
Examination of urine______________________
Table U-l WEIGHT-HEIGHT AGE TABLES
Introduction to Life Skills for Psychosocial
Competence____________________________
Mental Health - Dr.Srikala Bharath___________
Composition of Food (Nutrition)______________
Promotion of Mental Health in Women_________
Psychological Interventions in Mental Health
problems of Women (NIMHANS)_____________
Sampling
________________________
World Bank Funded Health Care - Dr.Vineeta
Gupta_____________
Rural
Development
through
People’s
Mobilization. Case study of Ralegan Dr.Ramesh Awasthi
Alternative Strategies & India’s Development
Health & Development
Health Development - K.V. Narayan
Health & Development - KV. Narayan
Strategies for Development and People’s
participation - Medha Patkar________________
Health & Development (Approaches to the
Measurement of Development) - KV. Narayan
Planning and Development - Madhu Dandawate
A Visit to Ralegan Siddhi
(Rural scan. Quarterly.Vol 2.Issue 1)___________
The cost of Free Trade: The WTO Regime & the
Indian Economy - Utsa Patnaik______________
Globalisation & Health______________________
Neoliberal Finance & Crisis in the Developing
World
Globalisation, Information & Labour movement
(NCAS Advocacy Internet Issue)______________
The New Face of Capitalism: Slow Growth,
Excess Capital & a mountain of Debt
(Monthly Review, April 2002)____________
Globalisation - Definition_______________
A
Human
Development
Approach
to
Globalisation (Advocacy Internet Issue # 18)
Consumers, Social Justice & The World Market
(Advocacy Internet Issue #19)_______________
Liberalisation : An Indian Overview
A Meeting of Minds: The Times of India Sept 1
2000______________________________
Crisis & the Capitalist cycle: A Symposium:
Edited by A.Rumyantsev
38
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
VIKALP (Alternatives)
Special Issue - Gender & Transformation
Sahyogini Report (1st October - 31st March)
Lay Reporting of Health Information (WHO-1978)
Understanding Human Behaviour Dr. C.R.Chandrashekhar ________________
Guidelines for Homeopathic Treatment
Module on Epidemiology _________________
Module on Women & Health________________
Module on Village Development_____________
Module on Anatomy & Physiology____________
Module on Research________ ______________
Module on Respiratory System
39
ANNEXURE 6
TRAINING MATERIAL
Sr. No
Health & Development
Research
Clinical
Management
1.
VIKALP - Alternative
Special Issue.
Gender and Transformation
What is
Science
module
Project
proposal
writing - write
up
2.
Crisis and the capitalist
cycle
Statistics
Sampling
3.
A Meeting of minds
(An article from The Times
of India)_______________
Consumers, Social Justice
and the World Market
(Article from Advocacy
Internet Issue)__________
A Human Development
Approach to Globalisation
(Article from Advocacy
Internet Issue)
Epidemiology
module
Psychological
interventions in
Mental Health
problems in
Women______
Understanding
Human
behaviour_____
Promotion of
mental health in
women_______
Mental Health
Issues in
Women
4.
5.
6.
7.
8.
9.
10.
11.
12.
The Great Concern Globalization___________
Monthly Review April 2002
Globalization Information
and the Labour Movement
(NCAS Advocacy Internet
Issue)________
Globalization and Health
(Article from Advocacy
Internet Issue)_________
The Cost of Free Trade :
UTS A PATNAIK
The WTO Regime & the
Indian Economy
(Social Scientists, Vol 27)
A Visit to Ralegan Siddhi
(Article from Rural Scan Vol 2, Jan-Mar 2000)
Health & Development K.V. Narayan
Basics
Statistical
concepts and
techniques
Tests of
significance
Introduction to
Life Skills for
Psychological
Competence
(NIMHANS)
Nutrition
Examination of
Urine.
Detection and
Estimation of
Protein in
Urine._______
Anatomy
module
Physiology
module
List of
Exercises
Sahyogini
Project Report
Sr.No
Health & Development
13.
Alternative Strategies and
India's Development
Rural Development through
People's Mobilization.
A Case Study of Ralegan
Siddhi - Dr.Ramesh
Awasthi________ _______
Centrally Sponsored
Schemes for Rural
Development Devrajbhai Chauhan
14.
15.
Research
Clinical
Management
41
ANNEXURE 7
(PROCESS DOCUMENTATION OF THREE MONTHS)-
Overview of the methodology used
Sr
N.
Topic
1.
Village Environment
2.
Occupational
practice
✓
3.
Religious & Cultural
Practice
Z
4.
Superstition
5.
Gender Situation
6.
Community
Development
7.
8.
Communication_Method
ML
DL
Neg
Conf
Agr
Strategy
Class
Room
teaching
Group
Discussion
Brain
storming
Play/
Poster
method
Time plan/Period
LB
9.30
1.00
pm
am
2.30
pm
4.30
pm
Days
requireol
Practical
Exposure
20%
20%
3
days
20%
2
days
z
Audio
visual
3
days
z
30%
2
days
30%
2
days
1
day
Z
Food Intake
30%
20%
1
day
1
day
Sanitation
42
Sr
N.
Topic
Communicatior^Method
ML
DL
Conf
Neg
Agr
Strategy
Class
Room
teaching
Group
Discussion
Brain
storming
Play/
Poster
method
Practical
Exposure
Audio
visual
Time plan/Period
LB
1.00
9.30
pm
am
2.30
pm
4.30
pm
1 Da'/S
1
required
1
day
9.
10
Drinking water
20%
10 days
Know your body
11
Cause & Effect of
Minor Illness
12
Health
Practices
13
Vitamins & Minerals
Sources / functions
30%
Emergency
20%
14
15
z
I 5-7 day:
Care
3
days
Identification
&
utilization of Herbal
Medicinal plants
1
day
20%
i days
3
days
43
Time plan/Period
LB
1.00
9.30
pm
am
Days
required
Sr
N.
Topic
16
Physical Exercise &
Yogas
100%
3
days
Application
Homeopathy
Medicine
30%
2
days
17
18
19
Communication_Method
ML
DL
Neg
Conf
Agr
Strategy
Class
Room
teaching
Group
Discussion
Brain
storming
Practical
of
Exposure
Audio
visual
2.30
pm
4.30
pm
20%
Allopathy Medicine
1
day
Utility of Naturopathy
•
•
•
•
•
Play/
Poster
method
ML - Monologue
DL - Dialogue
Neg - Negative
Conf - Confontration
Agr-Agreement
44
Development
Introducing the Foundation was not the only motive but also provided the
perspective of the organization through it. The Foundation constantly learnt
during its formative years. The Foundation faced many problems while
learning and learnt from these problems. This process is a learning cycle. No
institution is dependent on a single person. Many people participate in the
growth of any institute. This participation helps in development and growth of
the institution.
The Foundation went through various stages of growth. This created a
different thought process. Clinical awareness or health is not related to only
‘disease’, but environment and its related factors, gender etc, are closely
related to it and also inter-dependent. Trainees were taught to sing songs.
This helped increased concentration in training and make them conscious
about prevailing social conditions and to create an atmosphere of openness
and being open to suggestion. They were told some rules and regulations to
help in discipline and to reduce conflicts. As the training period was of three
months, discipline was required during their stay.
The subjects covered in syllabus, were discussed because the trainees were
under the impression that they were going to get training from FRCH to
become doctors. This was felt necessary to clear any wrong impressions and
to introduce the subjects along with the method of training explanation.
Health is not related to just disease, but there are various facets to it. As
health is one of the culminating outcomes of development, the trainees were
told about development. For this, the example of Punjab and Kerala was
given. Despite economic prosperity, terrorism is still a problem in Punjab.
Literacy rate is low. Infant mortality rate is high. As against Kerala, there isn’t
much economic development, but literacy is high, gender equality is present.
Infant mortality rate is low. Human development has taken place. The trainees
were asked to compare using these examples. They were provided with a
perspective that health stays good only if holistic development of humans
takes place.
45
As the trainees were going to work in action research , they were told the
method and importance of process documentation.
The training methods adopted and syllabus formed were flexible; therefore the
trainees were informed that they could suggest changes.
The trainees were told about participatory training method. They were told
that they could make their own choice after introspection and independent
thinking.
To make sure they understood what a participatory training method meant, it
was explained once again. Participatory training method means discussion
and developing a habit of thinking. To be able to differentiate between right
and wrong is important.
One trainee enquired, whether FRCH would provide notes of topics taught.
This type of training was explained again and the difference between training
for co-ordinators and grassroots level functionaries was emphasised. They
were encouraged to
be able to find information sources and work
independently.
The trainees were told that the training method is one that is process-oriented
rather than content-oriented. They were told about the Parinche project. While
talking about the structure of health services, they were informed about the
system adopted by the government vis-a-vis FRCH. To point out that
participation of people, especially rural women is important in the process of
development, FRCH has endeavoured to empower them. By explaining this
motive the relationship between development and gender was clarified.
To know and understand the existing system before creating an alternate, the
trainees were asked about the usefulness of public health services in their
region. Government schemes are not being developed for the people’s needs,
e.g., Family planning. Due to India’s geographical and cultural differences,
the schemes should be developed region-wise, but a single scheme is
46
implemented for all. Hence the trainees were given a view of designing
schemes only after understanding the needs of their area. At the same time
extending help is essential only if the people realize the need for it. This helps
in successful completion of any programme.
While talking about the Parinche project by FRCH, information was provided
on questions such as to how the Tais, Sahayoginis were selected? What was
the criteria? How a syllabus was formed while training the tais? In the whole
process, the participation of villagers was paramount. The project took shape
from their needs.
The trainees were told about the principles on which the Parinche project
works. For development of a village a holistic programme is required. People
were encouraged to make use of natural resources to aid and hasten
development, the Foundation would provide technical support when it was
required. By creating awareness in the people about this basic aspect of
development the Parinche project took shape. This clarified the concept of
development as well. The example of Ralegan Siddhi was also given as the
trainees have to do a similar kind of work in their villages. While
understanding a project its positive as well as negative aspects should be
known.
People in villages should demand for development themselves for continued
growth of the village. Upon this a trainee asked, ‘how can we take
development to the villager, if they are not aware of their needs?’ It was
further discussed that we should not do favours for anybody, but empower
them. It is essential to move towards actual needs from felt needs. To
illustrate this an example was given, wherein the government provides
medicines for diarrhoea, but does nothing for the root cause of diarrhoea, that
is lack of sanitation, a hygienic environment and potable water.
A discussion about attitudes and empowerment approach followed. Examples
of the freedom movement, Dalit movement and Narmada Bachao Andolan
were given. In these movements, the people brought forth their needs
themselves. Similarly during natural calamities people have to be provided
service. Which approach to follow for village development has to be decided
47
according to the circumstances. Example of Buddha was given. To achieve
balance under any situation and being able to find a central path is important.
To start the topic of development, we began with the conceptual framework.
This helped in identifying the components of development and understanding
the relationship between these components.
While doing conceptual framework 3 parts are important.
1) Facts
2) Concept
3) Theory.
Nobody understood the definitions of these parts therefore these were
explained by simple examples. As an example for fact it was stated, ‘Sun
rises from East’. Such small and simple facts make a concept, it later creates
a theory.
48
INITIAL CONCEPTUAL FRAMEWORK FOR
DEVELOPMENT’ BY TRAINEES
Employment
Primary needs
Peace
Law
Religion
Agriculture
Culture
Development
System
Panchayati Raj
Industry
of
Political Education
Communication
Environment
Socio Economic and
Culture
49
GROUP 1
LAW
CONSTITUTION
*
*
RIGHTS &
DUTIES
POLITICAL SYSTEM
DEMOCRACY
PARTICIPATION FROM
DIFFERENT SECTIONS
DECENTRALIZATION
MULTI PARTY
SYSTEM
Y
*
FLEXIBILITY
(SCOPE FOR
>
.CHANGE)
POLITICAL
CULTURE
POLITICAL DEVELOPMENT
r
POLITICAL AWARENESS
& EDUCATION
n
A
J S'
>
DIFFERENT ORGANIZATIONS
POLITICAL/APOLITICAL
AUTHORITY OVE^s
OTHER SYSTEMS^
UNITY &
INTEGRITY
POLITICAL
INFORMATION
INTERNATIONAL
PRESSURE/
RELATIONS
INDUSTRIAL &
UNDERWORLD
LOBBYING
These points were
added by FRCH
team -
Implementation of law
Making media independent
Seeking political information
50
Awareness of Rights and Responsibilites
Making participation meaningful
Knowing the agenda of different
parties
The last level of decentralization
should be the absence of any party.
GROUPS
PROVISION OF
PRIMARY NEEDS
HEALTH
EDUCATION
LIBERTY
SERVICE SECTOR
FRATERNITY
HUMAN & ENVIRONMENTAL
DEVELOPMENT
QUALITY
SECURITY
CULTURE
ETHICS
RIGHTS &
RESPONSIBILITIES
REPLENISHABLE
RESOURCES
POLITICAL &
RENEWABLE
SOURCES
ALTERNATIVES
NON RENEWABLE
SOURCES
SCIENCE &
TECHNOLOGY
51
DEVELOPMENT
JUDICIOUS
UTILIZATION OF
RESOURCES
GROUP 1
Gross Domestic
Product
Panchayat Raj system
Communication
Maw
Bureaucratic
Transparency
Education
Svstem
Child Labour
Gender Development
Mass Awareness
National Labour
Policy
Political Development
.___ J
National Law Policy
International All
Relations
Agriculture Policy
Education
technology system
Employment
Economic Policy
Health Policy
Traditional system
rhanoec
3
c. o
DO
52
1
> GOVERNMENT BODY
INTERNATIONAL
INFI .1 IF.NCF
Globalisation
Political policies
Decentralisation
Health Policy
Education
Health Training
Institute
Mass media
Health services
Research
Gender
HEALTH DEVELOPMENT
Economic status
Economic policy
Local
government
Culture
Social practices
customs
Natural
Environment
Sanitation
Water
Local
Local knowledge
and beliefs
53
Nutrition
Agricultural
policy
PRE-TRAINING
Agriculture
Environment
Land
Education
Income
Economic Development
Labour
Production
Import
Export
Communication
Health
Industry
Employment
W.T.O
Relation
Technology
54
Globalisation
POST - TRAINING
PROGRESS
Gross Domestic
Production
Capital
Distribution of
Primary
Resources
ECONOMIC
DEVELOPMENT
Political
Development
Means of
Production
Human & Natural
Resources
Surplus
Employment
Trade
Import/Export
Technology
> Environment
International
Politics
55
Purchasing
Power
Performing conceptual mapping shows that any incident may have various factors,
which could be related to each other. This activity was felt necessary as it would
enable the trainees to take a holistic approach rather than vertical approach in
thinking. To implement this, the trainees were first asked about their concepts on
education, health and to do conceptual mapping for them. Afterwards they were
divided into 3 groups and asked to do conceptual mapping for power, training. What
is a “variable” was also clarified at this time. For training, subject, trainee, teacher are
variables. After these discussions, the trainees were asked to make conceptual
mapping of development once again. They were also asked to consolidate
everyone’s efforts and present them on the black board, so that if anyone had
missed out anything, they could come to know about it.
Such activities are understood and absorbed well through repetition and this helps
increase confidence. The trainees were asked as to why they were asked to perform
these activities or exercises, one trainee responded that it would be useful to explain
to the funding agency. So it was explained again that conceptual mapping is
necessary to for our own satisfaction, curiosity and to boost confidence.
Development is affected by various factors in varying intensities. Example of
Parinche project was give for this and story of David Wener was narrated. “There
lives a young boy in a village. A rusted nail pierces his foot while working in the field.
The little boy dies because it is not possible to take him to a doctor immediately/”
The trainees were asked as to what they felt about the story. Why did the young boy
die?
Medical students or doctor state that the boy died because he was infected by
Tetanus. This is one of the causes, but the more important reason is that there is no
doctor in the village, there is no transport to take him to a doctor in the city. The
boy’s father is weak financially, therefore he could not afford to provide a pair of
slippers to the young boy, therefore the nail got into the boy’s foot, he contracted
Tetanus and died.
In this way, there may be ten different reasons contributing to the occurrence of one
incident. Development is linked to health. So if the development of the village takes
place, then naturally the people’s health will be better.
56
It is important to know how and why development occurred. For this it is essential to
have process documentation.
The Godhra riots were discussed and a song was sung related to it. Caste and
religious riots have a detrimental effect on development, therefore there should be
peace in society. Peace was thus added as a component of development.
Development which started off with conceptual framework. The component ‘peace’
which was never considered for development was added. It is essential to define
development, as definitions of development may vary in each region. Conceptual
framework is required to provide direction to the work and to define related
components when undertaking such work. For example, in 1960s gender as an issue
was not linked to development, but work was done on the issue of caste. Therefore,
while assessing its impact, we cannot say work was not done on gender, because
during that time the caste issue was at fore-front.
Participants were given this example and were informed about attitude of
the
researcher by mentioning that it is essential to define the components on which the
work is dependent and the components on which there will be an impact.
It was difficult for the participants to understand the concept, therefore they were
given the example of Parinche project.
Evaluation is required of any work. It is essential to know the components while
going about the proper way in evaluation.
It is essential to know the objectives, definitions, what strategy was followed, and
what was the impact, during evaluating.
Participants were told about the process of data collection and analysis. For this,
they were asked to collect data from various sources like newspapers, television,
radio, magazines, and derive proper conclusions after analysing this data.
After this the participants were given group activity for one hour. Political, economic
and environmental advancement are three important factors that contribute to
development. The trainees were asked to prepare conceptual framework on these
57
three components to understand them properly. The idea behind this activity was
that the participants should think independently and analyse these components and
their confidence should grow.
One member from each group made presentation of the group activity. This gave
them exposure. They did this presentation voluntarily; hence it helped in their
confidence growth.
Discussions were held on the components presented by the participants. This
activity gave direction to their thoughts. It was observed during the presentations that
since the participants who presented factors of economic and political development
were from the same educational background, it was easier for them to identify the
components, but they were unable to establish relationships within the components.
A lecture on globalisation by Mr. Rajiv Sane was held. The participants were
impressed. They were told about the difference between lecture method and
participatory training method once again. FRCH trainer then talked about the positive
outcome of participatory learning method.
Trainees were told at the beginning of the training that they were co-ordinators,
therefore it was important for them to know some English words. So that they would
not face any difficulty while attending some seminar or meetings. For this, English
words were used deliberately in the training.
One should be able to establish relationship between any two incidents. They should
be able to work at the Micro and Macro level simultaneously. For example, when
talking about gender, it is not enough to have gender equality at community level, the
laws of the land have to be changed.
Using conceptual mapping, it was explained that the relationship can be positive as
well as negative. Development is not only technology. Technological advancement is
necessary, as over a period of time human’s needs change. Some needs are
luxuries, but over time changes, they become basic necessities for example,
electricity. Technology can sometimes be used wrongly, as in atom bombs, fire. Ultra
sound is used to determine the health of a foetus, but it is used for gender
58
determination and if it is a female foetus, it is aborted. Development is not just
technology, buildings or industries.
Some needs change over time, for example, pre-historic humans did not need
electricity but slowly the need arose.
Discussions were held about development from pre-historic human to contemporary
humans. Human development followed means of production.
While discussing economic development, it was pointed out that the results of work
performed by women either at home or in the field is not accounted for in the Gross
Domestic Product. This is due to the difference of patriachy.
Participants asked questions on Gross Domestic Product, What is capital?, surplus,
globalisation etc. and also on international politics as well as on multinational politics.
While discussing economic development, the impact of globalisation was also
touched upon. Globalisation is being forced upon us. Economically strong western
countries are earning huge profits by dumping their surplus goods in third world
countries. The government as well as the people should know as to, at what level we
should accept or reject the multinationals. If we get some new technology, which we
can not produce indigenously, then we should accept that multinational for example,
drugs for tuberculosis.
If a multinational company buys primary goods from us and sells secondary goods to
us, we should be able to recognise their duplicity. For example, international
investment in newspapers will lead to more emphasis being given to murder, riots
etc. eclipsing the current prevalence of political news. We could use Swadeshi goods
as an alternative to multinational products. For this the example of Mr. Prakash Gole
was given.
Discussions were held on topics such as economic development, globalisation and
conceptual framework was done. Mr. Rajiv Sane’s lecture was arranged. Due to
these activities the trainees started the process of thinking. Due to repeated
discussion on some topics, they were able to internalize it. First they became
confused and to clear this confusion they started asking questions.
59
Participants were asked to think independently about globalisation versus economic
development. Listening, understanding followed by internalization is important. When
giving idea about the whole training, we introduced two persons with different
perspectives. The trainees had to listen to both persons, think over it and find a
middle path. Each individual had to decide which technology to accept and what to
reject after thinking independently.
The ex-sarpanch of Hiwre Bazaar visited the co-ordinators and he told the history of
Hiwre Bazaar and how he helped in village development. He has done work similar
to Anna Hazare. This shows that even a common man can develop a village. The
trainees were provided with a perspective that every work should start off from one s
self. No matter how much one is insulted or encounters difficulties, one should not
desist from doing the good work. So long as people do not realize their own needs,
they should not be given help.
Popatrao Pawar is the ex-sarpanch of Hiwre Bazaar. During the period of 1972-82,
the social, economic and political state of affairs decreased in the village due to a
famine. People started migrating, level of addiction rose. He made efforts to raise the
socio-economic levels. As a young, educated citizen, he put aside his own personal
interests. Trainees learnt how to face difficulties, how to work and that with a strong
will, even a simple person can work.
Popatrao Pawar undertook village development under the following components :
1) Community organisation and motivation — Five-point plan of ideal village
was used
2) Programmes developed through peoples needs e.g., school, liquor ban
3) Economic development - Self help groups
4) Environmental development — plantation, watershed, development of
water management, fodder, community farming
5) Government + NGO schemes implemented for village development e.g.,
Jawahar Yojana, Swarna Jayanti rural employment scheme, Jeevan
Dhara Yojana
60
While discussing these issues it was realized that the trainees were under the
impression that the work being done at Hiwre Bazaar was in isolation. To clear this
wrong impression they were given further examples like
1) Fatima Bi (Andhra Pradesh)
2) Anand Karve (Phaltan)
3) Anna Hazare (Ralegan Siddhi)
4) Pani Panchayat (Saswad)
5) Gomukh (Ratnagiri)
After this the participants were asked as to which works, undertaken by Popatrao
Pawar would they like to replicate in their own villages. The common feedback was
that they would like to work on the five-point programme of an ideal village, but they
felt it would be difficult to motivate the people for shramadan.
They were told that to bring people together and to encourage them for shramadan,
a common point or factors of interest to all, for example in Maharashtra water
problems and in Orissa, joint forest management, could be the starting point.
Using this platform, we can convince the people of the needs and involve them. It is
important to involve more people for development rather than do more development.
Any work becomes sustainable if there is self-interest and group participation.
After this, discussions were held on various approaches to development, their
positive and negative components, decentralisation of power, second line leadership
etc.
Development become sustainable due to second line leadership. For example, Dalit
movement in Maharashtra. Lack of a second line leadership poses hurdles for
sustainable development, for example Jai Prakash Narayan - Education.
Trainees were asked to understand the issue and the underlying principles. For this,
example of FRCH was given, as people and strategies of the Foundation may
change, but principles remain the same.
Even if one topic is studied thoroughly, instead of collecting content on multiple
subjects, the thought process is started. Knowledge could be gained from anywhere,
61
if there is self-motivation. Strategy adopted by FRCH to start the thought process in
people was told to the trainees. For example, repeated discussions on various
topics. The flow this provided to their thoughts, exposure visits and difference in tais.
One trainee initiated a game about shramadan. Two groups were formed. Each
group was given an image cut into pieces, and they were asked to generate a
meaningful image from these pieces. One of the participants was asked to guide
them in the role of a sarpanch, after this they were told about the idea behind the
game, and discussions were initiated to find what they learnt from this game. From
this game, they were made conscious about the difficulties faced in working after
involving people at village level, how to solve these difficulties? How to make use of
peoples’ psychology after understanding it?
Planning is important in every stage of community work. A game was organised to
explain it. On a square piece of paper, 10-12 persons were asked to stand. Everyone
got in equal, insufficient space. After this the paper was cut into long strips and glued
together to form a long strip. After laying down this trip everyone got equal space. It
was also inferred from this activity, that proper distribution of available resources
results in equal advantage to everyone.
Along with this, moral values were also discussed. It is not necessary that the social
moralities prevalent in society should always be right; we should decide what is right
and wrong from them.
It is essential to have an open mind, while solving any problem. This facilitates
decision making after thinking from different points of view.
The participants were shown a film regarding female reservation in politics, current
abuse of the system and what women can do in development, through the
panchayati raj system.
The topics discussed during the training were listed, which are as follows:
1) Privatisation Vs. Public Sector
2) Use of new technology Vs. Development
3) Government Vs. Non-Government
4) Decentralisation Vs. Centralisation
62
5) Freedom Vs. Equality
6) Choice Vs. Compulsion
7) Service Vs. Empowerment
8) Liberalisation Vs. Total Control
9) Development Vs. Environment Protection
10) Consumerism Vs. Need based use of materials.
As the means of production changed, it changed the social, economical and political
system. It had an impact on cultural values and social patterns as well. Marx’
theorem of historical materialisation was given. Financial gains became the primary
cause in changing political systems, for example, slavery system, king system,
feudalism, capitalism. The trainees were told that these systems are always
dynamic, but because we are not aware of it, we are afraid of changing any system.
Some books and novels were suggested for the trainees to read and to study the
changes which occurred in the social, political and financial system during the era of
feudalism, for example, Devdas, Shrikant. This could be useful for the trainees to
establish relations with other systems. They were also told that the novel "Lalita" by
Saratchandra, where relation between malaria and feudalism is shown could be
treated as an example of process documentation.
For the issue of New Technology Vs. Development, example of Thailand was given.
Instead of big dams, smaller dams were built, because of which water problems and
problems of displacement did not arise. It is important to keep in mind, which
technology to use and where and how to use it.
To address the issue of centralisation, the trainees were told that one should know
which things to centralise and which to decentralise, for example, health and
education could be decentralised, but defence and foreign relations cannot be
decentralised.
Regarding Freedom Vs. Equality, it was told that the Britishers exploited Indians and
in this way it seems that they misused their independence.
63
Example of an earthquake was given to explain Service Vs. Empowerment. For an
earthquake, service should be provided, it won’t do to employ empowerment
approach here.
Same approach can’t be used in all matters and no approach is against the other.
They complement each other. Trainees were given a view that balance has to be
attained between the approaches and to use them according to the need.
One thing was noticed during the training that the trainees themselves were coming
forward to discuss the topics which they felt was difficult. They were asking question
and making presentation without fear or inhibitions. This showed that the trainees
had developed an interest in training and their thinking process had started.
The upper classes and castes exploit the lower class/caste and accumulate their
own capital. To understand this a game Shenganyacha khel was played. This led to
a discussion on globalisation. Globalisation affects individuals and society as well.
The trainees were given a group activity. They were divided into 3 groups and were
asked to do conceptual mapping. The subjects were as follows 1) Gender development
2) Educational development
3) Health development
They were given a time of one and a half hours. One of the groups presented on
education development, but because it was not focussed, a presentation was given
to give it correct direction.
To gain complete knowledge on any subject; self-study, participatory learning
method, discussion, performing activity or practical and analytical reading is
essential.
Hence the trainees were given reading material for and against
globalisation, and they were given 3 options, ie.
1) Divide into 3 groups, each group will be given reading material, which they
should read and understand and then each group should present.
2) The group should read the material and do conceptual mapping.
3) Discuss after reading the material in front of everyone.
64
The trainees selected the last option, due to the fact that, this way English could be
translated into Hindi immediately, as not everyone understood English. Usha
Patnaik’s article The cost of free trade: the WTO regime and the Indian Economy
was selected, as it was relevant for the participants, but was difficult to understand.
Using this method, it was told to the trainees that analytical reading was also a part
of research method.
Globalisation, GATT, rejection of Indian goods, MNC policies were discussed. These
topics were related to earlier discussions held in context of development, therefore
understanding the concepts became easier, and as the discussions were repeated, it
helped in internalization.
Using some examples of organization in Maharashtra and Saurashtra, it was told
that technology can be decentralised, for example, a tractor manufactured using
simple technology and some other agriculture-related equipment, organic farming
etc.
Development is not dependent on factories alone. Israel’s example was quoted to
point out that development can also be achieved by improving the efficiency of
agriculture and related industries undertaking research for these fields.
From the geographical areas of the trainees where they will later work, it was pointed
that West Bengal has no industry, whereas in Gujarat, industries are in excess.
Trainees from Gujarat talked about the drawbacks of industrialisation, while trainees
from West Bengal were glad that industrialisation had not taken place in West
Bengal. At the start of the training, they were under the impression that
industrialisation means development, but now they came to know a new facet of
development.
After this the trainees were asked as to which components would be used if
development takes place in their village. Everybody mentioned these components.
The viewpoints of trainees about development on the first day of training and showed
a vast difference. The answers that they gave later were as Utilisation of local resources
65
i
Unity
Social and political awareness
Cottage industry
Rural technology
Natural resource management
Access to community resources and benefit sharing.
Participants had left out primary needs, while creating a concept of development;
therefore they were told that without taking care of basic needs, development is
incomplete.
As gender is also an important component of development, it was also discussed.
When development takes place in a village, we have to check, whether men and
women are treated equally. But such equality is not possible and to know why it is
not possible, we have to first understand how a man and a woman are developed by
society. Therefore a list of qualities following the same by society was generated. An
ideal man and woman are created out of this.
Status of a woman in society is always secondary. They are always deprived of
authority and rights. But she has lot of duties to perform. Most important is to ensure
piety of a woman’s body. They were also told about the history of evolution of family
system.
It was observed during the discussion that some of the male trainees did not
participate, whereas male participation was high when virtues of an ideal woman
were being discussed.
66
ANNEXURE
QUALITATIVE ANALYSIS
Mr. Khalasi Shailendra:
: If you want to do development in society you must have
Before
development in social,
technological and economic
sectors.
Politics
plays role in development,
Economic
essential items in every house.
Social
Food grain, electricity, transportation
Education essential for development.
Health
No one should be diseased.
After
I got idea of how development is possible in the areas of
politics, economics, environment and health.
In health Tais offer affordable and effective services to society. It has given us new
thought.
After watching watershed development projects I was able to understand lot about
new development concept.
We got new perspective to look at science, education, environment, culture,
entertainment.
How you will use this in your area -
- In my area less people participate
•
How many people participate in gram sabha?
■
How many women participate in gram sabha?
■
Whether people from various caste participate or not?
■
What are the questions asked?
*
Whether these questions are answered or not?
There is always a poor result in school
■
Whether teaching is bad?
■
Whether pupils are casual about school?
■
Are there less examinations?
■
Children concentrate less in class?
■
Whether practicals are less?
67
There is less agriculture. Why? What it was 3 years ago is very less
now.
■
Is there water scarcity?
■
People are now more in company service? Hence less
agriculture.
■
Less rain?
■
Because of arrival of companies employment opportunities
increased?
■
No one wants headache of maintaining cows, buffaloes,
goats,etc.
Establishment of Mahila mandals, Yuvak mandals is essential for
development of village. People should be made more aware of health,
environment. People should learn to communicate with each other.
Everybody should be involved in process of production. There should
be larger Forum to discuss and solve problem of village.
68
ANNEXURE
QUALITATIVE ANALYSIS
POST HEALTH DEVELOPMENT
Niranjan, Sanjay, Pramila, Alpa, Joyita
Understood different factors of development and were able to establish
1)
relationships among them. (Integrated Approach)
Manoj
D
Now able to think critically and analytically.
Alpa
1)
Initially there were no questions in mind but not there are lots of
questions to think upon.
Shailendra
1)
In Development your own thinking is important.
Alpa, Manoj
1)
Broader framework of development gained through discussion, visits,
guests and practicals.
Joyita
1)
We can look at Population Explosion' as human resources rather than
a problem.
Pramila
1)
For Development of country, there should be change in person, family,
village and then state. I will present the works of Anna Hazare and
Popatrao Pawar in our Gram Sabha.
Manoj, Pramila
1)
Development should start from village to city/urban area.
69
Shailendra, Alpa
Manoj, Joyita, Sanchita, Pramila, Sanjay
1) Change in thought process
Digal
1)
Initially interested in information and notes. Now interested in
discussion.
Sanjay, Sanchita, Joyita, Pramila, Sugatha
1)
Believed in our own body to cure minor diseases.
2)
Decreased dependence on medicines.
Joyita, Pramila, Sanjay
1)
Proper utilisation of available local resources.
70
ANNEXURE
CLINICAL TRAINING
INTRODUCTION
(22 August 2002)
On the first day of training in development and research, various definitions of "Health"
and "Illness" other than the World Health Organization’s definition was discussed. This
was done to enable them to understand "that perceptions and attitude of people guide
their behaviour". It was emphasized that they should familiarize themselves with the
way people perceive health. To make the issue relevant the following example was
given:
During FRCH's project in Parinche, the community's response to who is healthy
varied. For example; being rich, having a son, having children, being manied
etc. constituted health, but the common factor stated by the community was
"having respect in the village". This indicates that the community has taken into
account emotional stability, good inter personal community relationships as
important indicators for health.
During a project conducted in the Konkan region, women of that area had said
"Self respect" was the indicator for health.
In one study from a highly industrialized area, people considered health as
"having a job".
Some people think "a fat child" is healthy. If a child is malnourished, water
retention (oedema) in the body occurs. This makes parents feel that the child is
healthy and they do not seek the help of health services.
Thus the way people perceive health guides their behaviour.
To further illustrate this issue, a discussion on "how they look at their own bodies" was
conducted. Following were the responses:
•
Compact machine
•
Machine
•
Co-operative society
71
Biological machine
Home for Soul
Marvel
Mystery
’Kalpa Vriksha' - "like a tree which will grant your wish"
Next it was decided to identify proverbs related to the body. A few such proverbs
identified are listed below:
Body is Nashwar
Cage for soul
From dust to dust.
The group analyzed all these responses and proverbs and came to the conclusion that
our bodies are perceived in the following ways -
•
Body as a utilitarian object
•
Body as an unknown, mystery which could not be
understood.
•
Body as a vehicle for the soul
•
Body as a part of nature
•
Body is mortal
•
Body is to be revered
These perceptions about our bodies also guide our behaviour. If we look at it as
something, which is dust, we don't take care of our bodies. On the other hand if the
body is seen as a mystery we don't attempt to learn about it.
Thus to improve understanding about health awareness, the group concluded that it is
important to know the community’s perception and plan our health education content
on that basis. The consensus was that the approach taken would not be one of direct
confrontation but to build on correct perceptions.
Another important issue discussed was "do we trust our bodies?" Do we listen to what
our bodies are trying to communicate to us? Pain could be one such signal where our
bodies are trying to tell us that it requires rest or a change in life style. Another signal
could be indigestion.
72
Participants related some of their experiences where their bodies tell them not to do
certain things such as keeping 'fasts’ as it leads to gastritis, stress leading to headache
etc.
The next issue discussed was that if we trust our bodies, we should bear the
responsibility of keeping it healthy. People know that smoking, eating gutkha, eating
food rich in fat and leading a sedentary lifestyle can lead to health problems. Still we
continue to do the same. Even our relationship to our bodies is hierarchal. "I" is related
to our faces or our thoughts. We take care of our faces to make it beautiful but we
hardly take care of our other body parts. The entire advertising world is built on this
misconception. If we think we are a part of nature then we should have certain life style
principles, which are common with other living beings, for example, the smallest unit of
life - the cell.
From the most primitive life form, complex life has evolved. If we are a part of nature
then like other animal forms, primitive man must have had an instinct for healing herbs.
For instance, when cats suffer from indigestion they eat a particular grass to induce
vomiting that helps clean their system. It has also been observed by zoologists that
elephants and chimpanzees also eat special herbs when they are sick, but due to
modernization we have distanced ourselves from nature. Instincts have been subdued.
But we still see a reflection of our relationship to nature in certain rituals like offering
prayer to "Pimpal", "Neem" and "Tulsi" trees. One of the common practices in
Maharashtra is that temples have some land under their control. No tree in this area is
allowed to be cut. This area is called "Devrai". This was one way of protecting trees
and at the same time giving them the status of being "Divine". Participants responded
that in their areas too such practices are observed.
Where do we put man’s place in nature? To find the answer, participants were asked to
draw a picture of "Man’s place in nature".
The following observations were noted from the pictures:
The group from the industrialized area reflected predominantly pollution.
The group from Phulbani had drawn trees and hills, which is a
representation of their own area.
73
One of the participants had placed "Man above the other living being and
non- living objects."
Three of the participants used the utilitarian approach. The picture clearly
showed that they had drawn man at the centre with all natural resources
directed towards him.
Two of the participants had shown a symbiotic relationship with nature.
Few of the participants said that the relationship with nature depends on our
perspective as to how we see man's arrival on earth.
A majority (80%) believed in evolution. Those remaining felt we had come from another
planet. One of the participants felt that
man was created by God. A discussion
followed which addressed the issue "did life forms exist on other planets". To explain
this "Unique event theory" was explained. Biologists do not believe that life is possible
on other planets i.e. events, which occurred earlier, were co-incidental and it is not
possible that those same events would be repeated again. Physicists believe that such
events do occur and life could exist, but there is no proof that we have come from
another planet.
At present scientists believe that evolution is the answer/choice to show "man's" arrival
on earth.
Discussion period
3 hrs.
Activity
25 minutes
PERSPECTIVE
•
•
•
•
•
We are a part of nature
Health is our responsibility
Our bodies are equally important as are our minds.
All body parts are equally important.
Trusting in their own bodies.
KNOWLEDGE
•
•
•
Evolution
Unique event theory
Different definitions of health
•
•
•
How to generate qualitative information.
How to analyse picture drawing
Analysis of qualitative information
SKILL
74
DIGESTIVE SYSTEM
(22-23 August 2002)
A total of 12 hrs. were spent on teaching.
The objectives of the training were:
To know the digestive organs;
To understand the process of digestion;
Convey common problems related to digestion and their
treatment;
To learn symptoms of diseases related to digestive system;
To recognize danger signals
Process of training
To assess the knowledge of trainees about digestive system they were asked to draw a
picture of the digestive system. Trainees were able to draw/list various organs except
salivary glands and pancreas. Discussion of the various organs, their placement and
functions was carried out. A correct picture of the digestive system was drawn.
To explain that anatomy of an organ is directly related to its function, various organs,
their structure and role was explained. This led to a discussion on different types of
tissues and their function. After that the role of digestive system was explained. The
process of digestion was explained.
The next day, training started with revision of digestive organs, cells, tissues and
process of digestion.
The following diseases with their symptoms, signs, treatment and referral criteria were
explained:
1.
Diarrhoea and Dysentery
2.
Gastritis
3.
Piles
4.
Stomatitis
5.
Ulcer disease
6.
Ulcerative colitis
7.
Vomiting
75
8.
Worm infestation
For the above-mentioned diseases home remedies and life style changes were also
told. Trainees had difficulty in understanding terms like aerobic, anaerobic, by-products
and end product
Total hours
12 hrs.
Demonstration/Activity
1 hr.
Lecture
5 hrs.
Discussion
6 hrs.
Teaching Aid
Models, Blackboard, paper
and pencil.
76
RESPIRATORY SYSTEM
(24th, 26th, 27th and 29th August 2002)
A total of 26 hrs were devoted to training.
The objectives of the training were:
1.
To learn about respiratory organs and their functions.
2.
To identify common respiratory illnesses and provide treatment.
3.
To recognize danger signals and provide appropriate and timely referral.
Process of training
The participants were asked to draw respiratory system. The participants could not
make a satisfactory presentation. Hence respiratory system was drawn on the black
board and explained. Composition of air was discussed and respiratory physiology was
explained. Following diseases with signs and symptoms and treatment were explained.
1.
Allergic rhinitis
2.
Common cold
3.
Pharyngitis
4.
Sinusitis
5.
Tonsillitis
This session on diseases and treatment was repeated again.
The next day training started with 'cellular respiration'. This was the difficult part of the
training and required repetition. It took three hours to explain cellular respiration.
Chest mapping was carried out. Different types of pain in the chest and their differential
diagnosis was explained.
The following diseases with signs and symptoms, criteria for referral and treatment
were explained:
1.
2.
3.
4.
5.
6.
7.
Acute bronchitis
Adenoiditis
Bronchiolitis
Chronic bronchitis
Diphtheria
Emphysema
Laryngitis
8.
9.
10.
11.
12.
Lung cancer
Otitis media
Pertusis
Pneumonia
Tuberculosis
Skills imparted
1.
Counting respiratory rate
2.
Tonsil examination
3.
Lymph node examination
4.
Observe intercostal indrawing
5.
How to install saline drops in nose
6.
How to administer steam inhalation at home
The following perspectives were imparted:
1.
Role of antibiotics in viral infections.
2.
Role of home remedies in common respiratory problem.
3.
Inadvertent use of steroids by private practitioners in respiratory illnesses.
4.
Use of rational drugs.
5.
Tuberculosis is a infectious disease and can be cured.
6.
Drug resistance and judicious use of antibiotics.
7.
Concept of immunity and its relation to nutrition and mental health.
8.
Concept of vaccination, types and schedule.
Total hours
26 hrs.
Lecture
17 hrs.
Practical and demonstration
4 hrs.
Discussion and activity
6 hrs.
Difficulties faced
1.
Cellular respiration
2.
Judicious use of antibiotics
3.
Eliciting chest sounds
4.
Concept of immunity
78
PAINS AND ACHES
(30.08.2002 to 01.09.2002)
A total of 18 hours were devoted for training in pains and aches.
The objectives of the training were:
1.
To know the role of pain in disease
2.
To know the factors, which have an impact on pain
3.
To view pain positively
4.
Gender and pain
Participants were encouraged to narrate their own experiences of pain
Pain was classified into various types and the significance of type of pain to
specific organs was explained.
eg. Hollow organs (intestine, gall bladder) produce Colicky pain.
Classification was Dull throbbing pain
Pricking pain
Colicky pain
Crushing
Strangulation
Radiating pain
Criteria for referral was explained and associated factors told when referral
should be done.
A positive outlook and attitude towards pain in labour was given.
Role of gender vis-a-vis pain was discussed.
Pain in various body parts/areas was explained
Chest
Upper and lower limb
Shoulder
Skills imparted were
Straight leg raising test
Detecting muscle spasm
The next day training began with revision of skills
>
Trainees were asked to examine patients
>
Osteoarthritis of knee and being able to diagnose it was explained by eliciting
signs
79
Cases seen in the hamlet clinics were discussed
Exercises were taught to strengthen back and neck muscles
Abdominal pain was taught
Trainees were unable to relate site of pain to organ placement (in the abdomen).
To make the participants understand this, an exercise was carried out.
- Body mapping of abdominal organs was performed.
This helped the trainees to relate site of pain to underlying organs.
The next day, training began with trainees narrating experiences of pain. This
highlighted that threshold of pain for different individuals vary. Thus defining the
type of pain was difficult.
Asking where the pain was located, type of pain, radiation of the pain and
associated factors if present were to be elicited. Not attaching too much
significance or relying on patients perception of pain was emphasized.
Total hours
18 + 3 = 21 Hrs
Practical and hands on training
7 Hrs
Lecture
10 Hrs
Discussion and Activity
5 Hrs
80
REPRODUCTIVE SYSTEM
(2-3 September 2002)
The objectives of the training were:
To recognise and treat antenatal problems
Use integrated systems of medicine
Recognition of danger signals with appropriate referral
Anatomy and physiology of the reproductive tract was taught.
Teaching aids used were pictures and models.
Function of each part was explained.
Menstrual cycle was explained in detail.
Hormonal changes
Changes in ovaries
Changes in uterus
Changes in behaviour
Social/cultural views on menstruation
Historical views on menstruation
eg. strength, fear, sprinkling of menstrual blood in fields before
planting new crops, etc
Viewing the menstrual cycle in the larger dimension incorporating physical,
mental, cultural and social factors was taught and discussed in detail.
Diseases and abnormalities in the reproductive tract was taught in detail.
Menstrual irregularities
Menstrual problems such as pain during periods, heavy menstrual
flow, mood changes preceding menstruation was discussed.
Fibroids
Pelvic inflammatory disease, its causes and signs and symptoms.
Cancer of cervix was discussed.
Danger symptoms and signs were told.
Physiologic changes in pregnancy were taught.
Body changes in each stage of pregnancy were discussed in detail.
Diagnosis of pregnancy was taught by using only signs and symptoms.
Stages of foetal development were explained.
How to determine stage of pregnancy was told.
How to calculate Expected Date of Delivery (EDD) was explained
81
Dietary practices to be adopted in pregnancy was explained.
Other interventions like tetanus injection, iron and folic acid supplementation
were told.
What is needed to conduct a safe delivery using WHO prescribed standards and
other culturally acceptable practices were taught.
Exercises :
Lamaze during pregnancy
Kegel's during and after pregnancy was explained.
Danger signs and symptoms in each stage (trimester) of pregnancy were
explained in detail.
82
FEVER
(6-7 September 2002)
Total days devoted to training
2
The objectives of the training were:
1.
To identify common fevers and treat
2.
Identify danger signals and make appropriate referral
3.
To use integrated systems of medicine to treat fever
Body as a whole was dealt with
Various temperature regulating mechanisms were explained
Conduction
Convection
Radiation
Role of each body part and its effect in controlling body temperature was
explained
Hypothalamus in the brain
Blood
Skin
Why fever occurs, physiology was explained
Concept of threshold was explained.
Fever was classified as;
mild
-upto 100° F
moderate
-101 -103° F
High
-103°F
Diseases with signs and symptoms were explained
Hepatitis
Typhoid
Rheumatic fever
Malaria
Chicken pox
Tuberculosis
Puerperal sepsis
Urinary tract infection
Measles
Wounds
Pneumonia
Meningitis
Influenza
Pelvic inflammatory disease
Bacillary dysentery
83
Danger signals with fever was explained in detail.
Role play was conducted for the above mentioned diseases. The trainees
participated in this. This enabled the trainer to ascertain as to how much they
were able to understand.
Also it was emphasized that one symptom could be a pointer of multiple system
disorders ie, it could be a part of more than one system.
Discussing diseases causing fevers separately also led to a repetition of these
conditions.
eg.
Pneumonia in respiratory system
Pneumonia in fever.
84
ORTHOPAEDIC TRAINING
(8-9 September 2002)
The objectives of the training were:
1.
Relation of strain to pains and aches.
2.
Relation of exercises to maintaining flexibility, and movement of
joints
How to recognize fractures and provide first aid in fractures and
3.
immobilization if required?
4.
Alternatives to plaster immobilization.
5.
When,how and why to refer an orthopaedic patient.
6.
Management of orthopaedic patients.
Pains and aches relating to following body parts were discussed.
Skills imparted :
■
Pains and aches
A) Backache
•
SLR examination
•
Palpation of spine
•
How to recognise Neurodeficit? and thereby understand its
severity.
•
Exercises
B) Neck pain
•
How to recognise muscle spasm? Various pressure points to elicit
that.
Exercises
C) Knee pain
•
How to recognise instability .
•
Various painful conditions associated with knee pain osteoarthritis; contusion; swelling.
•
Exercises
Trauma
Fractures of following parts:
Wrist - colies fractures
Forearm - green stick fracture
Hip
85
Leg
Vertebra - compression fractures
Shoulder
These were discussed with emphasis on first-aid; principles of supports; do's and
don'ts of immobilisation; alternatives to plaster material in Orissa, Bengal and Gujarat;
how to immobilise the extremity or the part attached.
Training Process:
Trainees participated in this. They had a broad idea of minor and major fractures. They
understood the objectives and principles of immobilisation. All immobilisation
techniques were demonstrated to trainees and they were asked to practice
immobilisation techniques on each other.
Regarding musculoskeletal system, they were given charts of neck, back and shoulder
exercises.
86
MEDICAL EMERGENCIES
(13 September 2002)
Total
-
4 Hrs
The objectives of the training were:
To identify signs of life threatening emergencies
To make timely and appropriate referral
The emergencies fall into three categories :
Problems of breathing
Problems of shock and unconsciousness
Problems of poisoning and snakebite
BREATHING PROBLEMS
Choking on food or other foreign bodies
Absence or decrease in respiratory effort
Cyanosis
SHOCK AND UNCONSCIOUSNESS
Anxiety and restlessness
Cold and clammy skin
Pallor
Rapid and weak pulse
Rapid and shallow breathing
Decrease in urine output
Large dark patches on skin
Wheezing
Decreased consciousness
Dilated, pinpoint or unequal sized pupils with abnormal reactions of pupils
to light
Unequal pupils: damage to opposite side of brain
pinpoint: poisoning and insecticides
does not react to light: severe damage to brain
neck stiffness
tone of skin vis-a-vis dehydration
Did the patient start choking while he/she was eating?
Did the child have any throat infection (Diphtheria, Croup)?
87
Was the patient found in a closed room with fire?
Was s/he close to an electric wire?
Did the patient suffer injury to neck or head?
Was the patient taking any drugs?
Was the patient found close to water?
Are fontanelles depressed?
Any history of convulsions?
BITES
Blue and black skin and severe pain
Drooping eyelids and slurred speech
Bleeding from gums and mouth, urine, skin (snake bite)
BURNS
Burns around mouth.
INSECTICIDES / PESTICIDES
History of sweating and drooling
These poisons affect the nerves, sweat glands and salivary glands. Slow and
Shallow breathing, unusual odour on patient's breath.
- Enquire if possible how long patient has been in coma ?
1. Has the patient been vomiting
2. Suffering from diarrhoea
3. How did patient get burned?
4. Did the patient receive any injection?
5. Has patient been sick during the past 1 week?
6. Any chronic disease
7. Drinking alcohol
8. Gradual or sudden unconsciousness
EXAMINATION:
1.
Patient's respiration (type and rate)
2.
Pulse rate
3.
Blood pressure
88
4.
Temperature
5.
Colour of the skin
6.
State of consciousness
7.
Pupillary reaction
8.
Alert: Time and place, event
9.
Confused: responds to hearing his/her name important in head injuries
10.
Responds after shaking: low level
11.
Responds to pain - very low level of consciousness
12.
Cannot be aroused: deep coma
SHOCK
Following listed points to be looked into.
Bleeding as evidenced from external body appearance, respiration,
pulse.
Low blood pressure
Burns
Loss of body fluids
Infections
Heart attack
Allergic reactions
Injury - internal bleeding
Diarrhoea, vomiting, weak dizzy, anxious, fear of death.
Thirsty, blurred vision, cannot breath, itching, fever
The process of training:
Danger signals were explained. First Aid was shown for snakebite, electric shock,
drowning and for fractures.
89
MISCELLANEOUS PROBLEM
(13 September 2002)
Information on following diseases was given:
Skin
1.
Abscess
2.
Allergic reaction (Urticaria)
3.
Cracked heels
4.
Fungal infection
5.
Guinea worm
6.
Herpes Zoster
7.
Leprosy
8.
Leucoderma
9.
Lice
10.
Pimples
11.
Psoriasis
12.
Rash
13.
Scabies
14.
Thorn prick
15.
Ulcer
16.
Wound
Eye
Conjunctivitis
Glaucoma
Refractive errors
T rachoma
Ear
Pain in ear
Discharge from ear
90
NUTRITION
(19 September 2002)
Total Days devoted to training
3
The objectives of the training were:
Principles of a balanced diet
To know various deficiency diseases
Emphasis on special diets
•
What is nutrition was explained.
•
Concept of balanced diet was explained and demonstrated by taking into
account percentages of different food groups.
•
Different diet plans for pregnant and lactating mothers was given.
•
An exercise was carried out to demonstrate caloric value of one day’s food
intake.
It was seen that one meal catered to the whole days need of energy
requirements. Hence overeating was touched upon.
•
Different food groups
Carbohydrates
Proteins
Fats
Vitamins and mineral salts
Water
These were taught by explaining caloric value per lOOgm and its sources.
Function of each food group with resultant deficiency symptoms and signs was
explained.
Importance of balanced diet, certain nutrient supplementation in
pregnancy was emphasized. Dietary restrictions and taboos
during pregnancy were dealt with.
Dietary practices during pregnancy as a subject for formulating a
questionnaire was carried out.
Malnutrition was explained under the following heads:
Causes and reasons
Symptoms and signs of Kwashiorkar and Marusmus with
reason behind
91
each symptom and sign
Interventional measures to be taken using government
resources, home diets that incorporate locally available,
cost effective, culturally acceptable food sources was
emphasized upon.
How to diagnose malnutrition by signs and symptoms and mid arm
circumference was told.
• Nutritional anaemia was explained
Role of micro-nutrients like vitamin C was taught.
•
Goitre was told and its effects were described.
•
Vitamin A deficiency was explained and sources of food rich in
Vitamin A conveyed.
•
Vitamin B deficiency was explained and sources of food rich in
Vitamin B conveyed.
•
Vitamin C deficiency was explained and sources of food rich in
Vitamin 0 conveyed.
•
Vitamin D deficiency was explained and sources of food rich in
Vitamin D conveyed.
•
Vitamin E deficiency was explained and sources of food rich in
Vitamin E conveyed.
•
Vitamin K deficiency was explained and sources of food rich in
Vitamin K conveyed.
92
MENTAL HEALTH
(20.09.2002 to 23.09.2002)
A total of 23 hours were utilized to teach mental health. It was clarified at the outset,
that the session will focus on mental health issues.
The objective of the training were :
to establish a relationship between mind and body,
to provide skills to recognize abnormal from normal.
The session started with an activity.
Participants were asked to close their eyes for two minutes and narrate the thoughts,
which occurred within this stipulated time.
Answers that followed as told by participants are listed below:
1.
Memory of mother
2.
Durga Puja
3.
Journey back to hometown
4.
Upcoming examinations
5.
Memories associated with friends or village
6.
Children's exam
This list was analysed by the participants and conclusions drawn. This exercise
showed that we think of either the past or the future. It is very difficult to focus on the
present. This leads to conflict and subsequently stress, as the past cannot be changed
and for the future, corrective actions cannot be taken.
The discussion that followed was on future plans and this led to the important issue
"What is the purpose of life?"
Every participant was asked to share their view on purpose of life. A list was prepared
which is listed below:
1.
Foot prints should be there after death
2.
People should remember us
3.
To take care of family
4.
To complete job responsibilities
5.
For self-development
6.
For social cause
93
For social development
8.
For self-satisfaction
9.
For attaining happiness
10.
For attaining peace
11.
No purpose
This list was discussed again. An important issue that came up was that all of us want
people to remember us after our death, or why people want to work for the community
or society.
Few of the participants felt that it is due to our egos. One of the participants said: ‘when
one identifies oneself it is with caste and religion.’
Everyone introduced themselves. A few of the participants introduced themselves with
their degrees, caste or telling about family and relatives in high post.
This led to the discussion "Was this really our identity?” How does one describe
oneself? Following this, Id, ego and super ego were discussed. Factors affecting ego
and super ego were discussed.
It was realized that emotions are a major part of our reactions. And this is directly linked
to our ego.
A list of emotions are listed below -
1.
Anger
2.
Peace
3.
Jealousy
4.
Sorrow
5.
Joy
6.
Disgust
7.
Mercy
8.
Pride
9.
Cruelty
10.
Love
11.
Infatuation
12.
Greed
94
13.
Aggression
14.
Hate
15.
Sympathy
16.
Sadness
17.
Remorse
18.
Fear
19.
Irritation
20.
Regret
One primitive emotion identified was fear, as babies also have fear. As the child grows,
from fear arises greed and jealousy.
Thus it was decided to discuss more about fear. Everybody narrated their experiences
of fear.
Fear of animals, drowning, death, rape, ghosts, God, elders, death of near ones,
breaking self image was discussed.
Factors affecting fear were discussed. Gender issues were also discussed.
Following this fear of the "unknown" and self-image was discussed.
It was agreed that as thoughts precede emotions, the same would be applicable in the
case of fear.
If we attempt to rationally observe our thoughts we will be able to control fear. How can
we do this? It was discussed that sharing, exploring the unknown, meditation, prayer
helped in controlling fear.
It was discussed that introspection may also decrease our fears. Introspection may also
bring up unnecessary information collected by us. This unnecessary information leads
to stress and affects our relationships and emotions.
How to empty our minds from this unnecessary information?
The group discussed the above-mentioned issue and felt that, only awareness about
this unnecessary information can control it.
95
The group decided to share their "unnecessary information" as a step to be aware of it.
All the participants contributed and suggestions were made by others.
The second day session started with again classifying of the mind i.e.,: Id, ego and
super ego.
Freudian explanation to mental health disorders was explained which is based on
repression. Viewpoints other than Freud were also explained.
Different personality types such as Sanguine, Phlegmatic, Melancholic and Choleric
were explained with their characteristics.
Participants felt that after fear another problem creating emotion was anger and
required discussion.
"Why does one get angry?" was the question put forward. Answers that followed were;
if somebody does not listen to what we are saying
if we are not satisfied
if we are stressed
if something does not go according to our wish
These were some of the reasons of anger, and this was analysed.
Anger was also linked to our expectations and desires. Expectations and desires are
linked to our ego.
A discussion on factors affecting ego followed. Being aware of these factors that ego
was the solution the participants felt. All religions in their own way have tried to control
ego.
From ego, discussion moved to how we develop defence mechanisms and that these
are also indicators of our personalities. Three major defence mechanisms: aggression,
withdrawal and flight were identified and discussed.
Later in the training various mental disorders and their symptoms were explained. The
importance of referral was stressed. Mental disorders are like any other physical
disorder and they are curable. This was explained.
96
The various disorders taught
1.
Mania
2.
Depression
Symptoms were discussed which overlap multiple mental disorders like
1.
Delusions
2.
Hallucinations
3.
Psychosis
4.
Neurosis
Mental disorders with reference to women were explained. Factors are not only
biological but cultural, social, work- culture related practices were also discussed.
Disorders dealt with were:
1.
Pre-menstrual stress
2.
Menopause
3.
Backache
4.
Headache
5.
White discharge per vagina
6.
Possession
7.
Hysteria
Principles of counselling were discussed.
Most of the participants were confused about "Love" as an emotion. It was explained
that is "Love" is a faculty/function of brain/mind.
A total of 23 hours were devoted to mental health training.
Lecture
2 hours
Discussion
21 hours
97
Napie
Education
Environment
Health
Pre
test
Pre
test
1.
Ramashish
Pre
test1
2.
Joyita
1
3.
Sanchita
4.
Sr.
No
Post test
1
1
Post
test—
1
Post
test
2
Gender
Political
Social
Economic
Pre Post
test- test
3
Pre Post
test- test
1
Pre Posttest- test
2
3
Pre
test
Post
test
7
5
5
1
3
4
2
1
Basic
Amenities /
Infrastructure
Pre Posttest
test
1
Total Marks
Pre
test8
Posttest
7
8
17
4
10
3
3
12
1
9
13
1
4
9
2
6
14
3
8
25
1
5
7
1
3
1
1
2
1
Alpa
1
2
1
1
1
2
3
1
5.
Manoj
1
2
2
1
5
5
1
6.
Niranjan
4
3
7.
Shailendra
1
4
2
1
8.
Diggal
4
3
7
4
5
9.
Sugatha
1
1
1
1
4
10.
Pram i la
3
1
4
2
1
3
11
11.
Sanjay
1
1
3
5
2
7
6
Total Marks
4
11
42
34
22
1
1
1
1
2
4
2
1
1
2
1
1
3
2
1
1
7
1
22
2
12
3
5
2
98
8
3
2
3
8
TRAINEES RESPONSES FROM QUESTIONNAIRE
Training Method
Marks
Percent
4
40
Clinical
Marks
7
Percent
47
Mental Health
Marks Percent
6
40
53
6
40
6
40
4
40
5
33
5
33
4
27
3
30
Shailendra
4
27
6
40
6
40
5
50
5.
Sanchi ta
5
33
5
33
5
33
6
60
6.
Joyita
7
47
7
47
6
40
7
70
7.
Ramshish
3
20
4
27
4
27
4
40
8.
Sugatha
6
40
6
40
5
33
5
50
9.
Pramila
6
40
7
47
6
40
4
40
10.
Sanjay
6
40
5
33
3
20
5
50
Sr.
Trainees
No
1.
Alpa
Development
Marks Percent
6
40
2.
Manoj
8
3.
Niranjan
4.
ANNEXURE Cl
BIO DATA OF TRAINEES
State
Sex
Educational
Qualification
Age UnGrad Grad Post
Grad
M
40
15 years
2 years
F
29
2 years
1 year
M
F
27
30
1 year
7 years
S 2 years
f 7. years
(teaching)
M
21
F
23
F
25
M
35
F
M
23
29
M
21
Experience
No
Exp
0-1
year
1-5
years
Rural
5-10
years
Above
Development
Research
Training &
Clinical
Management
Communication
ORISSA
Ji rim io
I Digal
Sugatha
Pan i grab i
Sanjay Bhol
Pramila
Konhr___
West
Bengal
Ramasis
Mukhree
Jyoita
Sarkar
Sanchita
Sarkar_____
I Hazira
I Niranjan
Patel_____
Alpha Joshi
Shailendra
Khalasi
Manoj Patel
/
f 3 years
(teaching)
4 years
2 1Z2 years
S 3 years
(teaching)
4 months
(accountant)
100
ANNEXURE C2
CLINICS
'A
12/07/02
Dhankawadi
16/07/02
Pangare
19/07/02
Mandhar
23/07/02
New Hargude
26/07/02
Yadavwadi
30/07/02
Hargude
02/08/02
Khengrewadi
06/08/02
Parinche
09/08/02
Pangare
16/08/02
Shindewadi
20/08/02
Dudhalwadi
30/08/02
Kambalwadi
03/09/02
Khengrewadi
06/09/02
Dhankawadi
16/09/02
Pangare
101
ANNEXURE C3
LIST OF CASES SEEN BY FACILITATORS
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
Acute bronchitis
Allergy
Amoebiasis
Anaemia
Arthritis
Asthma
Boils and blisters
Cancer stomach
Chronic bronchitis, Emplysema
Common cold
Facial palsy
Fever
Fracture
Fungal infection
Gastritis
Hypertension
Infected wound
Itching
Jaundice
Malaria
Numbness
- knee pain
Pains - low back
Piles
Pneumonia
Rheumatic Heart disease
Sinusitis
Sore throat
Spondylitis
Urinary Tract Infection
Uterine prolapse
Weakness
White discharge
Worm Infestation
’^L’Sn-XRY
irrc;
ND
TION
)
102
'TM- II O
u
ANNEXURE C4
SCHOOL HEALTH PROGRAMME
The school health programme was planned with the following objectives
•
To recognize what is normal
•
To provide appropriate screening to recognize health problems for further
treatment.
All trainees were involved in the school health programme. The importance of school
health check ups was explained. The session was conducted and some children were
diagnosed to have problems and were referred. A total of 368 students have been
examined.
Process of conducting school health programme
Trainees were divided into five groups for conducting the following activities:
•
Weighing the child and counting the pulse;
•
Measuring the height and counting the respiration;
•
Vision check-up;
•
General examination;
•
Listening to heart sounds
After trainees had filled in the above-mentioned necessary information and examined the
child, s/he was sent to the doctor for verifying the result of the trainees examination. This
also ensures that if trainees have missed certain details about the health of child, doctors
can correct and make necessary changes. The observations regarding the performance of
trainees need of new information or practice of a skill then becomes a part of that day's
session.
The trainees were rotated from one group to another. This ensured that the trainees got
hands-on-training in every skill. The number of children to be examined or a given day is
limited to 55 as it provides enough time for each to conduct activities giving each student
the required time.
103
The chart below shows the types of cases detected by trainees:
CASE DISTRIBUTION
Sr.No
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
No.of
cases
41
___
Tonsillitis______
60___
Waxjnear
Dental caries_______ 66___
34___
Cardiac murmur
4____
Throat inflammation
Cervical lymph node 7
enlargement
Cough_____________ 21
Fever_________ 1
7
White patch on skin
Boils______________ 2
Icterus____________ 3
1
Chronic diarrhoea
2
Peri orbital swelling
Jaundice__________ 1
5
Worm infestation
Phimosis__________ 22
Mouth ulcers_______ 1
. Anaemia(mild)______ 2
Malnutrition ______ 3
12
Abdominal pain
1
Low backache_____
Chronic suppurative 1
otitis media________
Headache_______ 4
Irregular periods
1
Stye
lllness/Disease
Percentage
13.62
19.93
21.92
12.29
1.32
2.32
6.97
0.33
2.32
0.66
0.99
0.33
0.66
0.33
1.66
7.30
0.33
0.66
0.99
3.98
0.33
0.33
1.32
0.33
0.33
Out of 368 students 301 (81.57%) were detected to have some problems. 126 students
(34.23%) had problems related to poor hygiene such as wax in ear or dental carries. This
shows that health education, a graded referral system and regular school check ups are
necessary.
After initiation of this activity it was observed that trainees require more practice in the skill
of listening to heart sounds and being able to detect between normal and abnormal heart
sounds. A total of 34 students with cardiac murmur were detected. The school health
programme has helped trainees to gain confidence.
104
Functional
; sr.
Classification
(GRADE)
23/07/02
26/07/02
07/08/02
14/08/02
' NO
NAME OF
ILLNESS
21/08/02
27/08/02
04/09/02
01/10/02
01/10/02
IL
Tonsils
II
8
8
4
4
3
14
9
12
5
2.
Wax in ear
1
4
3
11
6
14
22
11
9
7
: 3.
Dental caries
ii
12
23
7
4
20
5
6
! 4.
Systolic
murmur
Diastolic
IV
5
3
5
3
4
8
1
9
-2
4
TOTAL
%
67
12.83
13
100
19.15
2
1
89
17.04
1
3
42
8.04
9
1.72
9
1.72
14
2.68
24/09/02
7.
murmur
Throat
Inflammation
Cervical
Lymph node
Cough
R.
Fever
II
1
1
0.19
; 9-
White Patch
II
1
1
1.14
Hr
Boils
I
2
9
1.72
H.
Icterus
III
3
0.57
12.
Chronic
diarrhoea
II
1
0.19
135
25.86
1
0.19
I 5>
I 6.
II
1
2
II
4
1
13. ‘ Within “
114-
1
II
Normal limits
III
Periorbital
2
10
1
7
-5
1
3
1
1
1
2
1
: 27
21
8
4
1
I swelling
105
4
16
16
21
15
SR.
NO
NAME OF
ILLNESS
Functional
Classification
(GRADE)
15.
Worms
I
16.
Phimosis
III
17.
Ulcer
on Il
tongue_____
Anaemia
II
(Mild)
Malnourished II
18.
19.
23/07/02
26/07/02
07/08/02
14/08/02
21/08/02
3
8
4
27/08/02
04/09/02
7
01/10/02
24/09/02
2
2
3
01/10/02
11
1
1
1
2
3
TOTAL
%
8
1.5
33
6.32
1
0.19
7
1.34
1
1
2
0.38
1
1
2
3.44
18
0.19 I
1
0.19 J
8
1.53
22.
Abdominal
pain
(epigasmic/
umbilical/
during
menses)
Low
Backache
C.S.O.M
III
1
I 23.
Headache
II
4
Irregular
Menses
Styes
II
1
1
0.19
II
1
1
0.19
Undescended
Testes_____
Arthritis
Chronic
II
1
1
0.19
1
0.19
3
0.57
1
0.19
20.
21.
i----
F
26.
27.
I
II
7
5
1+1
3
1
1
2
1
1
| 28.
Squint
1
i 29.
H/O
Heart
Disease
1
106
1
1
I SR.
NO
ho?
j 32.
i
p| 34.
35.
NAMEOF
ILLNESS
Functional
Classification
(GRADE)
23/07/02
26/07/02
07/08/02
14/08/02
21/08/02
27/08/02
04/09/02
01/10/02
01/10/02
24/09/02
TOTAL
%
Infected
wound_____
Ear discharge
1
1
0.19
i
1
0.19
Spasmatic
chest pain
Common
cold_______
Eye
sight
check up
Vitiligo
1
1
0.19
6
4
10
1.91
3
4
7
1.34
1
0.19
1
594
107
ANNEXURE C4
23/07/2002
Parinche
26/07/2002
Parinche
07/08/2002
Yadavwadi
14/08/2002
Yadavwadi
24/08/2002
Yadavwadi
04/09/2002
Yadavwadi
ANNEXURE C4
SCHOOL HEALTH PROGRAMME ANALYSIS
From 23/07/02 to 1/10/02
Parinche
Place
Gharmalkarwadi
Yadavwadi
Standard
1st to 4th
5th to 10th
Total
522
Female
244
Male
Female
46.74%
Male
53.25%
278
mo
ANNEXURE C4
DATE
PLACE
04/09/02
Yadavwadi
24/11/02
Yadavwadi
Yadavwadi
FEMALE
MALE
TOTAL
19
37
56
7^
30
34
64
gtfi-
26
19
45
gW
23
17
40
STANDARD
01/10/02
24/09/02
01/10/02
24/09/02
Yadavwadi
21/08/02
Yadavwadi
10tK
26
17
43
14/08/02
Yadavwadi
5^
22
27
49
07/08/02
Yadavwadi
-|st_4th
20
23
43
23/07/02
Parinche
-|S,_4th
26
29
55
26/07/02
Parinche
•|st_4th
21
36
57
27/08/02
Gharmalkarwadi
-|st_4th
27
35
62
11/10/02
Yadavwadi
Absent
4
4
8
Total
244
278
522
i
j
____
11 r
ANNEXURE C4
ABSENT STUDENT
PLACE
FEMALE
MALE
TOTAL
Gharmalkarwadi
3
2
5
Yadavwadi
3
2
5
Yadavwadi
3
2
5
Yadavwadi
1
2
3
Yadavwadi
1
4
5
1
1
Yadavwadi
Yadavwadi
1
1
13
12
1/10/02
Absent Student
8
check-up done
17
Absent student
25
111
ANNEXURE C5
(05/09/2002 and 12/09/2002)
10 AM
-3 PM
Total
-10 Hrs
Two days were exclusively utilized to answer trainees queries/doubts regarding clinical training
The questions asked were :
•
What is allergic reaction?
•
What is Chlorphenarmine tablet
•
What is Gastritis?
•
Can drugs cause gastritis ?
What should we advice?
•
What is a chronic illness?
•
Home remedies for backache?
•
Home remedies for Family planning?
•
What is filariasis? How to treat filariasis?
•
What is the difference between filariasis and Malaria?
•
What is the cause of dengue fever?
•
What is a cardiac murmur?
•
What is meningitis?
•
What is gonorrhoea?
•
How to motivate mothers to bring their children for vaccination?
•
Reasons for low sperm count
•
What is pelvic inflammatory disease?
•
How long a person can live with one kidney?
•
Why are alcoholics fat?
•
Why women don't suffer from kidney stone?
•
Is night emission a disease? If it occurs daily is it normal
•
What is impotency? Is it related to nutrition?
•
What is Phimosis?
•
What is breast cancer?
•
What is an artery and vein?
•
What is diabetes?
•
What is mental retardation?
11
ANNEXURE C5
LIST OF YOGASANAS SHOWN
1.
Bhujangasan
2.
Butterfly
3.
Kavachai
4.
Mandurasan
5.
Suryanamaskar
6.
Tadasan
7.
Yognidra
1 1
ANNEXURE C6
Sr.
No
1.
Name
Indications
Dosage
Paracetamol (500 mg)
F ever/Headache/
Body ache
Dysmenorrhoea
2.
Metronidazole (200
mg)
Yellow frothy
stools/ stools with
blood or Mucus
3.
Mebendazole (100
mg)
Worms
4.
Chloroquine (150 mg)
Malaria
5.
Ibruprofen(200 mg)
Bodyache,Tooth
ache, Backache
0-6 months - 1/8 tab three times a day
6months - 2 years - 1/6 tab
2-4 years - 1/4 tab
4 - 7 yrs - 1/2 tab
8-12 yrs - 1 tab
Above 12 yrs - 1 -2 tabs__________
Below 3 yrs - 1/2 tab (100 mg)
3 - 7 yrs - 1/2 tab (100 mg)
Above 8 yrs - 12 yrs - 1 tab (200 mg)
Above 12 yrs - 2 tabs (400 mg)
3 times x 7 days_________________
1 tab (100 mg) twice a day for 3
days(Adults)
‘A tab (50 mg) twice a day for 3
days.(Less than 12 yrs)____________
For adults - 4 tabs after blood smear,
after 6 hrs. - 2 tabs
1 tab twice for 2 days_____________
4 yrs - 8 yrs. - 1/2 tab twice a day.
8 yrs - 12 yrs - 1 tab twice a day.
Above 12 yrs - 2 tabs twice a day.
6.
Salbutamol
7.
CPM (4 mg)
Already
prescribed as per
Doctor’s
instructions
Allergy
8.
Cotra (80 mg)
Gelusil_________
9.
10. ' Metoclopramide10 mg.
11.
12.
13.
Domperidone - 10
mg.____________
Albendazole
Asprin (use in
years)
20
Acidity
Vomiting
Antihelminth
Fever,
Bodyache,Knee
pain.
6-12 yrs. - 1/2 tab
12 yrs and above - 1 tab___________
< 1 - avoid, but 1/4 tab twice a day
1 - 3 yrs. - 1/4 tab
4 - 8 yrs. - 1/2 tab
9-12 yrs. - 1 1/2 tab
Above 12 yrs. - 2 tabs (twice a day for
5 days)________________________
For Adults - 2 tabs_______________
Adults - 10 mg. t.i.d.
Children
9-14 years - 5 mg. t.i.d.
5-9 years - 2.5 mg t.i.d.
3-5 years - 2.0 mg t.i.d.
1-3 years - 1.0 mg t.i.d.
< 1 year -1.0 mg t.i.d.
Contraindication
Jaundice
Pregnancy,
Lactating
Pregnancy,
Lactating
Lactating
10 mg. t.i.d - 15 minutes before food.
Pregnancy
Adults 400 mg. - 1 H.S.
Child < 10 kg. 200 mg. 1 H.S.
300 mg q.i.d
Pregnancy.
Lactating
Sr.
No
14.
Name
Indications
Benzyl benzoate
Scabies
Dosage
Contraindication
Take bath
with hot
water,
apply from
neck
downwards
. Reapply
after 24
hours.
After 48
hrs. (2
days) take
hot water
bath.
Reapply on |
hands after
every time I
hands are I
washed. Do
I
not apply
I
I on face.
ANNEXURE C6
AYURVEDIC MEDICINE
R^dl)
To induce Fermentation,
menopause, Fibroid
(URT^ : 100 mi ;
STtf ■ 100 TH ;
TH ;TifkT : 50 RH ; HIH^TR : 100 TH ;
50 TH)
: 100
HH :
1*Id N'T)
Htprefrft (tl'S*!!'^)
antidiabetic
3i
(zymnima sylvestar) (^0)^1
Midi)
antiworm , anti diarrhoea
$S?^1c|
ThHR (3llMdq|x| 3TT^)
(Bombax Mulbaria)
Rcddi^i^, Pimples,
(Andrographis Peniculata) -
chlco^M
•MefR’MI
, cmoM'TI , cRod+i)
(Pedalium Murax)
(Trabulus Terextis)
Rbcj^cfqd
Fever (Aristo Locia,
Bractiolata)
§n^ (Sentela Sentilica)
ibr ciA<^
(nps mft)
- (cisses quadingularis)
For normal kidney function
(fsTdr dddim 3T <A^I RmoD)
<^ui
Piles
ms (mn)
Hod cl ef
mW*
Hod^cf 20 TR , mums 20 TH , 6|\lt>oil'd b>ld 10 TH
3 MH RdMl)
11 (
(31-id ^06)
Lactation
crrftqiTO (Dioscoria Bulbifera)
(^T tow)
+ TOT
cblTO'S (Aloe Vera)
3TTTOT (Thilantus Faternus)
(Evolvisus microphilus)
TO dddi cfl-i^i (Geriatric)
Menstrual ailments
4106
^T ciiPl d->
0H Icilcf)
worms, skin diseases
Cfrcj Meld
toto) (Triocozanthis
cucumarina) - Acidity
Wind cristing , low BP
catalyst
7I^
(Borivilianam)
tl A C|7
(Roulfia Sarpentina)
(Roulfia Tataphulia)
(TOft)
Vitamin A, allergy
tot (Saida cortifolia , Rhombipholia, tostJ
A''! >51
Diarrhoea
1 T
ANNEXURE C6
HOMEOPATHIC MEDICINES
Trainees were initially acquainted with following aspects of Homeopathy
Principles
Individualization
Selection of medicine
Compounding a medicine
Dispensing a medicine
Reviewing patients
Following medicines were discussed with trainees
Arsenic album
Argentum Nitricum
Calcarea carb
Sulphuric acid
Robinia
Natrum Mur
Carbo veg
Aconite
Belladona
Pulsatilla
Aloes
Veratrum alb
Chamomilla
Podophyllum
Merc sol
Merc cor
Mag phos
Colocynth
Abies Nigra
Lycopodium
Bryonia alb
Chelidonium
Cardus mar
Collinsonia
Ratanhia
Aesculus
Hammamillus
Antim crud
Kreosote
Senecio Q
Cimicifuga
Secal cor
Aletris Farinosa
Hydrastis
Thalaspi Bursa
Pyrogen
conium maculatum
Sanguinaria
Belladona
Apis mel
Thuja
Naja
Antim tart
Hepar sulph
Above mentioned medicines were discussed as singular medicines or in compound form. In a
module which is given to trainees Homeopathic medicines with reference to Digestive system,
Reproductive system, Respiratory system, Skin, Eye, Ear, Head, Excretory system, Accidents,
pains and aches are discussed widely. Entire module was discussed with trainers.
Herbal and Home remedies
Preparation of
How to evaluate medicinal potential of plant?
How to draw extract?
How to purify it for consumption? These issues were discussed with
trainers.
Following plants were shown to trainers :
, STRr^l ,
, cfjfSHR , ejgHlTl , tiqiycTI
We discussed with them preparation of following medicinal syrups.
For anaemia
Drumstik ; Jaggery ;
; ^fk ;
,■
For cough, asthma - eggs + lemon juice syrup
Jackfruit syrup for white discharge and TB
Hibiscus syrup for white discharge
We discussed following ayurvedic medicines
Along with this recommended diet patterns in various ailments as enlisted in Ayurveda is
discussed.
ANNEXURE R1
Base Line Survey Questionnaire prepared by the Trainees
Objectives:
1)
2)
(a)
To assess health services in the project area.
(b)
To assess the expenditure incurred on health care.
(c)
To know the type of morbidities present in the project area.
Personal Information :
(a) Name:
3)
(b) Age :
18+
(c) Caste:
SC/ST/OC
Marital Status
: Married/Unmarried
Sex
Male/Female
Family Members :
Age
Name
Sex
Occupation
Educational
Relation to the
Qualification
Household
Head
4)
Health Seeking Behaviour:
To whom do you visit first when any of your family members is ill
Private Doctor
Hospital
Traditional Healer
Others
5)
(a)
No. of family members were sick in last one month -
120
Ill . J i
(b)
Name
Illness
Symptoms
6)
Nature of disease, please specify.
7)
Please mention the total expenditure on health care for the purpose. Rs.
8)
(a)
Have you met any severe illness by any of your family members
during last one year?
1.
2.
3.
(b)
Nature of disease
(c)
Cost involved in treatment
9)
When do you use herbal medicine and why?
10)
No. of children
0-7 days
8-29 days
29-1 year
1 year-4 years
5 years - 14 years
15 years - 45 years
45 years - 65 years
65 +
11)
The place of delivery
(a)
Hospital
(b)
TBA
(c)
ANM
(d)
Private Practitioner
(e)
Others
llllllBli
12)
Have any of your family members met an incidence in last one year?
(a)
Dog bite
(b)
Snake bite
(c)
Burns
(d)
Drowning
(e)
Shock
QUESTION TO GRAM PANCHAYAT
1)
Type of health services available in your Gram Panchayat jurisdiction
No
Provision________
Private Practitioner
Traditional Healer
Government Hospitals
Others
2)
Nature of drinking water resource in the community
No
Type
Tube well
Dug well
Ponds
Water tanks
Others
3)
Is there any sanitary provision?
No
Type
Soak pits
Toilets
Dust bin
Others
4)
Is there any water purification system followed ?
Bleaching
Cleaning the dug wells/ponds
5)
Is any child or children or pregnant mothers have died?
6)
If Yes, Please mention
(a)
Name
(b)
Address
(c)
Date of death/place :
122
7) Was there any epidemic outbreak in your area
in last one year and no. of deaths?
(a)
How many were ill?
(b)
What was the epidemic?
(c)
How many no. of people died?
What services ANM’s provided in the area?
8)
Name the five diseases, which you feel them dangerous.
9)
1.
2.
3.
4.
5.
10)
Nature of Veterinary health services available in your area.
11)
Cattle population
Cattle
Goat
Cow
Buffaloes
Hen
Pig
Sheep
Duck
Rat
Horse
12)
13)
No
Name the five diseases that affect the cattle population in your area.
ls there any Health camp been organized/ conducted in your area in last one
year?
123
ANNEXURE R2
NATURE OF SCIENCE
WHAT IS SCIENCE___________________
SCIENTIFIC METHOD
THEORY AND FACT
ROLES OF THEORY AND~FACT
DIFFERENCES BETWEEN THEORY AND
FACT_______________________________
SCIENCE AND SOCIAL SCIENCE
COMPARISION BETWEEN NATURAL AND
SOCIAL SCIENCE____________________
RESEARCH DESIGN
~~
IMPORTANT FEATURES OF RESEARCH
DESIGN________________ ____________
CHARACTERISTICS OF A GOOD
RESEARCH DESIGN
_______________
TYPES OF RESEARCH DESIGN
STEPS IN RESEARCH DESIGN
TOOLS AND TECHNIQUES OF DATA
COLLECTION
___________________
OBSERVATION
INTERVIEW
QUESTIONNAIRE
CASE STUDY METHOD
SAMPLING
ANALYSIS
QUALITATIVE ANALYSIS
MEASURES OF CENTRAL TENDENCY
STANDARD DEVIATION
QUALITATIVE ANALYSIS
CODING
CONTENT ANALYSIS _______________
1 ">.1
ANNEXURE R2
NATURE OF SCIENCE
What is science?
The word Science is derived from the Latin word Sceri which means 'to know’.
Science is difficult to define primarily because people often confuse the content of
Science with its methodology. Although Science has no particular subject matter of
its own, we do not view every study of phenomena as science.
Science is that body of knowledge which deals with the ongoing understanding of the
phenomena occurring in the universe. Science is the accumulation of systematized
knowledge based on facts.
As famous scientist Infield and Einstein say “Science is the attempt of the human
mind to find a connection between the world of ideas and world of phenomena. All
the essential knowledge in science were born in a dramatic conflict between reality
and our attempt to understanding the same’’. Science is believed to arrive at practical
solutions of all the problems to a great extent but this does not mean that this is the
only path to understand the reality.
Science has also been failed to unravel certain persisting mysteries of life. But since
its basis is mostly on facts and finally leads to the education of theories, and these
theories are further able to give a generalized understanding of the existing
relationship between the existing phenomena.
Science seeks to discover and exhibit logical relations between or among the facts.
Will Durant in his definition of Science say, “ Science is the captured territory (in the
siege of truth). As soon as a field of enquiry yields knowledge susceptible of exact
formulation, it is called Science.
Science is an intellectual thought model and its aim is to conceptualize the
impersonal facts of experience in verifiable terms, as exactly as possible, as simply
as possible, as completely and meaningful as possible. It is concerned with physical
as well as psychical process; as well as with nature. It takes the knowable universe
125
for its subject. It has to do with everything to which its methods can be applied. What
makes a science is not of course the nature of things with which it is concerned but
the method by which it deals with these things. According to Karl Pearson, “ Science
is an objective, logical and systematic method of analysis of phenomena devised to
permit the accumulation of reliable knowledge. It is a systematized form of
analysis... not any particular body of knowledge".
Science attempts to account for particular events by reference to general laws
together with the actual conditions under which these laws act to account for laws by
reference to principles still more general.
SCIENTIFIC METHOD
Karl Pearson said, “There is no shortcut to the truth... no
way to gain knowledge of
the universe except through the gateway of scientific method,
It refers to a method of
investigation or a procedure by which scientific and
systematic knowledge is
acquired.
And its elements are:
1.
Reliance on empirical evidence: A person of science is firmly committed
to the belief that truth can be established on the basis of evidence that our
sense organs can get at. He further believes that since knowledge of existence
outside oneself is reached through experiences; it must always be uncertain
and tentative. A scientist’s attitude is of critical empiricism. A person of science
regards rational ideas or guiding principles for making predictions or formulating
explanations to be tested subsequently by observation, i.e. empirical evidence
now or at some point in future. It is required for the advancement of science a
continuing
interplay between logical frontiers (rational) and its empirical
frontiers
(empirical). Both these aspects are very important for scientific
methods.
2.
Use
or
of relevant concepts:
Concepts:
Concepts
are
logical
constructions
or
abstractions created from sense impressions, percepts and experiences
Concepts are the symbols that science works with. The world in which we live,
and in which science is discovered at work, is apparent in nature. The world
which science describes is a creation of human intellect which may bear some
resemblance to casual nature is not identical with it. The scientific procedure
I ?(>
consists in involving, defining and manipulating concepts are symbols with a
view to contributing variously to the corpus of systematic knowledge and/or to
establish some new bit of knowledge.
3.
Commitment to Objectivity: The nature of scientific method is such that a
practitioner of science must set aside his hopes and his intuition. The man of
science is firmly committed to the belief that to go nearer to the goal of truth, he
must above all things.... strive at elimination in his judgment and provide an
argument which is true for each individual mind and his own.
4.
Ethical Neutrality: A man of science should be ethically neutral he should
not follow favoritism, he should not be biased, he should not be follower of a
school. The man of science should only respect the things, the phenomena and
should have faith in them. Finding out truth should be his main objective. A
scientist should
keep his personal judgments away for the accurate
measurement of things.
■
5.
■'
Generality: Generalization is an important aspect of scientific method;
generalizations are statements of general applicability. Generalizations emerge
naturally after a large enough number of particular observations. The more
mature a science is, the greater is its generalizing principle.
127
THEORY AND FACT
The basis of modern science is the intricate relationship between theory and fact.
Popular understanding of this relationship obscures more than what it illuminates.
Theory is confused with speculation and thus a theory remains speculation until it is
proved. When this proof is made, theory becomes fact. The relationship between
theory and fact is very important in scientific enquiries, as the basic theme of science
is based on the processes of induction and deduction. Induction is a process in
which generalizations are made on the basis of facts and these facts or
generalizations are added to the existing body of knowledge or theory. Deduction is
a process in which facts are deduced from theories for the understanding of any
phenomena.
So, the scientific process starts from a hypothesis, based on the theoretical
knowledge the hypothesis is then tested and it becomes a fact and this fact is added
to the existing theory. Thus, it goes in a cyclical fashion.
Theory
Deduction
Induction
◄
Hypothesis
Fact
Testing
In the process of induction, a number of facts and the essence of the relationship
between the facts get abstracted to form concepts. All these concepts then further
add to the formation of constructs and from these constructs a theory is built, which
contains very high logical activity. Induction moves from particulars to arrive at
general propositions. It operates on faith that in the course of things for a long time is
a basic, and regularity evidenced surely enough for the inference that it will continue
so in future.
Deduction is a device for the discovery of the truth that lies concealed within a set of
statements. A new relationship between the concepts is discovered. Deduction
yields to propositions and propositions yield knowledge. The empirical test is the final
128
test and if one of the most usual pattern of explanation in science is evidently
deductive, form of universal statement or statements (laws) together with some
particular statement of condition is deduced a statement; describing the event to be
explained.
So science never imposes anything, it states. It aims at making true and adequate
statements.
ROLES OF FACTS AND THEORY
FACTS
•
Facts are materials for theory building.
•
Facts are essential for testing or verification.
•
Facts fill in the gaps of theory.
•
Facts help in reinterpretation of phenomena.
•
Facts help in the initiation of theory and add to the existing theories.
THEORY
Theory provides orientation.
Theory is an organization of facts.
Theory helps in ordering or systematization of facts.
Theory helps in analytical interpretation.
Theory helps in the classification of phenomena based on facts.
Theory is needed for interpretation.
Theory is a source of prediction.
Theory is a source of identification of new areas of research.
Theory helps in identification of gaps or lacunae in existing store of facts.
DIFFERENCES BETWEEN THEORY AND FACT
1.
Fact is a categorically singular entity, whereas a theory always refers to
relation between phenomena and entity.
2.
Fact may stand as an isolate, but theory is integrative in nature.
3.
Fact is elemental in nature while theory is systematic.
4.
Fact is idiosyncratic and theory is homothetic.
5.
Fact tends to be descriptive in nature but theory tends to be interpretive and
conclusive in nature.
1
6.
Facts are concrete, theory is abstract.
7.
Facts are based on observation, theory is derived from facts.
8.
Facts are basic building blocks whereas theory refers to the context which
imparts meaning to the facts.
9.
Fact are relatively unchangeable, theory is highly changeable, amenable to
modifications.
BASIC ASSUMPTIONS OF SCIENCE
The scientific approach is grounded on a set of basic assumptions that are unproven
and unprovable. These fundamental premises are necessary pre-requisites for the
conduct of scientific discourse.
Epistemology the study of the foundations of knowledge examines the nature of
these premises and how they work. By examining these assumptions we can better
understand scientific approach and its claim of superiority over other approaches to
knowledge.
1.
Nature is orderly: The basic assumption of science is that there is a
recognizable regularity and order in the natural world, events do not occur
randomly.
2.
We can know nature: Nature is no more provable that nature is orderly and
that laws of nature do exist. Individuals and phenomena exhibit sufficient
recurrent orderly and empirically demonstrable phenomena to be amenable to
scientific investigation.
That is, the human mind is not only capable of knowing nature but also of
knowing itself and minds of others.
3. All natural phenomena have natural causes: The assumption that all natural
phenomena have natural causes or antecedents epitomize the scientific
revolution. Until scientists can explain the phenomena in natural terms they reject
the argument that some other supernatural explanation is necessary. This
assumption directs scientific research away from a research for omnipotent
supernatural forces and towards the discovery of the empirical regularities and
order that underlie natural phenomena.
4.
Nothing is self-evident: Scientific knowledge is not self evident, claims for truth
must be demonstrated objectively. Scientists cannot exclusively rely on tradition.
Subjective beliefs and common sense to verify scientific knowledge.
Scientific knowledge is skeptical and critical.
5. Knowledge is derived from the acquisition of experience: If science is to help
us to understand the real world, it must be empirical, that is it must rely on
perceptions, experience and observations. Perception is a fundamental tenant of
the scientific approach, and it is achieved through our senses.
6. Knowledge is superior to ignorance: This argument does not mean that
everything in nature can or will be known. Rather scientists assume that all
knowledge is tentative and changing. Truth in science is always relative to the
evidence the methods and the theory employed and is always open to
modification.
131
SCIENCE AND THE SOCIAL SCIENCE
The ultimate goal of the social and all other sciences is to produce a cumulative body
of verifiable knowledge. Such knowledge enables us to explain; predict and
understand the empirical phenomena that interest us.
is to establish
In the words of Richard Braithwaite: The function of science
general laws covering the behaviour of empirical events or objects with which the
science in question is concerned and thereby to enable us to connect together our
knowledge of the separately known events and to make reliable predictions of events
as yet unknown
of science is in a highly developed state... the laws which
have been established will form a hierarchy in which special laws appear as logical
consequences of a small member of highly general laws.... of the
the laws
early stage of development
science is in an
may be nearly like generalizations
involved in classifying things into various classes.
Two basic types of scientific explanations are needed in social sciences :
Deductive
Explanation:
A
deductive explanation
call for a)
a
universal
generalization b) a statement of the conditions under which the generalizations hold
true c) an event to be explained, and d) the rules of formal logic.
In deductive reasoning the premises lead necessary to the conclusion; that is if the
premises are true the conclusions must be true, if however, the premises are not
true, the conclusion will not be true.
Probabilistic explanation: Not all scientific explanations are based on universal
laws. This is particularly the case in the social sciences. Social scientists are
primarily using probabilistic or inductive explanations. The major limitation of
probabilistic or inductive generalizations, in comparison to universal laws, is that
conclusion cannot be drawn about specific cases with complete certainly.
Prediction: The ability to make correct predictions has been regarded as the
outstanding characteristic of science. If knowledge is deficient, prediction is
impossible. The expectation that scientific knowledge should lead to accurate
predictions is based on the argument that if it is known that x causes y and that x is
present then we predict that y will occur. Underlying this argument is the assumption
6.
In natural sciences, physical phenomena may be known directly through
senses; the social phenomena are known symbolically through words or terms
e.g. tradition, customs, values etc.
7.
Subject matter of social sciences is qualitative and does not admit quantitative
measurement.
8.
There is greater heterogeneity in case of social phenomena than natural
phenomena.
9.
Natural sciences are known as exact sciences and controlled laboratory
experiments are possible unlike social sciences.
10.
In social phenomena the cause and effect relationship is difficult to segregate
as compared to natural sciences.
Thus on the basis of the comparison made between natural science and social
science the problems of social science research are mainly: epistemology, ethical,
practical and experimental in nature.
1 ? 1
RESEARCH DESIGN
A research design as defined by Clive Selltiz and others is “ the arrangements of
conditions for collection and analysis of data in a manner that aims to combine
relevance to the research purpose with economy in procedure”.
The research design is a conceptual structure within which research is conducted; it
constitutes the blueprint for the collection, measurement and analysis of data.
Decisions regarding what, where, when, how much by what means concerning an
inquiry or research study constitute a research design. The design includes on
outline of what the research will do from writing the hypothesis and its operational
implications to the final analysis of data.
The design decisions happen to be in respect of:
1.
What is the study about?
2.
Why is the study being made?
3.
Where will be the study carried out?
4.
What type of data is required?
5.
Where can the data be found?
6.
What periods of time will the study include?
7.
What will be the sample design?
8.
What techniques of data collection will be used?
9.
How will the data be analyzed?
10.
In what style will the report be prepared?
IMPORTANT FEATURES OF A RESEARCH DESIGN
1. It is a plan that specifies the sources and types of information relevant to the
research problem.
2. It is a strategy specifying which approach will be used for gathering and
analyzing the data.
3. It also includes the time and cost budgets since most studies are done under
time constraints.
Therefore a research design must necessarily contain - 1) a clear statements of the
research problem, 2) procedures and techniques to be used for gathering
I 35
information, 3) the population to be studied and 4) methods to be used for the
processing and analysis of data.
CHARACTERISTICS OF A GOOD RESEARCH DESIGN
•
The concepts should be well connected to the variables.
•
The choice of variables should be such that the relationship between them should
be the same as the relationship between concept variables.
•
The relationship between concepts should be effectively transformed to
relationship between variables.
•
There should be maximum focus on the research problem.
•
The frame of reference should be well defined.
•
It should ensure consistency.
•
It should ensure objectivity
•
There should be a proper organization of all the activities.
•
It should be able to ensure reliability.
•
It should be able to ensure replicability.
TYPES OF RESEARCH DESIGN
Exploratory: Used in formulative research studies. The main purpose of such
studies is that of formulating a problem for more precise investigation or of
developing the working hypothesis from an operational point of view. The major
emphasis in such studies is on discovery of ideas and thoughts.
A research design appropriate for such studies must be flexible enough to provide
opportunity for considering different aspects of a problem under study. Generally
three methods of a) study of concerning literature b) experience survey and c)
analysis of ‘insight - stimulating' examples are used for exploratory research.
Descriptive and Diagnostic: This kind of research design is used in most of the
social science research. Descriptive studies are those studies which are concerned
with describing the characteristics of a particular individual, or a group whereas
diagnostic research studies determine the frequency with which something occurs or
its association with something else. The aim in these studies is to get the complete
and accurate information; therefore the design has to be carefully planned. The
design should be rigid and not flexible and must focus on:
136
•
Formulating the objective of the study.
•
Designing the methods of data collection.
•
Selecting the sample.
•
Collecting the data.
•
Processing and analyzing the data.
•
Report the findings.
Experimental: An experimental research design is used when the researcher tests
the hypothesis of causal relationship between variables. Such design is used in
studies which require procedures that will not only reduce bias and increase
reliability, but will permit drawing inferences about causality.
STEPS IN RESEARCH DESIGN
r
I
PLANNING
IMPLEMENTATION
BROAD AREA
TESTING
BROAD PROBLEM
DATA COLLECTION
REVIEW OF LITERATURE
PROCESS AND ANALYSIS
FORMULATION OF PROBLEM
REPORT WRITING
HYPOTHESIS FORMULATION
DEFINING A RESEARCH PROBLEM
A research problem originates from a broad research area in which a researcher is
interested. A research problem in general refers to some difficulty which a
researcher experiences in the context of either a theoretical or practical situation and
wants to obtain solution for the same.
The components of a research problem are:
1.
There must be some objective (s) to be attained at. If one wants nothing, one
cannot have a problem.
2.
There must be an individual or a group which has some difficulty or the
problem.
3.
There must be alternative means (or courses of action) for obtaining the
objective (s) one wishes to attain.
4.
There must remain doubt in the mind of a researcher with regard to the
selection of alternatives.
5.
There must be some environment (s) to which the difficulty pertains.
POINTS OBSERVED IN SELECTING AND DEFINING A PROBLEM
1.
Subject which is over done should not be normally chosen for it will be a
different task to throw any new light in such case.
2.
Controversial subject should not become the choice of an average researcher.
3.
Too narrow or too vague problems should be avoided.
4.
The subject selected for research should be familiar and feasible so that the
related research material or sources of research are within one’s reach.
5.
The importance of the subject, the qualifications and the training of a
researcher, the costs involved, the time factor are few other criteria that must
also be considered in selecting a problem.
6.
The selection of a problem must be preceded by a preliminary study. This may
not be necessary when the problem requires the conduct of a research closely
similar to one that has been done.
7.
Technical terms and words or phrases, with special meanings used in the
statement of the problem, should be clearly defined.
8.
Basic assumptions or postulates (if any) relating to the research problem
should be clearly defined.
9.
A straightforward statement of the value of the investigation (i.e. the criteria for
the selection of the problem) should be provided.
10.
The suitability of the time-period and the sources of the data available must
also be considered by the researcher in defining the problem.
11. The scope of the investigation or limits within which the problem is to be studied
must be mentioned explicitly in defining a research problem.
REVIEW OF LITERATURE
Review of literature is an important element in research design. It help in the proper
formulation of a problem to be studied.
c
l ^8
J helps in understanding the nature of problem and
is built upon
Earlier work done by researchers is
it.
, To understand the scope of the su fee
2. To know the structure of the su^e<j
3. to understand the retatrons of subteotwrt
4. To understand the nature of earte
sub|ects
reseatchers.
R To know about the methods useo
6. To identify lacunae or gaps injhe
7
T°idet(hre—Xii^ionsoo-study.
; rT::x“^»-eal-——s
new and innovative ingenious rase
W^tiiUing pads of existing literature the facts.
by undertaking totally
preposll,ons
SOURCES OF LITERATURE
The iiterature can he derived through
directory of doctorai dissertations> accep,
riza intimals Reviews published,
ete„ puMc „bra,ies. as
agenpies and
^:;zxspX :—x—' - =
,r
special fields.
HYPOTHESIS
A hypothesis is a tentative statement consisting of a dependent as well as
independent variable.
A hypothesis may be defined as a proposition or a set of prepositions set forth as an
explanation for the occurrence of some specified group of phenomena either
asserted nearly as a provisional conjecture to guide some investigation or accepted
as highly probable investigation or accepted as highly probable in the light
established facts.
CHARACTERISTICS OF HYPOTHESIS
1. Hypothesis should be clear and precise. If not, the inferences drawn on its basis
cannot be taken as reliable.
2. Hypothesis should be capable of being tested.
3. Hypothesis should state relationship between variables, if it happens to be a
relational hypothesis.
4. Hypothesis should be limited in scope and must be specific.
5. Hypothesis should be stated as far as possible in most simple terms so that the
same is easily understandable by all concerned.
6. Hypothesis should be consistent with most known facts i.e., it must be consistent
with a substantial body of established facts.
7. Hypothesis should be amenable to testing within a reasonable time.
TYPES OF HYPOTHESIS
Goode and Hatt have identified three levels of abstraction reached by hypotheses
and classified the hypothesis.
a. At the lowest level of abstraction are the hypotheses which state existence of
certain uniformities. The hypotheses of this type may state that certain behaviour
patterns may be expected in a specified community.
b. At a relatively higher level of abstraction are hypotheses concerned with
complex 'ideal types’. These hypotheses aim at testing whether logically derived
relationships between empirical uniformities obtain. This level of hypothesizing
in
moves beyond the level of anticipating a simple empirical uniformity by
visualizing a complex referent in society.
c. At the highest level of abstraction hypothesis is concerned with the relation
obtaining amongst analytic variables. This level of hypothesizing is not only more
abstract compared to others; it is also more sophisticated and vastly flexible
mode of formulation.
VARIABLES
A concept which can take on different quantitative values is called a variable.
Concepts like weight, height, and income are all examples of variables. Qualitative
phenomena (or the attributes) are also quantified on the basis of the presence or
absence of the concerning attributes.
Phenomena which can take on quantitative different values even in decimal points
are called continuous variables’. But all variables are not continuous. If they can only
be expressed in integral values, they are non-continuous variables or in statistical
language discrete variables.
Age is an example of continuous variable and no of children is an example of noncontinuous variable.
Dependent Variable: If one variable depends upon or is the consequence of the
other variable it is termed as dependent variable e.g. height is a dependent variable.
Independent Variable: The variable that is antecedent to the dependent variable,
i.e. does not depend on the other variable is called as independent variable e.g. age
is an independent variable.
Extraneous Variable: Independent variables that are not related to the purpose of
the study, but may affect the dependent variable are termed as extraneous.
141
RESEARCH DESIGN
EXERCISE
Broad Research area: Enculturation and Socialization
The process of learning one’s own culture is called enculturation. Every human being
has to go through the process of enculturation for without the adaptations it
describes, it becomes difficult to become a member of the society. The difference
between the nature of enculturation experience in the early years of life and later is
that the range of conscious acceptance or rejection by an individual continuously
increases as he or she grows older. By the time he or she has reached maturity a
person has been conditioned so that he or she moves easily within the limits of
expected behaviour, set by his group. After this acquisition of skills of learning
behaviour through the intimate institutions like family, a person has to apply these
skills of learning behaviour through.
REVIEW OF LITERATURE
A. Thio, Socialization (1996:100)
Socialization is a process that does not end at childhood, though it begins at
childhood. It continues with emergence of adulthood and stop only when the person
dies. Being socialized is learning new role. Like children, adult learn many new roles
as they go through various stages of life. At the same time adult’s specific
socialization experiences do differ from those of children.
Alan C. Kerckoff. Socialization and Social class (1972:232)
Socialization has been described as a process in which the socializee interacts with
socializers in such a way that he acquires skills, knowledge, values and motives that
are functional in this later programme of adult roles. In the course of the process, the
socialzee becomes increasingly instrumental in determining the degree and nature of
his interaction with the socializers.
•
Individualism vs. co-operation.
•
Parent-child relationship: factors affecting it.
•
Attitudinal changes
•
Changes in value orientation.
•
Status of children based on sex: male and female.
•
Impact of westernization etc.
PLAN OF DATA COLLECTION
Can include observation as a tool, interviewing, group discussion and case studies.
OBSERVATION
•
Observing the changes from past way of life.
•
Observing the patterns of interaction.
•
Observing the child-parent relationship.
•
Observing the changes in attitudes.
•
Observing the impact of westernization through media etc.
•
Observing the factors responsible for certain trends in child rearing.
•
Observing the value orientation etc.
PROBLEM STATEMENT
In the emerging content of cosmopolitan culture people have to reorient the values of
children and after their patterns of socialization.
VARIABLES/ATTRIBUTES TO BE CONSIDERED
•
Socialization practices in a cosmopolitan.
•
Impact of the trends of an urban scene.
•
Differences in characteristics of urban and rural life.
•
Changes in cultural patterns.
•
Impact of media.
•
Religious background.
•
Changes in economic status.
•
Importance of social status.
•
Importance of education.
143
Interviews: Interviews can be conducted on the basis of an interview guide and
interview schedule incorporating certain questions related to the child rearing
practices and the changes that have come in.
Group discussions and case studies:
Group discussions and case studies of
/
families can be taken which are useful in understanding the changes in patterns of
enculturation as a result of westernization and modernization.
Plan of analysis: Qualitative analysis can be done of the data gathered. To quantify
the data coding can be done for certain variables. Hypothesis should be tested and
re-tested.
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OBSERVATION METHOD
The observation method is the most widely used method in social sciences.
Observation becomes a scientific tool and the method for data collection for the
researcher, when it solves a formulated research problem, is systematically planned
and recorded and is subjected to checks and controls on validity and reliability.
Under the observation method, the information is sought by way of investigator's
own observation without asking from the respondent.
While using this method, the researchers should keep in mind things like: what
should be observed? How the observations should be recorded? Or how the
accuracy of observation can be ensured?
This method is particularly suitable in studies which deal with subject who are not
capable of giving verbal reports for one reason or another.
TYPES OF OBSERVATION
Structured observation: When the observation is characterized by a careful
definition of the units to be observed, the style of recording the observed information,
standardized conditions of observation and the selection of pertinent data of
observation, then observation is called as structured observation. Structured
observation is used mostly in studies designed to provide systematic description of
the phenomenon or to test caused hypothesis. The use of structured observational
technique presupposes that the investigator knows what aspects of the situation
under study are relevant to the research purpose, and is in a position therefore to
develop a specific form or plan for making and recording observations before s/he
begins the collection of data. Structured observation may take place in natural field
setting or in laboratory setting. Structured observation is considered appropriate in
descriptive studies.
Unstructured observation: When observation takes place without any definition of
the limits to be observed, then it is unstructured in nature. Unstructured observation
technique is mostly used in exploratory studies. As in that case, the observer's
understanding of the situation is likely to change as he/she goes along. Therefore
these are shifts in the focus of observation. According to changing situations
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observation changes. Unstructured observation is therefore flexible. There are no
hard and fast rules in observation as the observer is always prepared to take his
cues from unanticipated events in an attitude of alert receptivity.
Participant observation: If the observer, observes making himself, more or less, a
member of group he is observing so that he can experience what the members of
the group experience, the observation is called participant observation. In participant
observation the researcher is enable to record the natural behaviour of the group.
The researcher can even gather information which could not easily be obtained, if he
observes in a disinterested fashion, but there may be loss of objectivity to an extent if
the researcher gets emotionally involved in it.
Non-participant observation: when the observer as a detached emissary without
any attempt on his part to experience through participation what others feel, the
observation is termed as non-participant observation.
Controlled observation: When observation takes place according to definite pre
arranged plans, involving experimental procedure, it is termed as controlled
observation.
In controlled observation mechanical instruments as aids are used for accuracy and
standardization controlled observations take place in laboratory or controlled
conditions.
Uncontrolled observation: If the observation takes place in a natural setting, it may
be termed as uncontrolled observation, no attempt is made to use precision
instruments. The major aim of this type of observation is to get a spontaneous
picture of life and persons. It has a tendency to supply naturalness and
completeness of behaviour allowing sufficient time for observing it. But only
subjective interpretation can be done in this case.
TYPES OF BEHAVIOUR OBSERVED IN OBSERVATION METHOD
Non-verbal behaviour: The body movements of the organism, which consists of the
motor movements and facial expressions, in particular convey a whole range of
emotions.
146
Spatial behaviour: It refers to the attempts of individuals to structure the physical
space around them e.g. people move away or towards a person or object; they
maintain closeness or distance. The range, frequency and outcome of such
movements provide significant data for a variety of research goals. Every culture
develops unwritten codes regulating how closely individuals can approach each
other.
Extra linguistic behaviour: Words, linguistic content make up only a small portion
of observable behaviour. The non-content aspects of behaviour, such as rate of
speaking loudness, tendency to interrupt, pronunciation peculiarities constitute a
fruitful source of data and is referred to as extra linguistic behaviour or Para
language.
Linguistic behaviour: Linguistic behaviour refers to the manifest content of speech
and the various
attributes of verbal communication.
The study of these
characteristics can be applied to a number of research goals.
Timing and recording in observation method: A major consideration in
observation concerns the timing and recording of observation.
Time sampling refers to the process of selecting observation units at different points
in time, as it is not possible to observe all the events, or activities.
This technique ensures the representative ness of the chosen ongoing activities.
In developing a time sampling design, the researcher must also develop a coding
system for recording the observations.
In order to transform the complexity of ongoing events into data that can be
expressed numerically and quantified, the researcher must first categorize data and
assign a code for each category. Recording is done by cameras, tape-recorders etc.
Inferences drawn from observation: The inferences drawn from the observations
are also of great consideration. When an observer, observes a certain act or
behaviour, he or she must process this information and infer as to whether or not the
behaviour indicates a certain variable. As a means of increasing the reliability of
inferences researchers designed training programmes appropriate to various
147
INTERVIEW METHOD
The interview method of collecting data involves presentation of oral-verbal stimuli
and reply in terms of oral-verbal responses. The interview approach, involves a
person designated as the interviewer asking questions in a face-to-face contact to
the other person or persons, designated as interviewers, who give answers.
TYPES OF INTERVIEW
Structured interview: Such interviews involve the use of a set of predetermined
questions and of highly standardized techniques of recording. Thus, the interviewer
in a structured interview follows a rigid procedure laid down, asking questions in a
form and order prescribed. Structured interviews mostly involve the use of fixed,
alternative questions. The alternative questions or close-ended questions are those
in which the responses of the subjects are limited to certain pre-designated
alternatives. Structured interviews may also involve the use of open-ended questions
but the questions and their order are predetermined. Generally the interviewer has
no freedom to waive a question except to get clarification of the subject’s responses,
and these questions must be non-directive or non-suggestive.
Unstructured interview: These are characterized by a flexibility of approach to
questioning unstructured interviews, do not follow a system of predetermined
questions and standardized techniques of recording information. In a non-structured,
the interviewer is allowed much greater freedom to ask, in case of need.
Supplementary questions or at times he/she may omit certain questions if the
situation so requires. He/she may even change the sequence of questions. He/she
has relatively greater freedom while recording the responses to include some
aspects and exclude others. But this sort of flexibility results in lack of comparability
of one interview with another, and analysis of unstructured responses becomes
much more difficult and time consuming than that of the structured responses
obtained in case of structured interviews. Unstructured interview because of its being
more economical, providing a safe basis for generalization and requiring relatively
lesser skill on the part of the interviews.
Other types of interviews which may be partially structured or unstructured at times,
are
150
a. Focused interview: Focused interview is meant to focus attention on the given
experience of the respondent and its effects. Under it the interviewer has the
freedom to explore reasons and motives. This main task of the interviewer in
case of a focused interview is to confine the respondent to a discussion of issues
with which he seeks conversance. Such interviews are used generally in the
development of
hypothesis and constitute
a major type
of unstructured
interview.
b. The clinical interview: This type of interview is quite similar to the focused
interview, the primary difference between them being that the clinical interview is
concerned with broad underlying feelings or motivations or with the course of
individual’s life experience, rather than with effects of the specific experience, as
in the focused interview. As in the focused interview here too, the interviewer
knows in advance what aspects of feelings or experience he wants the
respondent to talk about but the method of eliciting information is more or less
completely left to his discretion.
c. The non-directive interview: In case of non-directive interview, the interviewers
function is simply to encourage the respondent to talk about the given topic with a
bare minimum of direct questioning. The interviewer often acts as a catalyst to a
comprehensive expression of the respondent’s feelings and beliefs and of the
frame of reference within which such feelings and beliefs take a personal
significance.
151
MERITS AND DEMERITS OF INTERVIEW METHOD
MERITS
1.
More information can be obtained and that too in greater depth.
2.
Interviewer by his own skill can overcome the resistance, if any, of the
respondents; the interview method can be made to yield an almost perfect
sample of the population.
3.
There is greater flexibility under this method as the opportunity to restructure
questions is always there, especially in case of unstructured interviews.
4.
Observation method can as well be applied to recording verbal answers to
various questions.
5.
Personal information can as well be obtained easily under this method.
6.
Samples can be controlled more effectively as there arises no difficulty of the
missing returns; non response generally remains very low.
7.
The interviewer can usually control which person(s) will answer the questions.
8.
The interviewer may catch the informant off-guard and thus may secure the
most spontaneous reactions than would not e the case if mailed
questionnaires are used.
9.
The language of the interview can be adopted to the ability or educational
level of the person interviewed and as such misinterpretation concerning
questions can be avoided.
10.
The interviewer can collect supplementary information about the respondent’s
personal characteristics and environment which is often of good value is
interpreting results.
Tmhi O
152
DEMERITS
1.
It is a very expensive method, especially when large and widely spread
geographical sample is taken.
2.
There remains the possibility of the bias of interviewer as well as that of
respondent
3.
Certain types of informants such as important officers an executive or people
in high income group may not be easily approachable under this method and
to that extent the data may prove inadequate.
4.
This method is relatively more time consuming specially when the sample is
large and re-calls upon the respondents are necessary.
5.
The presence of the interviewer on the spot may over stimulate the
respondent, sometimes even to the extent that he may give imaginary
information just to make the interview interesting.
6.
Under the interview method the organization required for selection training
and supervising the field staff is more complex with formidable problems.
7.
Interviews at times may also introduce systematic errors.
8.
Effective interview presupposes proper rapport with respondent; this is often a
difficult requirement.
153
QUESTIONNAIRE METHOD
The questionnaire method is the heart of a survey operation. A survey research
most often includes questionnaire as a method of a data collection.
It is therefore, popularly used for big enquires. In this method a questionnaire is
either mailed or given particularly to individuals from which data has to be
gathered. It usually consists of a number of questions printed or typed in a
definite order in a form or set of forms.
The questionnaire is provided to respondents who are expected to read and
understand questions properly and write down the reply in the space
provided/meant for the purpose in the questionnaire, itself. The respondents have
to answer the questions on their own.
A questionnaire has to be carefully constructed for carrying out the research
successfully. If the questionnaire is not properly set up, then the survey is bound
to fail. The main aspects of a questionnaire should be considered like the general
form, question sequence and question formulation and working. Before using this
method it is better to conduct ‘pilot study’/pilot survey for testing the
questionnaires. Pilot survey in fact is the replica and rehearsal of the main
survey. Such as survey, brings to light the weakness, if any of the questionnaire
and also of the survey techniques.
ASPECTS OF A QUESTIONNAIRE
General Form: The form of questionnaire can either be structured or
unstructured.
Structured questionnaires are those in which there are definite, concrete and pre
determined questions. The questions are presented with exactly the same
wording and in same order to all respondents. A highly structured questionnaire
is one in which all questions and answers are specified and comments in the
minimum. But in unstructured questionnaire, these characteristics may not be
seen. The interviewer is generally provided with a general guide on the type of
information to be obtained, but the exact question formulation is generally, largely
his own responsibility and the replies are to be taken in respondent’s own words.
154
Question sequence: In order to make the questionnaire effective and to ensure
quality to the replies received, a researcher should pay attention to the question
sequence in preparing the questionnaire. A proper sequence of questions
reduces considerably the chances of individual questions being misunderstood.
Questions that put too great a strain on the memory or intellect of the respondent
or are related to personal character or wealth should be avoided. Thus, question
sequence should usually go from the general to the more specific, and the
researcher must remember that the answer to a given question is a function of
the question itself, but of all previous questions aw well.
QUESTION FORMULATION AND WORDING
1.
Question must be very clear otherwise can harm the survey irreparably.
2.
Question should be impartial.
3.
A question should be easily understood.
4.
A question should be simple.
5.
A question should convey only one thought at a time.
6.
Words with ambiguous meanings should be avoided.
7.
Danger words catch words, or words with emotional connotations should
be avoided.
8.
A question should be short and simple.
9.
Size of the questionnaire should be kept to minimum.
10.
Technical
terms
and
vague
expressions
capable
of
different
interpretations should be avoided.
MERITS AND DEMERITS OF A QUESTIONNAIRE
MERITS
1. There is low cost even when the universe is large and is widely spread
geographically.
2. It is free from the bias of the interviewer, answer are in respondents own
words.
3. Respondents have adequate time to give well thought out answers.
155
4. Respondents, who are not easily approachable, can also be reached
conveniently.
5. Large samples can be made use of and thus the results can be more
dependable and reliable.
DEMERITS
1. Low rate of the duly filled in questionnaire, bias due to no response is often
indeterminate.
2. It can be used only when respondents are educated and co-operating.
3. The control over questionnaire may be lost, once it is sent.
4. There is inbuilt inflexibility because of the difficulty of amending the approach
once questionnaire have been dispatched.
5. There is also the possibility of ambiguous replies or omission of replies
altogether to certain questions, interpretations of omissions is difficult.
6. It is difficult to know whether willing respondents are truly representative.
7. This method is likely to be the slowest of all.
TYPES OF QUESTION
Close ended: In a close-ended question, respondents are offered a set of
answers and then asked to choose the one that most closely respondents their
view.
a.
Daily ()
b.
Once in a week (
c.
Once in a month (
d.
Rarely
e.
Never
)
)
Close-ended questions are easy to ask and quick to answer, they require no writing
by other respondents or interviewee and their analysis is straight-forward. Their
major drawback is that they may introduce bias, either by forcing the respondent to
156
close from given alternatives or by offering the respondent alternatives that might
not have otherwise come to mind.
Open-ended: These questions are not followed by any kind of specified choice, and
the respondents answer are recorded in full e.g. what is your opinion about the Bill
Clinton’s visit to India?
The virtue of the open-ended question is that it does not force the respondent to
adapt to preconceived answers. Open-ended questions enable the interviewer to
clear up misunderstandings and they encourage rapport. However, open-ended
questions to analyze.
Contingency question: A contingency question is a special case of close-ended
question applies to subgroup a student of any college?
a.
No (
b.
Yes ( )
)
If yes, then
i.
Which college are you studying in?
ii.
Which stream have you opted for?
DIFFERENCES BETWEEN QUESTIONAIRES AND INTERVIEW SCHEDULE
1.
The questionnaire is generally sent through mail to informants to be answered
as specified in a covering letter. The schedule is generally filled by the
researcher.
2.
To collect data through questionnaire is relatively cheaper than schedules.
3.
Non response is relatively higher in questionnaire than in schedules.
4.
In case of questionnaire, the identify is generally not known but in case of
schedules it is known.
5.
The questionnaire method is very slow as compared to schedule.
6.
Personal contact is generally not possible in questionnaire but in interview
schedule it is not so.
157
7.
Risk of collecting in complete and wrong information is relatively more under the
questionnaire method, than schedules.
8.
Wider and more representative distribution of sample is possible in
questionnaire method as compared to schedules.
9.
Questionnaire method can be used only when respondents are literate but in
interview schedule it is not so.
10.
Along with schedules, observation method can be used but in case of
questionnaire it cannot be done.
158
INTERVIEW SCHEDULE
EXERCISE
Prepare an interview schedule to understand the status of women in a middle class
Maharashtrian family in Pune.
•
What is the age and educational level of the person?
•
When did the respondent get married?
•
Which place she belongs to?
•
What is the occupation of her husband?
•
How many children does she have?
•
How many members are there in the family she has got married into?
•
What status she enjoy in her own family, (i.e. father's house)?
What is the nature of the family she has married into; joint or nuclear?
•
How many earning and non-earning members are there in the family?
•
Is her husband the head of the family?
•
Does she have any responsibilities in her husband's family, like unmarried
siblings of her husband, parents etc?
•
Who manages the financial matters in the family?
•
What are the levels of interactions within the family, with whom does she share a
good rapport apart from her husband?
What role does she play in decision making in the family?
•
Is she a working woman? If yes, was she working before her marriage or not?
•
If no, has she stopped working after her marriage?
•
Is she satisfied with the present status in the family or does she require certain
changes, if yes, in what way?
INTERVIEW GUIDE
EXERCISE
Prepare an interview guide to understand the problem of tribal identity with reference to
a particular tribe.
159
DEFINITION OF A TRIBAL
•
History of the tribe
•
Geographical location of the tribe
•
Political organization
•
Economic organization
•
Religious organization
•
Educational level
• Beliefs and practices
•
Modes of living: dress patterns, language, specialized skills etc.
AGENTS OF CHANGE
•
Interference of other cultural groups
•
Interference of government
•
Urbanization
Industrialization
•
Non-governmental organizations
•
Social organizations
IMPACT OF CHANGE
•
Changes in occupational patterns
•
Migrations
•
Inter community relations
•
Effects on modes of living: language, dress patterns, etc.
•
Awareness on account of education
•
Break from past way of life
CASE STUDY METHOD
The method of exploring and analyzing the life of a social unit/entity, be it a role
incumbent (person), family, an institution or a community, is customarily known as
case study method. The aim of case study method is to locate or identify the factors
that account for the behaviour patterns of a given unit and its relationship with the
environment. The case data are always gathered with a view to trace the natural history
of the social unit, and its relationship with the social factors and factors operating and
involved in its surrounding milieu.
160
The major credit for introducing case study method into the field of social investigation
must go to Frederick Leplay.
Anthropologists and ethnologists interested in the systematic description and the study
of primitive as well as modern cultures have liberally utilized the case study method.
The specific method of case study would depend upon wit, common sense and
imagination of the person doing the case study, the investigator makes up his
procedure as he goes along. Saturating oneself in the situation is very important. The
adequacy of case history has been an important criteria for evaluating a case study.
John Dollard has proposed seven criteria for evaluating such adequacy.
1.
The subject must be views as a specimen in a cultural series. The scrutiny of the
life histories of persons must be done with a view to identifying community
values, standards and their shared way of life.
2.
The organic motors of action must be socially relevant. In other words, the social
meaning of behaviour must be taken into consideration.
3.
The strategic role of the family group in transmitting the culture must be
recognized.
4.
The specific method of elaboration of organic material onto social behaviour
must be recognized.
5.
The continuous related experience from childhood to adulthood must be
stressed.
6.
The 'Social situation' must be carefully and continuously specified as a factor.
7.
The life history material itself must be organized according to some conceptual
framework; this in turn would facilitate generalizations at higher level.
A case study may be considered the final destination of abstract
knowledge. It is the interpretations of the peculiar and the concrete that
contribute to the continual growth of abstract knowledge.
During the last few decades, case study techniques have shown a steady
trend toward formalization, that is case studies can now be conducted in such a
manner that the data are amenable to quantification and statistical treatment.
Case study techniques have become indispensable for administrative and
therapeutic purposes. The materials collected by research minded social
workers can be very useful for 'pure' or 'basic research.'
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SAMPLING
In a research process, typically generalizations are not based on data collected from
all the observations, all the respondents, or all the events that are defined by the
research problem. Instead, researchers use a relatively small number of cases (a
sample) as the basis for making influences about all the cases (a population) as it is
often impossible, impractical or extremely expensive to collect data from all the
potential units of analysis covered by the research problem. Researchers can draw
precise inferences of all the units (as set) based on a relatively small number of units
(a subset) when the subsets accurately represent the relevant attributes of the whole
set.
To accurately estimate unknown parameters from the known statistics, researchers
have to effectively deal with three major problems:
1.
The definition of the population,
2.
The sample design and
3.
The size of the sample.
POPULATION
A population is the “aggregate” of all cases that conform to designated set of
specifications e.g. by employing the specifications “students” and “enrolled in state
universities in India”, we define a population consisting of all the students enrolled in
state universities in India. Therefore one of the first problems facing a researcher
who wishes to estimate a population value from a sample value is how to determine
the population involved. The population has to be defined in forms of: (1) Content,
(2) Extent and (3) Time. E.g. a) All working women over 18 years of age living in
urban cities, (b) In India, (c) As of June 2002.
162
FINITE AND INFINITE POPULATION
A population may be finite or infinite, depending on whether the sampling units are
finite or infinite. A finite population contains a countable number of sampling units.
An infinite population consists of an endless number of sampling units.
SAMPLING UNIT
A single member of a sampling population is referred to as sampling unit. Usually
sampling units have numerous attributes, one or more of which are relevant in the
research problem.
e.g. if the population is all the first division holders in graduation, then the sampling
units are all first division holders.
A sampling unit can be a unit, a university, a city, or a nation.
SAMPLING FRAME
Once researchers have defined the population they draw a sample that adequately
represents the population. The actual procedures involve selecting a sample from a
sampling frame comprised of a complete listing of sampling units.
Ideally, the
sampling frame should include all the sampling units in the population.
TYPES OF SAMPLING
PROBABILITY SAMPLING
The characteristics of probability sampling is that for each sampling unit of
population you can specify the probability that the unit will be included in the sample.
In the simplest case, all the units have the same probability of being included in the
sample.
NON-PROBABILITY SAMPLING
In non-probability sampling, there is no way of specifying the probability of each units
inclusion in the sample, and there is no assurance that every unit has some chance
of being included.
163
SIMPLE RANDOM SAMPLING
Simple random sampling is the basic probability sampling design, and it is
incorporated into all the more elaborate probability sampling designs.
Simple
random sampling is a procedure that gives each of the total sampling units of the
population an equal and known nonzero probability of being selected.
Random selection procedures ensure that every sampling unit of the population has
an equal and known probability of being included in the sample; this probability is n,
where n stands for the size of the sample and N for the size of population.
SYSTEMATIC SAMPLING
Systematic sampling consists of selecting every Kth sampling unit of the population
after the first sampling unit is selected at random from the total of sampling units.
Thus, if we wish to select a sample of 100 persons from a population of 10,000 you
would take every 100th individual.
(K = N = 10,000 = 100)
n
100
Systematic sampling is more convenient than simple random sampling.
With
systematic sampling, each sampling unit in the population has a 1/K probability of
being included in the sample.
However, if there may be a pattern in the data
systematically occurring at every Kth unit, this phenomenon may bias the sample.
STRATIFIED SAMPLING
Researchers use stratified sampling primarily to ensure that different graphs of a
population are adequately represented in the sample, so as to increase the level of
accuracy when estimating parameters. The underlying idea in stratified sampling is
to use available information on the population to divide it into groups such that
elements.
CLUSTER SAMPLING
This is another type of probability sampling used by social scientists because it is the
least expensive sample design.
Cluster sampling involves first selecting larger
groupings, called clusters, and then selecting the sampling units from the clusters.
The clusters are selected by a simple random sample or a stratified sample.
IM
SAMPLING SIZE
A sample is any subset of sampling units from a population.
A subset is any
combination of sampling units that does not include the entire set of sampling units
that has been defined as the population.
The determination of sample size can be done by investing the formula of standard
error.
S.E. = _s S = Standard deviation of variable under study
n
n
n = Sample size
S.E. = Standard error.
Therefore n = S2
(S.E.)2
Within each group are more alike than are the elements in the population as a
“whole”.
The necessary conditions for dividing a sample into homogenous strata is that the
criteria for its division be related to the variable the researcher is studying. A second
consideration is that the criteria used should not require so many sub samples that
they increase the total size of the sample ever that required by a simple random
sample.
a. Proportionate stratified sample: If we select the same number of sampling units
from each stratum or a uniform sampling fraction ( n ) the sample is known as a
proportionate stratified sample, because the
N
sample size drawn from each
stratum (n) is proportionate to the population size of the stratum (N).
b. Disproportionate stratified sample:
If the total number (N) or the population
size in each stratum is different, that is if there are variable sampling fractions, the
sample is a disproportionate stratified sample.
In other words, when the total
number of people characterized by each variable (or stratum) is different, we need to
choose the size of each sample of each stratum according to our research
requirements.
SAMPLING
EXERCISE
1.
A social scientist is interested in investigating the relationship between
parent’s occupation and the grade point averages of students on a large urban
campus (N=35,000) As the information needed can be obtained from the
students records, a sample of n=700 records is selected. (Use systematic
sampling)
Sol.: The first step is to determine the sampling interval R as N = 35,000 and M
= 700,
K = 35,000 = 50,
i.e. K=50.
700
We now select the first record at random from the first K = 50 records listed and
then select the fiftieth thereafter until we have reached the sample size of 700.
2.
In a study of revitalization in an urban area, we plan to examine the altitudes
of new residents towards their community. We anticipate that the altitudes of
homeowners may differ from those of renters. Therefore, as means of ensuring
the proper representation of both the groups, we have to use proportionate
stratified sample with two strata: new homeowners and new renters.
Sol.: The population consists of N = Ni + N2 with Ni denoting the homeowners
and N2 the renters. Ni = 200, N2 = 300.
Therefore N = 500. We decide to select a proportionate sampling traction of 1/10
from each strata. Thus Ni = 20 homeowners and N2 = 30 meters.
Then the simple random sampling procedure can be applied separately to each
strata.
STATISTICS
Since 1950s, all social science disciplines have experienced a rapid increase in the
use of statistics and they have become essential to the field. Without statistics, we
cannot see the patterns and regularities in the phenomena we study.
We need
statistical methods to organize data, to displace information in a meaningful manner,
to describe and interpret the observations in terms that will help us to evaluate our
hypothesis.
The word ‘statistics’ has a dual meaning. Although it is used to refer to numbers e.g.
per capita income, batting average etc. it is also a field of study.
We refer to
statistics as a field of study and some basic statistical principles are used in social
sciences.
Role of Statistics:
The field of statistics involves methods for describing and
analyzing data and for making decisions or inferences about phenomena
represented by the data. Thus, there are two types of statistics.
a)
Descriptive statistics:
Enables researchers to summarize and organize
data in an effective and meaningful way. They provide tools for describing
collections of statistical observations and reducing information to an
understandable form.
b)
Inferential statistics:
Allows the researchers to make decisions or
inferences by interpreting the data patterns.
Researchers use inferential
statistics to determine whether an expected pattern designated by the theory
and hypothesis is actually formed in observation.
Both descriptive and inferential statistics help social scientists to develop
explanations for complex social phenomena that deal with relationships
between variables.
Statistics provides the tool to analyze, represent and
interpret those relationships.
TERMS USED IN STATISTICS
1.
Raw Data: It is the data that appears or may appear in the same way as
they have recorded in the field e.g. the age of the people of village Wadap
of 20 individuals is, -12, 24, 33, 48, 21, 16, 11, 8, 9, 14, 19, 25, 29, 47, 52,
18, 31, 17, 44, 27.
167
2.
Rounding off decimals (if any): If the data contain any decimal no, then it
is rounded off for convenience e.g. 4.27, 8.72, 21.64 can be written as 4.5,
8.8, 21.7 and further again if needed to round off then 5,9,22.
When rounding off “even-integer-principle” is followed the decimals are
converted into the nearest even integers not the odd integer. Because it is
seen that after rounding off the number, the automatic summation value of
the new even numbers approximates have closely with the actual numbers
summation, than when the numbers are converted to odd number integers.
3.
Array:
This is the process of arranging the data in ascending or
descending order of variables.
4.
Range of data: Differences between the highest and the lowest values of
the range of the data.
5.
Frequency: The number of times a particular value occurs in the data is
called the frequency of that value e.g. in a distribution of age of children
between 0-5 years, if the ages recorded are 3,2,2,2,1,5,1,3,1,2 then the
frequency of age 2 years is 4 and of 3 and 5 years is 1.
6.
Classifying the data: The whole range of the data may be put under
different class intervals for convenience. The number of classes may vary
according to the need of the research and how he / she decodes to use the
number of categories and the cutting point of each categories.
7.
Class Interval: The difference between the two end points of the class.
8.
Class midpoint I class work: The middle point between the two class
limits.
9.
Class frequency: The number of items that fall into each class intervals is
the frequency of that class.
From the given raw data, we can see how it can be arranged into different
class intervals.
The raw data arranged in ascending order can be written as:
1,1,2,2,3,3,3,3,5,5,6,7,8,9,9,11,12,14,16,18,21,24,31,33,37,43,47,48,65
168
Range of data = 65-1 = 64
Class Interval
(age in yrs.)
_________ 0-9
Frequency
(f)
16
5
2
_______ 10-19
20-29"
30-39
40-49
50-59
60-69
3
3
0
1
Real
class limit
-0.5-9.5
9.5-19.5
19.5- 29.5
29.5- 39.5
39.5- 49.5
49.5- 59.5
59.5- 69.5
Midpoints
4,5
14.5
24.5
34.5
44.5
54.5
64.5
Class width - Upper class limit - lower class limit
= 9-0 = 19-10 =.= 9
MEASURES OF CENTRAL TENDENCY
When only a short summary of the data is required, the entire distribution need not
be presented. In most cases, distribution tend to cluster around a control value or
around a certain range of values. This property allows the researcher to represent a
distribution using a single value rather than a large table and makes it easier for
them to compare different distributions.
e.g. the average age of a population that is located halfway between the smallest
and the largest observation in the distribution. When the observations are arranged
in ascending or descending order. To obtain the median of an ungrouped data the
middle observation is identified.
For odd no of observation, the median value is
equal to n+lth observation, for even number of observations the median value is half
way 2
between two central observations,
_r^ + n +~lth
2 2
2
e.g. 2,7,8,10,12;
2,7,8,10,12,14;
Md = 08
Md = 8+10 = 9
2
For grouped data median is located by interpreting within the interval containing the
middle observation:
Md - Lf [ N (0,5) - cf below ] x w
f
169
Where L = Real lower limit of the interval containing median.
cf below = cumulative sum of frequency below the interval containing the median
f = frequency of the interval containing the median
w = width of the class interval containing the median.
N = total no. of observations.
Or the average of income range of a population group is easier to represent
characteristics of a population that can be easily compared with that of the other
population graphs.
So statistical measures that reflect a typical or an average
characteristic of a frequency distribution are referred to as measures of central
tendency. The three measures that the social scientists generally use are:
a.
Mean
b.
Median
c.
Mode
Arithmetic Mean:
It is the most frequently used measure of central tendency.
When people talk about the average height of the students of a class or the average
age of the participant members or so, they indicate actually towards the arithmetic
mean.
The arithmetic mean is defined as “The sum total of all observations divided by their
member”
Median: It is a positional measure that divides the distribution into two equal parts.
It is defined as the observation.
Mode: It is the category or observation that appears most frequently in the
distribution, it is identified by singling out the category containing the largest number
of responses. Most distributions are unimodal i.e. they include only one category in
which the most cases are concentrated. However, sometimes the distribution may
be bimodal ortrimodal.
MERITS AND DEMERITS OF ARITHMETIC MEAN
MERITS
1)
It is rigidly defined.
2)
It is easy to understand and easy to calculate.
3)
It is based upon all the observations.
170
DEMERITS
1)
It cannot be determined by inspection, nor can it be located graphically.
2)
This cannot be used if we are dealing with qualitative characteristics, which
cannot be measured quantitatively.
Arithmetic mean is affected very much by extreme values.
3)
MEDIAN
MERITS
1)
It is also rigidly defined, easy to understand and easy to calculate.
2)
It can also be located merely by inspection
3)
It is not at all affected by extreme values.
DEMERITS
D
In case of even numbers of observations, median cannot be determined
easily. We merely estimate it by taking the mean of two middle terms.
2)
It is not based upon all the observations.
3)
It is not amenable to further mathematical treatment.
STANDARD DEVIATION
The most useful and frequently used measure of dispersion is the standard deviation
or root mean square deviation about the mean. The standard deviation is defined as
the square root of the arithmetic mean of the square of the deviations about the
mean. Symbolically
Where (sigma) stands for standard deviation.
For the sum of the square of the
deviations measured from mean and N for the number of items.
e.g.
Roll No.
“T“
2
3
Marks obtained
31
35
38
I7l
4
5
6
7
8
9
41
49
54
59
66
68
1
Marks Obtained
X
31
Deviationjrom
mean ( X- X = d)
-18
324
2
35
-14
196
3
38
-11
121
4
41
-8
64
5
49
0
0
6
54
5
25
7
59
10
100
8
66
17
289
9
68
19
361
Solution
Roll No.
N=9
dz
SD2 = 480
1480
Ld2
=
N
164.44
9
12.82 (approx.)
CODING
Coding schemes: The number assigned to an observation is called a code. This
code should be consistent across cases or units of analysis when the same condition
exists, e.g. if an code 'T means ’male’ the variable associates with gender should be
coded 1 for each 'male'. Information on what a code means should be listed in a code
book that accompanies the data set.
I 72
Rules of coding
1. Code numbers should make intuitive sense for variables that can be rank ordered for example, higher code should be assigned higher code numbers.
2. In deductive coding, categories should be linked to the theory from which the
research hypothesis was derived.
3. The coding categories must be mutually exclusive - each unit of analysis should fit
into one and only one category.
4. The coding scheme must be exhaustive - every response must fit into a category
with few responses being classified as 'others'
5. Categories must be specific enough to capture differences using the smallest
possible number of categories - the criterion of detail.
EXERCISE:
- A CODE BOOK IS CONSTRUCTED ON
BASIS OF THE
QUESTIONNAIRE.
173
CONTENT ANALYSIS
Information
about
culture
is
available
through
newspapers,
films,
novels,
etc.(communication material). It reflects the socio-cultural world of any society. It tells
what a society is, what it aspires to be and how it at itself.
The method of analyzing this communication material is known as the method of
content analysis. This method has been used for last many years in one for or the
other by historians, literary persons, journalists, etc.
Difference between tradition at method of content analysis and modern method is that it
has developed a method of quantification of qualitative research. It is developed by B.
Balson.
DEFINITION
A research technique for the objective, systematic and quantative description of
manifest content of communication.
TECHNIQUES
Content analysis involves coding, tabulating and analyzing existing data. The intent
may be either quantitative or qualitative. That is, it may be directed towards determining
the time frequency or duration of an event.
Or it may be directed towards more
subjective information such as motives, attitudes or values.
•
Hypothesis and formulation of research problem
A hypothesis has to be formulated even for a content analysis project, as any research
needs a direction.
•
Code categories
The next step is of developing appropriate coding categories codes should be
constructed that the categories closely approximate the meaning contained in the
original communication. This reduces the likelihood of erroneous interpretation at the
data-analysis stage. The choice of code categories is perhaps the most important.
174
Coding categories may take following forms:
1)
The number of occurrences of a symbol.
2)
The prominence of a symbol.
3)
The attitude towards a symbol.
4)
The intensity of feelings about a symbol.
One may tabulate the chronological course of event occurring.
Content analysis can provide a basis for inference. Three types of inferences may be
drawn:
1.
Trend inferences: such inferences related to changes over time in the quantity,
prominence, attitude and intensity of feeling about a symbol.
2.
Co variation inferences: Such inferences are based on the joint concurrence in
two or more symbols contained in the material being analyzed.
3.
Causal inferences:
Such inferences are based on perceived relationship
between the environment and the use of a symbol.
The techniques of content analysis can be used as the sole technique used for a
particular research or as supplementary to other methods of data analysis.
175
ANNEXURE R3
EPIDEMIC SURVEILLANCE
In one of the villages (Pangare) in the project area, there was an 'outbreak' of Hepatitis.
The information about the 'outbreak' was reported by one of our trainee Sahyogini’s.
To conduct active surveillance, a questionnaire was prepared with the trainees.
Trainees and FRCH staff were divided into groups. A map of the village and population
list were used while dividing the groups. Each group comprising 3 individuals surveyed
70-90 households and the required information was filled in the questionnaire. The
identification of patients suffering from jaundice was based on the following two clinical
features namely yellowish discolouration of the eyes and high coloured urine. All the
identified jaundice patients were examined by FRCH clinicians. Line listing of all the
cases was prepared to identify the index case. (See Annexure -)
Spot mapping of the case was attempted.(See Annexure-).
We were unable to detect the index case, though a broken water pipe line was
detected. Interviews of Watermen and Panchayat members confirmed that bleaching
powder is added regularly and in enough quantities to the water tank. But this activity is
performed only once in the morning and the water tank is filled twice a day. May be this
issue needs to be addressed in the early future.
Clinical services were provided to patients who wanted to get examined by FRCH
clinicians. A total of 12 cases were detected satisfying the definition of yellowish
discolouration of eyes and dark coloured urine.
Information about the leakage from the pipeline and about the precautions to be
taken if jaundice was detected was disseminated.
Following this a focus group discussion was held in the village to find out the
communities perception of why jaundice occurs and what needed to be done.
The facts, which emerged after Focus Group Discussion were :
•
Jaundice is considered as a physical ailment, which has no cause and effect
relation to supernatural (like God, ghost or planets) powers.
176
•
The Community is well aware of the symptoms of 'Jaundice' such as
yellowish discolouration of eyes, dark coloured urine, no appetite, nausea,
vomiting etc.
•
People in the community believe that oil and water are the causative factors
of jaundice.
•
People in the community believe that there is no medicine for Jaundice in
allopathy or western system of medicine, thus they take the help of
traditional healers. They use the juice of 'castor leaves' to treat jaundice.
They visit the allopath to get "Shakti injections/medicines".
•
The villagers had classified jaundice into two groups namely "Karnin" and
"Kavil". When there is yellowish discolouration of eyes and nails it is
considered to be
kamin'. When there is an abdominal pain and vomiting
and dark coloured urine it is considered "kavil". If someone is suffering from
kavil' only then, the help of a doctor is sought.
•
The community also feels that the first rains are bad and bring most
illnesses.
On the basis of the focus group the trainees has planned what information is to be
provided. Through this exercise, trainees have learned how to handle and manage
epidemic cases.
177
(Sanchita, Joyita, Ramshish - West Bengal)
ANNEXURE E-1
SYLLABUS FOR VILLAGE HEALTH FUNCTIONARY (V.H.F)
Sr.No
Subject
Topic
1.
Introduction
Relationship
2.
Development
3.
Health
4.
Disease of Health
Time
One day
(6 Hrs)
Definition of Development. Health is 10 days
a part of development. Environment (60 Hrs)
is a part of health, Sanitation, Social
and Economic issue______________
Concept of Health, Know Your Body, 7 days
Position of different organ, Function (62 Hrs)
of Human Organ_________________
Common Illness:
15 days
FEVER
Influenza.
Malaria,
Pneumonia, (90 Hrs)
Typhoid, Gastroenteritis, Chicken
pox, Measles, With wounds, UTI
peurperial Sepsis, Filaria, Rheumatic
Fever, Meningitis.
10 days
(60 Hrs)
PAINS & ACHES
Neck, Eye, Ear, Tooth, Chest. Back,
10 days
Hand, Leg, Abdomen.
(60 Hrs)
REPRODUCTIVE SYSTEM
Ovaries, Fallopian Tubes, Uterus,
Pregnancy,
White
discharge, 10 days
Periods,
Prolapse,
Miscarriage, (60 Hrs)
Delivery.
178
Type
Dialogue
Monologue, dialogue, audio-visual
show, negotiation, practical(build
rock-pit)
Monologue,
Dialogue
Practical(body mapping)
Dialogue, Monologue, Practical
(Temperature measurement, Blood
Pressure check, Haemoglobin test,
Urine
Protein
test,
Pulse,
Respiratory rate, heart sounds.
Dialogue, Monologue, Practical
Dialogue, Monologue,
(slide show)
Practical
Dialogue, Monologue,
(General Examination)
Practical
Sr.No
Subject
5.
Medicine
6.
Emergency
7.
8.
Nutrition
9.
Poverty
Topic
RESPIRATORY SYSTEM
Pharyngitis, Laryngitis, Bronchitis,
Diphtheria, Tuberculosis, Whooping
cough, Trancheitis, Tonsillitis.______
Use
of
medicine,
Allopathy,
Homeopathy, Ayurvedic, Home made
medicines, Use of medicine in
particular disease, Exercise________
Problem of breathing, bleeding,
shock, Loss of consciousness,
Fractures, Sprain and dislocation,
Snake bite, Burn_____
Gender,
Caste,
Illliterates(Presystem
literates),
PoliticalI
Panchayati Raj_______
Balanced diet
Time
Type
5 days
(30 Hrs)
Monologue,
dialogue
8 days
(48 Hrs)
Monologue, dialogue
10 days
60 Hrs
2 days
2 days
179
Practical
(Exercise)
ANNEXURE E-1
SYLLABUS FOR VHF TRAINING
1)
2)
Village environment
•
•
•
•
Forest
Water source, Air, Aquatic creatures
Land
Wild Animal
•
People
Occupational practices
•
•
•
3)
Shifting cultivation
Daily labour
Farming
Religious cultural practices
Rites and rituals
Taboos
4)
Superstitions
Do’s and don’ts
5)
Gender situation
•
•
Acknowledgement of women folk
Liberty, independency between men, women
6)
Community development
7)
Food intake
•
•
•
8)
Animal source
Agro source
Natural source
Sanitation
•
•
•
Drainage
Toilets
Soak pits
180
9)
Drinking water
•
•
•
•
10)
Know your body
•
•
•
•
11)
Respiratory system
Digestive system
Reproductive system
CVS
Cause and effect of minor/major illness
•
•
•
•
•
•
•
12)
Spring
Dug well
Tube well
Jack well
Pains and aches
Cold, Cough, Fever, RTI
Diarrhoea, Gastritis, Gastroenteritis, Typhoid
Measles, Small pox, Miscarriage, Uterine Prolapse
Perpeurial
sepsis,
Anaemia,
Pneumonia,
Bitot’s
beri,Conjunctivitis
Urinary Tract Infection
Jaundice, Pneumonia
spot,
Beri
Health care practices
•
•
•
•
Traditional healer
Quack
PHC
Sorcery
13)
Vitamins and minerals and its functions and sources - A, B, C, D, E, K
14)
Emergency - RTA, Burning, Shock, Fracture, Drowning
15)
Identification and utilisation of Herbal medicinal plants
16)
Physical exercises and Yogas
17)
Application of Homeopathy medicines
18)
Application of Allopathic medicines
19)
Utility of Naturopathy
181
ANNEXURE E2
MULTIPLE CHOICE QUESTIONS
For the evaluation of the trainees
1.
Where does the Respiratory System begin from?
1. Nose
2. Respiratory Tract
3. Throat
4. Mouth
2.
Which organs are present in Digestive system ?
1. Nose, Mouth, Liver, Lungs
2. Mouth, Oesophagus, Stomach, Pancreas
3. Mouth, Oesophagus, Stomach, Small intestine
4. Abdomen, intestines, liver, lungs
3.
This organ is a part of the Reproductive system
1. Abdomen
2. Appendix
3. Ovaries
4. Kidney
4.
What is the causative agent of Tuberculosis?
1. Bacteria
2. Pollution
3. Virus
4. Parasite
5.
What is the average duration in days of a woman's menstrual cycle?
1. 22 - 35 days
2. 16-20 days
3. 40 - 50 days
4. 27 - 28 days
182
6.
How many days prior to menstruation do the eggs emerge from the ovaries?
1. 16 days
2. 14 days
3. 18 days
4. 28 days
7.
Common Cold due a to viral infection means 1. Water - like clear fluid/liquid
2. Viscous - white liquid
3. Viscous - white liquid and blood
4. Green phlegm / mucus
8.
How is Tonsillitis diagnosed?
1. Inflammation in throat glands and fever
2. Inflammation in back-wall of throat and change in voice
3. Pain in chest and wheezing
4. Difficulty in breathing and cough
9.
Greenish-yellow phlegm/mucus is
1. Seen in germ infection
2. Seen in Bronchitis
3. Seen in Tuberculosis
4. Seen in Tonsillitis
10.
What is the recommended level of Haemoglobin in a healthy woman?
1.
2.
3.
4.
11.
1 mg %
6 mg %
11 mg %
8 mg %
What is the cause of Malaria?
1. Insects spread by air / wind
2. Polluted water
3. Mosquito bite
4. Unhygienic food
183
12.
A child is suffering from Diarrhoea, what will you administer / do immediately
1. Give ORS
2. Send to a doctor
3. Give something to eat
4. Nothing
13.
What causes viral jaundice?
1. Insects in air
2. Water
3. Drinking tea
4. Sneezing
14.
What will you take for high-fever?
1. Brufen
2. Sleep under rugs
3. Cotra
4. Paracetamol
15.
What are the symptoms of Typhoid ?
1. Rise and fall in body temperature
2. Continuous tears from eyes.
3. Continuous rise in fever
4. None of the above
16.
Air-cells are situated in 1. Digestive tract
2. Small intestine
3. Lungs
4. Blood vessels
17.
Anus is attached with 1. Kidney
2. Large intestines
3. Small intestines
4. None of the above
184
18.
Anaemia means 1. Lack of iron in blood
2. Lack of water in blood
3. Lack of calcium in blood
4. Lack of proteins in blood
Fill in the blanks -
Which disease, do the following symptoms point at:
19.
Curd-like
20.
Yellow-green discharge, continuous itching
21.
Ash-coloured discharge, fishy smell and itching
discharge,
sour smell,
itching
immediately
after menstruation
Which traditional cures will you use for the following problems :
22.
Candidiasis
1. Wash vaginal tract with curd.
2. Eat rice and wash vaginal tract with rice-extract
3. Nothing
23.
Bacterial vaginosis
1. Eat and wash vaginal tract with turmeric
2. Eat and wash vaginal tract with curd
3. Wash vaginal tract with extract of crushed Neem leaves
4. Wash with curd and tobacco.
24.
Trichomoniasis
1. Drink ginger-extract
2. Put unpeeled garlic pip in vaginal tract
3. Eat curd
4. Nothing
185
25.
What will you administer for bacterial disease ?
1. Cotrimoxazole
2. Paracetamol
3. Mebendazole
4. Brufen
26.
What will you advice for abdominal pain during menstruation ?
1. Avoid onion-intake
2. Drink ginger tea
3. Avoid jaggery intake
4. All of the above
27.
How will you recognize excessive bleeding during menstruation ?
1. Feel the need to change clothes twice in a day
2. Woman can't get up from bed
3. Low haemoglobin
4. Feel the need to change clothes at least 4-6 times
28.
Which of the following is a dangerous situation ?
1. Always excessive discharge during menstruation
2. Always less discharge during menstruation
3. Discharge in between two menstruation periods
4. None of the above
From the following, when will you advice a patient to consult a doctor?
29.
In respiratory system
1. A child is coughing excessively
2. Greenish-yellow phlegm/mucus
3. Area between ribs is being sucked in
4. The child is crying
30.
If a child has fever in which situation will you send him/her to a doctor ?
1. Fever is at 101.5° F
2. Joint-ache along with fever
3. Diarrhoea with fever
4. Cold with fever
186
31.
On noticing which of these symptoms will you send to a doctor ?
1. Headache
2. Inflammation in throat glands
3. Chin does not touch chest
4. Greenish-yellow phlegm / mucus
32.
How will you know that the pain is serious ?
1. Light pain in chest, which does not spread
2. Patient cannot sleep at night
3. Pain increases while working or lifting weights
4. No relief even after cotra is administered
33.
Where is the pain located in appendicitis?
1. Navel and the area between Navel and left thigh
2. Navel and the area between Navel and right thigh
3. Below the abdomen
4. Below left ribs
34.
How will you identify internal bleeding?
1. Drying of skin
2. Increased pulse rate
3. Bluish-yellow skin colour
4. Severe headache
35.
Whose fault is it if a female-child is born?
1. Woman
2. Man
3. Fate / Result of bad-deeds in previous birth
4. No one
36.
If a couple is not able to conceive, whom would you advice to consult a doctor?
1. Woman
2. Man
3. Both
4. No one
187
37.
In case of Sore throat what will you do
1.
2.
3.
4.
Give Cotra
Give CPM
Aspirin gargle
All of the above
38.
How will you calculate expected date of delivery
1. When labour pain starts
2. Nine months from IMP
3. Send to the doctor to calculate
4. months and 7 days
39.
From when should a pregnant woman take Iron Folic acid tablets?
1.
2.
3.
4.
40.
If a pregnant women complains of severe.headache, difficulty in seeing, abdominal
pain what condition will you think of
1.
2.
3.
4.
41.
Pre Eclampsia
UTI
Anaemia
None of the above
A pregnant woman complains of mild bleeding per vaginal in her 4th month of
pregnancy. What will you do?
1.
2.
3.
4.
42.
From when periods stop
After 6 months of pregnancy
After delivery
After 3 months
Reassure her it is normal
Advice her to take rest
Send to the nearest doctor
Give Iron and folic acid tablets
A 13 year old boy complains of fever, headache, and rash over the body in different
shapes and sizes. The diagnosis is
1.
2.
3.
4.
Measles
Typhoid
Chicken pox
Sore throat
188
43.
A patient is brought and the following signs are seen cold hands and legs, fast and
weak pulse, severe abdominal pain. The diagnosis is
1.
2.
3.
4.
44.
Severe dehydration
Typhoid
Internal haemorrhage
All of the above
Which of the following signs show internal bleeding?
1. Strong and fast pulse
2. Severe thirst
3. Increased sleepiness
4. None of the above
45.
Respiratory diseases are more commonly seen in
1.
2.
3.
4.
46.
Big houses
Small houses
In poor people
In over crowded houses
In suspected TB you will
1.
2.
3.
4.
Diagnose and start treatment
Take sputum and send to PHC
Take patient to the government hospital
None of the above
True or False
47.
Malaria is caused by a bacteria
48.
TB is treated by antibiotics for 6 months
49.
Typhoid fever shows the
pattern
of increasing
and
decreasing
every
day
50.
Epidemiology is the study of illness
51.
Anatomy is the study of why disease occurs
189
Fill in the blanks
52.
Chicken pox is caused by a
53.
Colour of Typhoid stool is
54.
The formula for calculating IMR is
55.
The drug of choice to treat Pneumonia is
56.
Rheumatic fever starts with a
57.
Severe Pneumonia in a 1 month old baby will have a respiratory rate of
58.
In case of nose block what is given?
59.
The most common cause of cold is
60.
A break in the continuity of skin or mucosa is called a
61.
Disease is caused when there is a imbalance between agent host and
62.
Percentage of women having Anaemia in India is
1. >70%
2. 50%
3. >50%
4. <50%
63.
How much Iron does the baby take from the mother?
1.
2.
3.
4.
5.5 gm
1-4 gm
3.5 gm
None of the above
190
64.
In Vitamin D deficiency the following may be seen
1•
2.
3.
4.
65.
Which of the following has largest protein content for 100 grams.
1.
2.
3.
4.
66.
Weakness
Bowing/bending of leg bone
Bitots spots
All of the above
Fish
Mong dal
Mutton
Soyabean
Vitamin A is found in
1. Papaya
2. Carrot
3. Liver
4. All of the above
67.
Vitamin C is necessary for
1. Formation of Hemoglobin
2. Formation of antibodies
3. All of the above
4. None of the above
68.
A pregnant women should gain weight as follow
1.
2.
3.
4.
69.
1.5 kilos totally
1 kg per month
500 gm every 2 weeks
None of the above
Placenta is formed at the end of
1.
2.
3.
4.
4 weeks
3 months
21 days
None of the above
191
70.
Fat soluble vitamins are
1.
2.
3.
4.
/
71.
A
A, E
D
All of the above
Measles can cause
1. Diarrhoea
2. Vitamin A Deficiency
3. All of the above
True or False
72. Tetanus injection is given during pregnancy
73. Throat infection may cause heart disease
74.
Iodine is found most in cabbage
75.
Mid arm circumference is used to detect malnutrition
76.
Lightening means baby’s head is near the ribs
77. Amoebiasis causes pain in right iliac fossa
78.
Patients having ulcer in 1st part of small intestine (duodenum)
are young individuals
79. Appendix has no function
80. Absorption of food takes place in large intestine
81. Growing baby gets nutrition from mother through ovaries
82.
Cancer means swelling, pain, redness and loss of function
83. Malaria can cause brain damage
84.
Pneumonia affects the larynx
85. After chewing food, it enters the stomach
86. Diphtheria may affect the Pharynx, Larynx and nose
192
87. Blood amount is our body is 3-5 liters
88. Pancreas produces 1 hormone
89. Our brain regulates heart rate, respiratory rate and temperature
90. Expectorant cough syrup is given in dry cough
91. Antibiotics are given in viral diarrhoea
92. Drug of choice in cold is cotromoxazole
93. High fever means temperature > 102° F
94. Malaria is a bacterial infection
95. CPM is given in ulcer disease
96. Measles vaccine is given at 4 months
97. Amniotic fluid is composed mostly of baby’s urine
98. Vomiting is early pregnancy is due to. progesterone
99. Deep breathing is one exercise during pregnancy
100. Cotrimoxazole can be given to the pregnant woman
193
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