Amarendra Kumar : learns about communicable and non communicable disease and its adverse effect on health.
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- Title
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Amarendra Kumar : learns about communicable and non communicable disease and its adverse effect on
health. - extracted text
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2014-2015
2015
Community Health Learning Programme
A Report on the Community Health Learning
Experience
AMARENDRA KUMAR
KUMA
COMPANY
555-543-5432
5432
www.yourwebsitehere.com
SOPHEA
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COMMUNITY HEALTH
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LEARNING PROGRAMME REPORT
SOCHARA SOPHEA
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2014- 2015
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AMARENDRA KUMAR
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CONTENTS
• Acknowledgement
• My inner learning’s
• Learning Objectives
• Learning’s from collective sessions
• Learning’s from field
• Research report
Acknowledgement
bl ,d o” kZ esa dh xbZ Qsyksf’ki ds nkSjku esjs ekxZn’kZd ds :Ik esa esjs izsj.kk lzksr ds :i dk vkHkkj O;Dr
djuk pkgrk gqWaA tgkWa LokLF; tSls fo” k; ij ljyrk ls le>us dk dk;Z fd;k x;kA bl dk;Zdze ds
nkSjku leqnk; izfdz;k vkSj lkeqnkf;d LokLF; dk;Zdze ds lkFk dk;Z djus dk lqugjk ljy vkSj O;fLFkr
leqnk; esa dk;Z djus ds rjhdksa dks dzec} <+x ls djus dh izsj.kk izkIr gqbZA eSa g`n; ls d`rK gwWa
lkewnkf;d LokLF; yfuZxa dk;Zdze lkspkjk csaxykSj ftUgksusa us eq>s Qsyks ds :I esa Lohdkj fd;kA bl iwjs
,d o” kZ esa vius lHkh Qsyks lkfFk;ksa dk Kku dkS’ky ,oa n{krk c<+kus esa dM+h esgur djds vuqBk iz;k’k
fd;kA
lkeqnkf;d LokLF; yfuaZx dk;Zdze lkspkjk csaxykSj esa lcls igys Mk- Fksyek ukjk;.k th dks dksfV dksfV
vkHkkj O;Dr djrk gwWaA ftUgksaus vius vkn’kZ O;fDrRo ,oa l?k” kZ iw.kZ thou ls gesa izsj.kk nhA
Mk- jfo ukjk;.k th dk vkHkkj O;Dr djrk gwWa ftudh dgkfu;kW ,oa fofHkUu laLFkkvksa ds dk;ksZ dk fooj.k
nsrs gq, gekjs fy;s lerkiw.kZ lkewnkf;d utfj;k cnyus esa izsj.kk lzksr ds :i esa dk;Z fd;kA
,l eksgEen th dk vkHkkj izdV djrk gwWa ftUgksus cM+s gh lgtrk ls gesa fjlpZ ,oa vkfVZdy ds fn’kk esa
vkxs c<+kus gsrw Kku ,oa lh[k c<+kus esa enn dhA
feLVj pUnj th dk vkHkkj ekurk gwWa ftUgksaus leqnk; ,oa leqnk; LokLF; ds ckjsa esa izdk’k MkykA
feLVj izlUuk th dk vkHkkj ekurk gwWa fd ftUgksaus Xykscy Lrj ij py jgh LokLF; lsokvksa ds ckjs esa
foLr`r :i ij izdk’k MkykA
Mk0 vkfnR; th dk vkHkkj ekurk gwWa fd mUgksaus i;kZoj.k ,oa LokLF; fo” k; ij yfuaZx dk;Zdze dks lQy
cuk;kA
feLVj jkgqy lj vkHkkj ekurk gwWa fd ftUgksusa us ges’kk [kqys eu ls fe= dh HkkWfr eu ls yfuZax dk;Zdze
dks lQy cuk;kA
feLVj lkcw th dk vkHkkj ekurk gwWa ftUgksaus fjlpZ fo” k; ij izdk’k Mkyrsa gq, fjlpZ ds egRo ds ckjs esa
le> cukus esa lg;ksx fn;kA
feLVj dqekj lj dk vkHkkj ekurk gqWa ftUgksus vius yEcs vuqHko ls gesa ykHkkfUor fd;kA
feLVj izgykn dk’kqdzxqtkj gWwa fd iwjs Qsyksf’ki ds nkSjku mudk rduhfd lg;ksx jgk rFkk LoPN is;
ty ,oa’kkSp lQkbZ tSls tfVy fo” k;ksa dks le>us esa gekjh enn dhA
lkFk gh lkFk lHkh rduhfd lkfFk;ksa dk vkHkkj O;Dr djrk gwWa ftUgksus us esaVj ds :I esa gesa fn’kk vkSj
ekxZn’kZu nsus dh viuh vgea Hkwfedk fuHkkbZ gSA blds lkFk gh lkFk mu lHkh lzksr O;fDr;ksa dk dksfV
dksfV vkHkkj O;Dr djuk pkgrk gwWa ftUgksus LokLF; ds fofHkUu fo” k;ksa ij gekjk Kku vkSj dkS’ky c<+k;k
gSA eSa vius lHkh LokLF; Qsyksf’ki lkfFk;ksa dks /kU;okn nsrk gwWa ftuds lkFk ,d o” kZ rd jgdj vius
vuqHkoksa dks ckWVus vkSj vkil esa gesa lh[kus dk ekSdk feykA
Content list
Why I wanted to do the community health fellowship
2003 dh ckr gS esjs ?kj esa esajs cM+h cgu dh 5 o” kZ dh csVh Mk;fj;k ls izHkkfor gqbZ FkhA og dkQh xaHkhj
gksus ds dkj.k mlds mipkj ,oa LokLF; dks iw.kZ :I ls Bhd gksus esa ,d lIrkg dk le; yxkA ;g
?kVuk esjs ,oa esjs ifjokj ds yksxksa dks cgqr gh nq%[kh fd;k tks fd bldk lac/k LokLF; f’k{kk lsa Fkk rFkh
ls esjs eu esa LokLF; ds izfr Dyhfudy fpfdRldh; mipkj ;k LokLF; dk;ZdrkZ cuus dks ysdj eu esa
dk;Z dh yyd curh jghA
2004 esa bykgkckn esa Lo;alsoh laLFkk fodykax dsUnz :jy fjlpZ lkslk;Vh bykgkckn }kjk ,d o” khZ;
fMIyksek leqnk; vk/kkfjr iwuZokl dk;ZdrkZ dkslZ ds p;u ds fy;s lk{kkRdkj esa Hkkx fy;kA ftlesa eSa
p;fur gqvkA ;g dkslZ iwjk gksus ds ckn dSail p;u ekuo lsok dsanz ukSx<+ pankSyh lh lh ,Q izkstsDV esa
dk;Z djus dk volj feykA izkstsDV ,fj;k cgqWr gh xjhch vf’k{kk fiNM+k igkM+h taxhyh uDly izHkkfor
{ks= FkkA ml {ks= esa LokLF; f’k{kk LokLF; izksUufr dk;Zdze dh cgqr gh tj:r Fkh ysfdu izkstsDV dk ,d
nk;jk ,oa laLFkk dh dk;Z lhek o esjh LokLF; ds ckjs esa tkudkjh dgh u dgh dk;Z dks djus esa ck/kk gks
jgh FkhA
2008 esa nwljh laLFkk fdj.k lkslk;Vh esa dk;Z djus dk ekSdk feykA fdj.k fo’ks"k cPpksa ds lkFk esa dk;Z
dj jgh gS ;g [kklrkSj ij laLFkkxr lsok;sa nsrh gS ,oa bldh ,d NksVh’kk[kk xzkeh.k {ks=ksa esa laLFkk ds
vklikl ds 20 xkoksa esa ,oa ehjtkiwj ftyk esa 2 Cykd ,oa 40 xkWoksa dk;Z dj jgh gSA xzkeh.k {ks= esa Hkh
fo’ks"k cPpksa ds lkFk] efgyk lewg ds lkFk] vkthfodk dk;Zdze dj jgh gSA ysfdu dgha u dgha LokLF;
dk;Zdze dh deh eglwl gksrh jghA tksfd lewnk; esa LokLF; dk;Zdze dk gksuk cgqr gh lDr tj:r FkhA
bl deh dks ns[krs gq, laLFkk ds esfMdy Mk;jsDVj Mk- eksfjuks VksYMks us LokLF; ij dk;Z dj jgh
jked`".k fe’ku laLFkk ds LokLF; izksUufr foHkkx ds leUo;d
Lokeh Mk- ofj” BkuUn ls ckrphr fd;kA jked`” .k fe’ku laLFkk ds }kjk fdj.k esa LokLF; f’k{kk] LokLF;
izksUufr fdj.k dk;Z {ks= dsa fo|ky;ksa ,oa leqnk; esa feydj dk;Z’kq: fd;k x;kA bl dk;Zdze esa eq>s
cgqr gh :fp gqbZ ,oa leqnk; ds lkFk LokLF; ij dk;Z djuk ,d vPNk ekSdk feykA LokLF; dk;Zdze dks
ns[kdj eq>s vf/kd ls vf/kd lh[kus ,oa tkudkjh dh vko’;drk eglwl gqbZ A esjk eukscy ns[krs gq,
Mk- eksfjuks VksYMks us jked`” .k fe’ku laLFk ds }kjk esjh lhchvkj Vhe dk ,d lkfIrkfgd {kerk c`f)
dk;Z’kkyk dk dk;Zdze laiUu gqvkA izf’k{k.k ls okil vkus ds ckn dbZ rjg ds leqnk; es LokLF; ds izfr
loky gqvk djrs FksA esjh lhfer tkudkjh dgha u dgha eq>s [kVdrh jghA fdj.k dh Mk;jsDVj laxhrk
cgu th lkspkjk csaxyksj dks mUgksaus dqekj th ds ek/;e ls foftV fd;kA foftV ds nkSjku Qsyksf’ki dj
jgs Qsyks ls ckrphr fd;kA blds ckn laLFkk okil vkbZ rks lh ch vkj Vhe ds lkFk cSBd dhA cSBd esa
lkspkjk laLFkk ds ckjs esa ppkZ dhA cSBd ds ckn lHkh dh bPNk tkuuk pkghA lHkh us viuh viuh bPNk
crkbZA ysfdu esjs mRlkg ,oa dk;Z dks ns[kdj Vhe esa esjk Qsyksf’ki dk;Zdze dks djus ds fy;s p;u
gqvkA ml fnu esjs [kq’kh dk fBdkuk u jgkA mlds ckn esSusa viuk lkeqnkf;d LokLF; yfuZax dk;Zdze esa
p;u ds fy;s viuk ck;ksMkVk baVjusV ds ek/;e ls HkstkA 15 fnu ckn lkeqnkf;d LokLF; yfuZx
dk;Zdze }kjk lk{kkRdkj ds fy;s cqyk;k x;kA ml fnu eS cgqr [kq’k gqvkA lkspkjk Qsyksf’ki djus ds ckn
LokLF; ds izfr ,d vPNh le> cu ldh vkSj eS leq nk; ds yksaxks dk vPNk LokLF; lkFkh cudj yksaxks
dks T;knk ls T;knk tkudkjh ns ldwWaxkA
My learning objectives-
1. To learn about health and community health
2. To understand social determinants.
3. To understand about NRHM and its functions .
4. To learns about communicable and non communicable disease and its advers effect on
health.
5. To improve documentation and networking capacity.
Learning from collective teaching session and field visit
LOkkLF; vkSj lkeqnkf;d fodkl
LokLF; vkSj lkeqnkf;d fodkl vkSj lHkh ds fy, LokLF; ij le> cUkh blds ckn LokLF; ,oa fodkl ds
iSekus dks ekius ds fy, LokLF; lwpdkad vkSj budk fdl izdkj fo’ys“ k.k fd;k tkrk gSA egkekjh dks
fdl izdkj izfoysul vkSj bUlhMsl dks ns[kk mldks jksdus dh ;kstuk djuk blds lkFk gh A
bldh’kq:vkr dSls gqbZ bldk fdz;kUo;u lajpuk fdl izdkj dk;Z djsxhA lsokvks esa lqÄkj fdl izdkj
fd;k tk; bl ij le> cuhA izf’k{k.k ds nkSjku ik;k fd LokLF; dks csgrj izca/ku dSls fd;k tkrk gSA
fodkl dh fLFkfr dks le>us ds fy, fdl izdkj LokLF; lwpdkad ds ek/;e ls fodkl’khy ,ao fodflr
gksus dh igpku dh tk ldrh gSA lkekftd fu/kkZjdks dh tckc nsgh lqfuf’pr gksrh gS rks LokLF; dh
fLFkfr dks fdl izdkj lq/kkj yk;k tk ldrk gSA
LokLF; ij le>
LokLF; ij ljy rjhds ls le> cu lds blfy;s ;gkWa ij lewg ppkZ jksy ekMy mnkgj.k MkD;qesaVzh
fQYe ds ek/;e ls le>us dk iz;k’k fd;k x;kA igys LokLF; dks esfMlhu dh n`f” Vdks.k ls le>k ;k
ns[kk tkrk jgk ysfdu vc izf’k{k.k I’pkr LokLF; dks le>us dk utfj;k esa cnyko gqvkAs ;g ,d
lkeqnkf;d igy gS ftles LokLF; fu/kkZjd o ewyHkwr lqfo/kkvksa dks ysdj vkxs c<+kukA igys Hkh bUgha
fo” k;ksa dks ysdj dk;Z djrs Fks ysfdu LokLF; dks viuk fo” k; dHkh ugh ekuk Fkk izf’k{k.k ds ckn yxk
fd LokLF; gekjs thou ,oa leqnk; ds thou dk izeq[k vax gSA
jk"Vªh;’kgjh LokLF; fe’ku dk’kqHkkjEHk
jk"Vªh;’kgjh LokLF; fe’ku dk’kqHkkjEHk 20 tuojh 2014 dks dsfn; LokLF; ea=h vktkn }kjk ,oa dukZVd
ds ekuuh; eq[;ea=h }kjk cSaxyksj fLFkr QzhMe ikdZ esa fd;k x;k A mijksDr dk;Zdze esa mifLFkr gksus
dk lkSHkkX; ges izkIr gqvk ftlesa gesa ;g le>us dk ekSdk feyk fd fdl rjg Hkkjr ljdkj fofHkUu
t:jrks ,ao vko’;drkvksa dh vksj /;ku vkdf” kZr dj jgh gSA bl dk;Zdze ds }kjk vlaxfBr {ksé esa
thou ;kiu djus okys dLcksa ds xjhc yksx] xyh dwpksa esa jgus okys cPpksa vlgk;ksa dks LoPN is;
ty]’kkSp] vkoklh; lqfo/kk] dqM+k fuLrkj.k] vkWxuokM+h vU; ljdkjh ;kstuk dh miyC/krk ls uxjh; {ks=
dh vk/kh leL;k lekIr gks tk;sxhA
fdUrq lcls izeq[k ckr ;g gS fd yksaxks dks vius tj:rksa ds izfr Lo;a l’kDr gksuk iMsxk ftlls og
vius ftEesnkjh dk fuogZu dj ldsaA
lkeqnkf;d LokLF;
ßlkeqnkf;d LokLF; Þ uke dks O;kid ekU;rk izkIr gS] LokLF; foKku tu LokLF; vkSj fujks/kd fpfdRlk
ds cnys vc bl uke dk mi;ksx gksus yxk gS] lkeqnkf;d LokLF; ifjp;kZ dh fo’o LokLF; laxBu dh
fo’ks” kK lfefr ds vuqlkj lkeqnkf;d LokLF; ls vfHkizk; leqnk; ds yksxks ds LokLF; Lrj]mudh LokLF;
lEcU/kh lEL;k;sa vkSj leqnk; dks miyC/k LokLF; lk/kuksa ls gSA lkeqnkf;d LokLF; mipkj ]fujks/k ,ao
LokLF; lEcU/kh lsaokvksa dk laxfBr :i gSA blesa lkeqnkf;d fuku vkSj mipkj ij fo’ks” k tksj fn;k tkrk
gSA source – community health science book.K park.
tu LokLF; vfHk;ku
;g yksxks dh LokLF; dks ysdj lapkj dk dk;Z gS ftlesa O;fDr ds ekuo vf/kdkj fo” k; ij le> cukbZ
tkrh gS] vkSj yksxks ds lkekftd vkfFkZd iksfyfVdy fo” k; ij ppkZ dj ml fLFkfr ls’kkldh; vkSj
flfoy laLFkk }kjk gy djus dk iz;kl fd;k tkrk gSA
esfMdks QzsMl ldZy
;g ,d LokLF; eap gS ftlesa LokLF; ds {ks= ij vyx vyx LFkkuksa ij LokLF; ds {ks+=ks es dk;Z djus
dh fLFkfr lkFk gh lkFk xaHkhj eqnnks ij vkilh fopkj foe’kZ ds }kjk ,d er cukdj bl dk;Z ;kstuk
dks if=dk esa izLrqr fd;k tkrk gS A
xzkeh.k lgHkkxh ewY;kdau
lse tkslsQ lj }kjk lgHkkfxrkiw.kZ xzkeh.k ewY;kdau ds ckjs esa crk;k x;kA bldk mi;ksx dj ge
leqnk; fd izkFkfedrkvksa dks leqnk; }kjk tkurs gSa ,ao fujkdj.k Hkh leqnk; fd vksj ls gh vkrs gS ih
vkj , ds ek/;e ls ge ;s tkuus dk iz;kl djrs gS fd cqfu;knh vko’;drk ;k leL;k D;k gS \ ;gkW
,slh fof/k gS tks yksxks ds fy;s mUgh ds }kjk fd;k tkrk gSA xzke ds vk/kkj Hkwr tkudkjh ,dfér djus ds
fy;s ,ao xzke dh leL;kvks ds ckjs esa tkuus ds fy, Transect walk, Social mapping ,Seasonal mapping
and venn Diagram ftlesa xkao dh Hkwfexr fLFkfr xzke esa dkSu lh lajpuk dgk gS og tkuuss ds fy,
xzke okfl;ksa ls tehuh Lrj dk uDlk cuok;k tkrk gSA vkSj xzke esa miyO/k lalk/ku tSls uDls ij ou —
f” k {ksé]edku] Hkou]LkMd]iwy]dq,]V;wcsy]’kkldh; Hkou]rkykc]unh]uky vkfn dks uDls ij n’kkZ;k tkrk
gSA xzke okfl;ks ls bl uDls ij xkao dh leL;k dh tkudkjh izkIr dh tkrh gSA
jk” Vh; xzkeh.k LokLF; fe’ku
Hkkjr ljdkj }kjk vizSy 2005 esa jk” Vh; xzkeh.k LokLF; fe’ku fd’kq:vkr ns’k ds 18 jkT;ks esa ,d lkFk
ykxw fd;k x;k]tks fd [kkldj detksj lkoZtfud LokLF; <kps okys jkT; gSA ,slk igyh ckj ugh FkkA
tc ljdkj us lkoZtfud LokLF; lsokvksa vkSj lkoZtfud O;oLFkk dh leL;kvksa dks Lohdkj fd;k FkkA
Hkksj lfefr ds izLrqr gksus vkSj izFke iapo” khZ; ;kstuk ds le; ls 1970 ds nld rd vusd flQkfjlsa dh
xbZA budk tksj lHkh rcds ds yksxksa dks fu%’kqYd LokLF; lsokvksa rd igqp cukus ij FkkA
y{; vkSj j.kuhfr;kW
1- lHkh dks izkFkfed LokLF; rd igqWpA
2- efgykvksa vkSj cPpksa dks iks” k.k] Vhdkdj.k] ikuh vkSj lQkbZ
3- uotkr f’kq’kw e`R;qnj rFkk ekr` e`R;qnj esa deh
4- lkoZtfud LokLF; ij [kpZ dks ldy ?kjsyw mRikn ds 2 ls 3 izfr’kr rd igqWpkukA
5- vk;q” k dks eq[;/kkjk esa ykdj lkoZtfud LokLF; O;oLFkk esa tksM+ukA
6- vk’kk ds ek/;e ls ifjokj ds Lrj ij LokLF; rd igqWpA
7- LokLF; O;oLFkk esa <+kpkxr lq/kkj rkfd ;g c<+s gq, vkoVau dk leqfpr mi;ksx dj ldsaA
8- lkoZtfud LokLF; lsokvksa dh LokehRo fu;aé.k ,oa izo/kau esa iapk;rh jkt laLFkkvksa dks’kkfey
djukA
9- iapk;rksa dh xzke LokLF; lfefrvksa ds ek/;e ls izR;sd xko ds LokLF; ;kstuk rS;kj djuk
10- lkoZtfud fuft lgHkkfxrk
11- lkekftd LokLF; chek vkSj tksf[ke mBkus dh O;oLFkk
bl izdkj jk” Vzh; xzkeh.k LokLF; fe’ku esa vk’kk dh Hkwfedk lcls egRoiw.kZ gS blh ds lkFk lkeqnkf;d
fuxjkuh Hkh ,d eq[; pj.k ftlds ek/;e ls mi LokLF; dsUnz ls ysdj lkeqnkf;d LokLF; dsUnz dh
xfrfof/k;ksa ij ge utj j[k ldrsa gSaA blds lkFk gh laiw.kZ LokF; dk tks ge liuk ns[k jgsa gS dgha u
dgha og lp gksus fd dxkj ij igqpus dk iz;k’k fn[k jgk gSA
;gk ij leqnkf;d yafuZx dk;Zdze ds vuqHko dks nks pj.kksa esa iw.kZ fd;k x;k tks fd ,d o” kZ rd iw.kZ
dk;Zdze jgkA ftlesa 6 ekg dk’kS{kf.kd dk;Zdze jgk gS ftlds vUrxZr cSaxyksj fLFkr lkspkjk laLFkk esa
jgdj lkeqnkf;d LokLF; ds xq.k jgL;ksa dks le>usa dk volj feyk tks fuEufyf[kr gS&&&&&&&&&&
Health system
According to WHO “a health system comprises all organizations ,institutions and
resources devoted to producing action whose primary intent is to improve
health.most national health system include public ,private,traditional and informal
sectors.The four essential function of a health system have been identifieds as service
Provision, .resource generation, financing and stewardship.
Hkkjr dh tks LokLF; iz.kkyh gS]og ,d Hkz” V LoLF; iz.kkyh gS]ftlesa fdlh Hkh dke fd tckc nsgh dk
izko/kku rks gS]ysfdu flQZ dkxtks ij tks fd vfejks ,ao xfjcks dks lekurk ls lqfo/kk,a iznku djus ds
fy;s izfrc} gSA blds izeq[k fcUnq bl izdkj gSaA
•
Financing- public, private ,out of pocket
•
Organization of health care systems.
•
Governance and accountability mechanisms
•
Implementation Issues.
•
Quality of care
•
Outcome and impacts,including equity.
•
Cphc approach to health system development.
•
Health systems as a health determinant. .
Health Policy in india.
According WHO a national health policy is an expression of goals for improving the health
situation, the priorities among those goals and the main directions for attaining them.
In india we have two national policy•
National Health policy [NHP] 1983 and 2002
National population policy[NPP] 2000.
bldk eryc gS fd leqnk; dh LokLF; uhfr;ks esa Hkkx ysus dk volj iznku fd;s tkus pkfg;saA leqnk;
fd lgHkkfxrk gksus ls LokLF; lsokvksa rd yksxksa fd igqp vklku gks ldrh gS aA
pquSkfr;ka vkSj ck/kk,a- leqnk;d dh Hkkxhnkjh ]Hkqxrku djus fd {kerk jktfufrd fodYi social
inclusion /exclusion, beliefs and experience and conflitct.
•
LokLF; fu/kkZjd -
fdl izdkj LokLF; fu/kkZjd ds izHkko ls LokLF; ij izHkko iMrk gS A
Socio-economic
Environment
Inborn
Health system
Socio- political
Behavioural
Demographic
Socio-cultural
A P D –Association of people with Disability
,- ih- Mh- cXykSj fLFkr laLFkkxr laLFkk gS]tks fd 1959 ls fo’ks"k cPpks ;qokvksa fofHkUizdkj ds fodykxrkvksa
ls xzflr ;qokvks ,ao C;fDr;ks ds lkFk dk;Z dj jgh gSA ;g laLFkk eq[; :i ls’kkfjjhd fodykax]lsjsczy
ikWYlh]Likbuy dkMZ batqjh] ekufld ean ]fg;fjx bEis;j esUV],ao cgq fodykaxrk ds lkFk foLr`r :i ls
dk;Z dj jgh gS A fo’ks” k :i ls laLFkkxr dk;Z vkj0 lh0 vkbZ0 }kjk
ekU;rk izkIr fMxzh fMIyksek
dkslZ ,ao C;olkf;d izf’k{k.k dk dk;Zdze pykdj iquokZl dj jgh gS A ;g 5 ftyks esa fofHkUu leqnk;
ds fodklkRed eqnnks ,ao leqnk; vk/kkfjr iquokZl dk;Zdze pykdj eq[; /kkjk ls tksMus dk dk;Z dj
jgh gS A
a
Q- vkj- ,y- ,p- Vh dk ’kS{kf.kd Hkze.k
vkt fnaukd 5 fnlEcj 2014 dks laLFkk }kjk ’kS{kf.kd Hkze.k ds fy;s ,Q vkj ,y ,p Vh laLFkk dh p;u
fd;k x;k FkkA ;g laLFkk gekjh laLFkk ls djhc 20 ls 25 fdeh0 nwj ’kgj ls ckgj {ks= esa fLFkr gSA
fo’ks” k :i ls bl laLFkk dk eq[; m}s’; gekjh izkphu fpfdRlk i}fr dk iqu:}kj djuk rFkk gekjs ns’k
esa izkd`frd lEink ds :i esa mifLFkr nwyZHk tM+h&cwfV;kWa tks yqIr gksrh tk jgh gS mudks lajf{kr djuk
rFkk muds oSKkfud egRo ij vuqla/kku djuk rFkk mls izkphu le; ls cgqr gn rd blh fpfdRlk
i}fr ij geyksx fuHkZj FksA fdUrq vaxzsth fpfdRlk i}fr ds vkfHkZHkko ds lkFk ;g misf{kr gks x;kA
ftldk lcls izeq[k dkj.k blds gLrfyf[kr izek.k vFkok lk{; dk vHkko rFkk lkFk gh lkFk bl dkS’ky
esa fuiw.k yksaxks dh la[;k esa fxjkoV Hkh ,d izeq[k dkj.k jgkA
bl {ks= esa c<+kok nsus ds fy;s ;g laLFkk blds oSKkfud egRoksa ij ’kks/k dk;Z dj jgk gSA ftlls blds
jgL;ksa ij ls inkZ gVkdj bls lHkh ds ykHkizn gks ldsA bl laLFkk dk fo’ks’k mRrjnkf;Ro ;g Hkh gS fd
bl fpfdRlk iz.kkyh dks eq[; vkjksX; dk;Zdze ds lkFk bl tksM+dj yksxks rd bldk ykHk igqWpk;k tk
ldsA
ekufld LokLF;
fiNys dk;Z ds nkSjku dbzZ ckj ekufld O;fDr;ksa dsk ns[kk x;k]ftlesa leqnk; dks Hkh blds ckjs esa de
tkudkjh gksrh gS] dbZ ckj ,sls O;fDr;ksa dks’kks” k.k dk vf/kd f’kdkj gksuk iM+rk gS vkSj lkeqnk; Hkh bldk
lg;ksx ugh dj ikrk gS
ekufld LokLF; lEiw.kZ LokLF; dk ?kVd gS ;g dsoy ekufld jksxksa ds’kh?kz funku rFkk mipkj ls
lacf/kr vPNs ekufld LokLF; ds laj{k.k rFkk lao/kZu vkSj ekufld jksxksa dh jksdFkke Hkh bldk nk;jk gS
ekufld LokLF; vkSj’kkjhfjd LokLF; ijLij lacf/kr gS LoLF; eu esa LoLF;’kjhj iqjkuh dgkor gS fo’o
LokLF; laxBu dh ifjHkk” kk ds vuqlkj LokLF; ls rkRi;Z’kkjhfjd vkSj ekufld LokLF; nksuks vkSj
lkekftd dY;k.k gS ekufld LokF; dh uho cpiu ds izkjaHk esa gh i<rh gS ekufld LokLF; esa lg;ksxh
fofHkUu ?kVd fuEu gS &
1- vPNk ’kkjhfjd LokLF;
2- ewy vko’;drk;sa
3- vknrsa
eysfj;k
eysfj;k ,d rst cq[kkj okyh chekjh gS ftlesa euq"; ds ’kjhj ds vUnj eysfj;k ds ijthoh mifLFkfr
gksrs gaS IykTeksfM;e lsfYlisje tkfr ds ijthoh fnekx ij vlj Mkyrk gS euq” ; esa eysfj;k iSnk
djus okys pkj izzdkj ds ijthoh gS A IykTeksfM;e ck;osDTl] IykTeksfM;e lsfYlisje] IykTeksfM;e
eysjh] IykTeksfM;e vksosy] ftlesa lcls T;knk IyksTeksfM;e ck;osDl IykTeksfM;e lsfYlisje ijthoh
dk ladzke.k vf/kdrj igkM+h {ks=ks esa vf/kd n[kus dks feyrk gS vkSj fdl izdkj xzkeh.k lkeqnk;
x<<ksa dh ejEer uhe ds iRrks dks /kqvkW djds lkFk gh tgkW ij Bgjs gq,W ikuh esa xiw eNyh dks
Mkydj ijthoh ds ykjok dks u” V fd;k tk ldrk gSA
LokLF; f’k{kk dk;Zdze
O;fDrxr vkSj lkeqnkf;d LokLF; nksuks ds izksRlkgu esa LokLF; f’k{kk dh Hkwfedk egRoiw.kZ gSA [kkl
rkSj ij LokLF; f’k{kk dk;Zdze Ldwy] leqnk; esa LokLF; f’k{kk cPpksa dks LoPNrk foKku ikB ds ek=
rd gh lhfer ugh j[kuk pkfg,A LOkkLF; f’k{kk ,oa LOkkLF; inksUufr dks O;ogkj esa ykuk ,oa
cPpksa ,oa O;fDr ds O;fDrxr thou esa cnyko dks ykuk vf/kd egRoiw.kZ gS] laHko gks lkeqnkf;d
LokLF; dk;Zdze esa LoPN is;ty dh lqfo/kk]’kkSpky; dk fuekZ.k] Vhdkdj.k vfHk;ku vkfn dk;Zdzeksa
esa cPpksa ,oa lkeqnk; ds yksxks dh Hkkxhnkjh lqfuf’pr djsaA Ropk] cky] nkar vkSj diMksa dh lQkbZ]
O;k;ke] uhan] iks” k.k vkSj vPNh vknrks dk egRo izfrj{k.k rFkk LOkPN ty dh vko’;drk] efD[k;ksa
vkSj vU; dhVksa dk fu;a=.k dqN ,sls fo” k; gS ftudh LOkkLF; f’k{kk dk;Zdze pykdj leqnk; ,oa
Ldwy ds cPpksa rd ykHk igqapk;k tk ldrk gSA
i;kZoj.k LoPNrk lEcU/kh leL;k;sa
dk vHkko rFkk ey fuLrkj.k dh LoPN rfjds lcls izeq[k gS]loZs{k.kks ds nzkjk xzkeh.k {kséks esa 90
izfr’kr ls vf/kd [ksrks esa ;k eSnkuks esa’kkSp ds fy, tkrs gS]vkSj okrkoj.k dks iznwfir djrs gSA orZeku
esa 25 izfr’kr’kgjh vkSj 75 izfr’kr xzkeh.k tula[;k dks lqjf{kr ty miyC/k djkus dh ckr gS] ns[kk
tk; rks leqfpr lqfo/kk;sa uxj okfl;ks dks 18 izfr’kr ,ao {ksé okyks dks 15 izfr’kr lqfo/kk;sa miyC/k
gks ik jghgS] i;kZoj.k LoPNrk dh leL;k okLro esa fo’kky gSA
my over all learning;gka ij lkeqnkf;d yfuZx dk;Zdze ds varxZr LokLF; tSls fo” k; ij ljyrk ls le>us dk iz;kl
fd;k x;k];agk ij [kqyk izdkj dk okrkoj.k gS tks fd fdlh vU;’kS{kf.kd laLFkk es ugh ns[kk x;k A
;fn mRrj izns’k esa ns[ks rks bl izdkj dk LokLF; dks ysdj dksbZ Hkh laLFkk Bhd ls dk;Z ugh dj jgh
gS ;fn lHkh ds fy, LokLF; dh miyC/krk djuh gS rks lHkh dks feydj dk;Z djuk gksxk A
;gk ij bl yfuZx dk;Zdze ds rgr dbZ lkjh phtks dks lh[kh ijUrw dqN dk gh fooj.k ;gk dj jgk
gwW A
tc Hkh bl dk;Zdze ds vUrxZr dgh u le> es vk;k rks mldks nqckjk iwNus ij ljyrk iwoZd
le>kus dk iz;kl fd;k x;k A ;gkW ij okLrfod fLFkfr dks tkuk A lse tkslsQ lj }kjk xzke es
fdl izdkj xzkfe.k lgHkkfxrk vkWdyu ds }kjk ih+ vkj+ ,-dk mi;ksx dj ogkW fd eq[; leL;k dk
p;u dj xzkfe.kks ds }kjk gh mls gy fd;k tkuk pkfg,A
MkW0 jfo us leqnk; D;k gS leqnk; LokLF; ] lkeqnkf;d fodkl ]ifCyd LokLF; ds ckjs esa dks ns[kdj
leqnk; ds }kjk gh mls gy djus dk iz;kl djuk A’kgjh leqnk; ls Ckkr dj oWgk dh okLrfod
LokLF; dh fLFkfr dks tkuuk gSA fdl izdkj xzkeh.k leqnk; vkSj’kgjhleqnk; esa lkekftd fu/kkZjd
vyx vyx rjg ls C;fDr dsk izHkkfor djrs gSa ] vkSj
LokLF; dh fLFkfr dks tkuk ],ao leqnk; es LokLF; flLVe dk;Z dj jgk gS leqnk; vkSj LokLF; es
fdl izdkj xSi gSs mldks tkuus dk iz;kl djuk gS A panj lj }kjk crk;k fd txg txg ij
lkekftd fu/kkZjd dkjd gS tks fd leqnk; ds LokLF; ij izHkkfor djrs gSA esaVy gsYFk dks ysdj
yksxks dh D;k fopkj /kkjk gSA leqnk; ls’kkldh; foHkkx ls dSlk lac/k gS vkSj og fdl izdkj og
LokLF; dh xfr fof/k esa Hkkx ysrs gS]xzke es yksdy fgyj dks fdl izdkj egRo fn;k tk jgk gS A
izkFkfed LokLF; dsUnz o lkeqnkf;d o ftyk Lrj ij leq nk; dks fdl izdkj dh lqfo/kk iznku dh
tk jgh gSA
blh izdkj’kS{kf.kd foftV ds nkSjku ;Wgk ij vyx vyx laLFkkvks esa Hkze.k dk;Z fd;k x;k ftles eSus
ns[kk fd ;gk ij xSj ljdkjh laxBu fdl rjg dk;Z dj jgs gS]mldk fooj.k bl izdkj gSA
FIELD PLACEMENT-
esjk fQYM {ksé mRrj izns’k ds okjk.klh tuin ds dk’kh fo/kk ihB Cykd esa fdj.k lkslkbZVh esa 6ekg
ds fy, gqvk ftlesa esjs esUVj Jh jathr dqekj flag gS] ftUgksus esjs bl dk;Z esa iw.kZ lg;ksx fn;k] esjs
fQYM ds mns’; bl izdkj gS A
Objective of field placement
Understanding of community
Understanding of community priorties.
Understanding of organization.
Understanding of social determination of health.
Understanding of situation analysis.
Health care providers and medical pleuarlism.
Understanding of NRHM and commnitization.
Understanding of mental health.
Understanding of climate change.
Understanding of public health system.
DIstrict INFORMATION
Geograhical area (2001) 1535 sq.km
Population(2011)
-3,682,194
Male
(2011)
- 1,928,641
Female
(2011)
-1,753,553
Rural
(2001)
-1878100
Urban
(2001)
-1260570
Schedule caste
-435540
Schedule tribes
-770
Sex ratio
-90
Population density
-2399 per. Sq.km
Literacy rate
-77.05%
1-Male
-85.12%
2-Female
-68.20%
NO. Of tehsil
.03
ABOUT KIRAN- Kiran literally means or light it is a centre for differentlyable children and youngster.Founded in September 1990 by a small group
of people from a various ray social, cultural and religious back grounds, it
has continued to work based on the idea of togetherness ,enriching every
one’s talent and abilities.
In 1998 kiran centre shifted from the city Varanasi to madhopure, a village
near to famous sultankeshwar temple located about 12 km. South of BHU.
Today the kiran center funcation as a the small village where children and
youngster with differently abilities recive education, skill and vocational
training and physical rehabilitation and where, Inclusivenss is giving
happiness to all.
More to the children and youngsters we work with are suffering from the
consequences of polio cerebral palsy,rickets or hearing imperment they
have the potential to lead normal lives,if only we can reach them some how
. Unfortunately many such childrens suffer the fate of being hidden and
kept at their home and getting no access to educatior or rehabilitation.
VISION – KIRAN S Vision is a resource centre that empowers differentlyable children and young people in partnership with their parents .by
providing a quality service to them without discrimination of cast ; religion
or financial circumstance.
MISSION STATEMENT-KIRAN provides quality services to support
differently able children and young people in optimizing their talents and
skill so that they may live dignified and satisfying adult lives. KIRAN does
this in partnership with parents and families.
STRATEGY- Our strategy is to provide individual care to differently –able
children through physical rehabilitation ,education, skill training and
enhancement of artistis .we also aim to intensify awareness creation and
advocacy.
Community based rehabilitation.
The CBR project is an important instrument for allowing the families to
remain in their village and still
get the needed support for their
disabled child. We provide micro
–credit to many families under
our CBR-field which improves
their situation and thus get them
better integration in the
society .our vast CBR project , working in 50 village , Focuses on health ,
Awarness and livelihood.
cNkao xkao vkaxuokMh dh lwph
dzekad
1
2
3
4
5
6
7
8
9
10
11
Uke
vo/ks’k
izHkk nsoh
Lusgyrk nsoh
rkjk nsoh
js[kk nsoh
xhrk nsoh
jkf/kdk nsoh
Xkk;=h nsoh
uhyw nsoh
etw nsoh
jkuh nsoh
In
lh Mh ih vks
Lqijokbtj
Dk;ZdrkZ
Dk;ZdrkZ
Dk;ZdrkZ
Dk;ZdrkZ
Dk;ZdrkZ
Dk;ZdrkZ
Dk;ZdrkZ
Dk;ZdrkZ
d;kZdrkZ
oPNko xk¡o dh LokLF; dk;Zdrk dh lwph¡
dz0 l0
Ukke
Ikn
1
2
3
4
5
6
7
8
nqxZkorh nsoh
eqUuh nsoh
flrkjk nsoh
lqUnjh nsoh
Xhrk nsoh
‘kgtknh
/kekZ nsoh
fouk nsoh
fjuk nsoh
,p0 oh0
,0 ,u0 ,e0
vk’kk
vk’kk
vk’kk
vk’kk
vk’kk
vk’kk
vk’kk
js[kk nsoh
vk’kk
BUnzkorh
vk’kk
9
10
11
izkFkfed LokLF; dsUnz dk’kh fo|k ihB Oykd LVkQ dh lwph
Dzekd
01
02
03
04
05
06
07
08
09
10
11
12
13
14
uke
Mk0 ,e0 ih0 pkSjfl;k
Mk0 vks0 ih0’kqDyk
Mk0 vfer
Mk0 izos’k
Mk0 lhek
Mk0 cUnuk
fcuksn flg
Mk0 v#.k
,0 vkj0 vks0
lqijokbtj
QkekZflLV
,0 Vh0
okMZ Ook;
LVkQ ulZ
In
eq[; fpfdRlk vf/kdkjh
,e0 vks0 vkbZ0 lh0
,e0 vks0
FpfdRld
fpfdRld Léh jksx
vk;q” k
,p0 b0 vks0
usé jksx
01
02
01
01
01
01
15
16
17
18
19
,p0 oh0
DydZ
pijklh
,0 ,u0,e0
vk’kk
02
01
02
23
295
Swachh Bharat Mission (S B M)
Ministry of drinking water and SanitationState
District
Utter Pradesh
Varanasi
Block
Kashi vidya peeth
Panchayat
Bacchhav
Panchayat status of Baseline Survey
SI. No.
Components
With Toilet
Without
Toilet
Total
01
02
03
04
05
06
07
Total Household
Total SC HH
Total ST HH
Total General
Total BPL HH(With and without toilet)
Total A P L H (with and without toilet )
Total schools(with and without toilet)
847
0
0
0
478
369
1
366
0
0
0
190
176
1
1213
217
1
996
668
545
2
S08
Total AWW(with and without toilet)
1
1
2
09
Total Sanitary Complex(with and
without toilit)
0
0
0
Panchat status (not having toilet )
SI.NO.
Component
Target
Achievement
Details
01
02
03
04
IHHL BPL ( without toilet)
IHHL APL ( without toilet)
no of Household (using Commuinty Tlt
IHHL TOTAL(without toilet+no.of HH using
CommunityTlt
School Tiolet
Anganwadi Tiolet
Sanitary Complex
190
176
0
366
228
15
0
243
208
0
1
1
0
1
0
0
0
0
0
05
06
07
1-
vk¡xuckM+h foftV xk¡o cPNk¡o %& lesfdr cky fodkl lsok,¡ dk;ZØe py jgs xk¡o cPNko esa
foftV ds nkSjku vk¡xuckM+h dk;ZdrkZ ls ;g tkudkjh feyh fd vk¡xuckM+h esa fofHkUu izdkj ds
dk;ZØe gS %& efgyk ,oa cky fodkl ea=ky;] Hkkjr ljdkj ds vkbZ0lh0Mh0,l0 dk;ZØe dh
lsok,¡ rd lesfdr iSdst 6 lky ls de mez ds cPpksa] xHkZorh ,oa Lruiku djkus okyh
ekrkvksa rFkk 15&45 o"kZ dh efgykvksaA
lsok,¡ &
1-
iwjd iks"kkgkj ,oa o`f) fuxjkuh vkSj izkRs lkgu]
2-
Vhdkj.k]
3-
izkjfEHkd ckY;koLFkk ns[kHkky ,oa Ldwy&iwoZ
f'k{kk]
4-
iks"k.k ,oa LokLF; f'k{kk]
5-
LokLF; tk¡p]
6-
jsQjy lsok,¡A
vk'kk dk;ZdrkZ ls lEidZ %& cPNk¡o xk¡o esa vk'kk dk;ZdrkZ ls lEidZ fd;k x;kA vk'kk
2-
dk;Zdrkvksa ls ckrphr ls ekywe gqvk fd mudh vk'kk dk;ZdrkZ ds in ij 3&4 o"kZ igys gqbZ
vkSj mudh f'k{kk d{kk 8 ikl o 10 ikl gS] ,oa muds dk;Z ds ckjs esa tkuk x;k fd vk'kk
leqnk; esa LokLF; lsokvksa ds ckjs esas tkuk x;k muls ;g ekywe gqvk fd leqnk; esa LokLF;
tkx:drk dk;ZØe dks yksxksa rd T;knk ls T;knk ykHk igq¡pkukA
tSls&
1-
xHkZorh efgykvksads iathdj.k]
2-
xHkkZoLFkk ds nkSjku LokLF; tk¡p]
3-
vk;u dh xksyh] Vh0Vh dk Vhdkdj.k]
4-
rhu ckj tk¡p] laLFkkxr izlo]
5-
chekfj;ksa ds ckjs esa LokLF; ds izfr tkx:drk
iSnk djuk fd xaHkhj chekfj;ksa ls cpko]
6-
MkWVl dk;ZØe esa tksM+uk] ifjokj fu;kstu ds
ckjs esa c<+kok nsuk]
7-
us= ls lEcfU/kr dk;ZØe ds ckjs esa leqnk; esa
tkx:drk iSnk djuk]
8-
Vhdkdj.k djokuk] xzkeh.k :jy gsYFk fe'ku
ds rgr LokLF; lfefr;ksa ds rgr LokLF; lfefr;ksa dk fuekZ.k djokuk ,oa mldk lapkyu
djokuk]
9-
tuuh lqj{kk ;kstuk ds ckjs essa tkuk x;k fd
izlo ds le; ,EcqysUl lsok miyC/k ;g ;sktuk lHkh leqnk;] tkfr] /keZ ds yksxks ds fy,
miyC/k gS]
10-
tuuh lqj{kk ;kstuk 'kq: gksus ls laLFkkxr
izlo esa dkQh gn rd lq/kkj gqvk gS vkSj f'k'kq ,oa ekr` e`R;q nj esa deh vkbZ gS ,oa izkRs lkgu
iqjLdkj Hkh fn;k tkrk gS]
,0,u0,e0 }kjk cPNko esa lsok;sa %&
4-
,0,u0,e0 }kjk xzke cPNk¡o esa lsok;sa nh tk jgh gS tks muls feyus ds ckn ekywe pyk fd
,0,u0,e0 dh D;k&D;k lsok;sa gSaA
tSls&
51-
xHkZorh dk iathdj.k]
2-
tk¡p 4 ckj]
3-
Vhdkdj.k]
4-
xHkkZoLFkk ds nkSjku iks"k.k]
5-
vk;ju dh xksyh;k¡]
6-
xHkkZoLFkk ds nkSjku [krjs ds y{k.k ds ckjs esas
tkx:drk iSnk djuk]
7-
xHkkZoLFkk ds nkSjku cpko]
8-
laLFkkxr izlo dks c<+kok nsuk]
9-
0&5 o"kZ ds cPpksa dk Vhdkdj.k]
10-
/kk=h efgykvksa dks tkx:drk iSnk djuk]
11-
fd'kksfj;ksa ds lkFk cSBd djuk fd'kksjkoLFkk
ds ckjs esa crkuk]
12-
izkbejh
Lrj
ij
LokLF;
lsokvksa
dks
tkx:drk iSnk djukA
13-
jsQjy lsok;saA
LokLF; dk;ZØe esa leqnk; dh Hkkxhnkjh %&
6-
cPNk¡o xk¡o esa leqnk; ds yksxksa dh LokLF; tkx:drk dk;ZØe esa Hkkxhnkjh cgqr de gksrh gSA
leqnk; ds yksx vk¡xuckM+h dh lsok;sa] ,0,u0,e0 dh lsok;sa vk'kk dh lsok;sa] Ldwy dk;ZØe
,oa Lo;a lsoh laLFkkvksa ds dk;ZØe esa Hkkxhnkjh ,oa leqnk; dh Hkkxhnkjh ugha gks ikrh gSA
efgyk LokLF; %& efgyk LokLF; ds ckjs esa
7-
,0,u0,e0 ,oa yksdy MkWDVjksa ls tkudkjh yh x;h rks leqnk; esas lcls T;knk 40 o"kZ ds ckn
efgykvksa ds LokLF; esa leL;k gksrh gS] tSls& lQsn ikuh tkuk] tksM+ksa esa nnZ] ,fufe;k]
dqiks"k.k dk f'kdkj gksuk bR;kfn
chekfj;ksa ls xzflr gSaA
Ldwy Vhpj ds lkFk ppkZ %& cPNk¡o xk¡o esa
7-
Ldwy dh tkudkjh yh xbZ rks dsoy ,d gh izkFkfed fo|ky; ,oa iw.kZ ek/;fed
fo|ky; gSA fo|ky; xk¡o ds chpks&chp esa fLFkr gf'k{kd }kjk ;g ekywe gqvk fd Ldwy
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RESEARCH REPORT
INTRODUCTION
Sanitation
“The control of all those factors in man’s environment which exercise or
may exercise a deleterious effect on his physical development, health and
survival” (“WHO expert committee Environmental Sanitation1963-1967”)
In Our Country India,Sanitation has been neglected for a long time. Due
to this high levels of sickness and death especially among infants and
children. More investment and attention is required in hygiene and
sanitation to Prevent the spread of excreta-related diseases such as
typhoid, cholera, diarrhoea and sdysentery.
Only 32% of rural households have their own toilets and that less than 50%
of Indian households have a toilet at home. There were more households
with a mobile phone than with a toilet.People are ready to invest money on
mobile phones & their entertainment but they don’t know the importance
of use of toilet & its construction in their houses.Most of civilians of our
nation are not aware about the disadvantages of not using toilets,because
of this reason many of children/infants suffer from chronic infections and
due to this its one of the prime reason for mortality of children & infants.
In fact, the last Census data reveals that the percentage of households
having access to television and telephones in rural India exceeds the
percentage of households with access to toilet facilities. Of the estimated
billion people in the world who defecate in the open, more than half reside
in India. Poor sanitation impairs the health leading to high rates of
malnutrition and productivity losses. India’s sanitation deficit leads to
losses worth roughly 6% of its gross domestic product (GDP) according to
World Bank estimates by raising the disease burden in the country.[1]
Open defecation
It is the practice of passing out excreta in open field and indiscriminately.
This excreta often finds its way into sources of drinking water and food and
may lead to disease.
A drop can kill: One gram of excreta can contain;
10,000,000 viruses
1,000,000 bacteria
1,000 parasites cysts 100 parasite eggs
Sanitation differentiate between men, women & infant mother
Women and men have different needs and customs when it comes to
sanitation. Men may be more comfortable than women relieving
themselves in public or open spaces. Women are burdened with a greater
share of family work like collecting and firewood, cooking, and cleaning.
They are usually responsible for taking care of children and their
sanitation needs as well. All of these affect their access to toilets that are
safe, clean, comfortable, and private. Addressing women’s needs often
challenges traditional ideas about how decisions are made.
Title of the study
“Sanitation practices and their cultural basics- and exploratory study in
bacchaw village.
Objectives
• To study existing sanitation practices in Bacchaw village.
• To understand the behaviour of man, woman and children (Under 5)
related to defecation especially on culturally determined practices.
• To understand the child fecal matter disposal method adopted by the
mother in the community.
Study
Study area
Bacchaw village of bacchaw Gram panchavat, Varanasi district , Utter
Pradesh.
METHODOLOGY
• Principal investigator trained female research assistant to ask
questions to the woman respondents.
Study design
• Cross sectional stuty design / Quantitative Data.
Data collection
• Schedule Questionnaire.
Sampling
• 5 Male
• 5 Female
• 5 Mother (Under 5 children)
ANALISYS
Community culture is defined as.Value attitudes, Behaviours, Beliefs, and
Assumption people share about themselves and other. And about the
natural world, in which they live, make up a community culture’.
(community culture and the environment A guide to under standing a
sense of place.)
The immediate problems faced by women because of lack of access to toilet
Most of my responders suffer due to lack of a toilet facility in secure
place, their gender identity (women) and family restrictions therefore
women fear to go open place women faced more problems while going open
place these follows.
Chances of to be unhealthy
Usually in this villages women go for toilet early morning and late evening
.In meantime if they get need for defecation, they can not go outside house
because of day hours & it leads to many kind of abnormalities & diseases
among themselves.and often it is quite dark in the village and they face
more problems of street dogs, snake bites, monkey bites, pig, bears, and
very often this animals usually move in the dark therefore women fear to
sit one particular place for defecation.
Teasing and harassment by young men
Usually in these villages when women go out for defecation, the youth
make comments and look at them in a manner that makes the women
uncomfortable. Sometimes the boys follow them and misbehave with them
and play vulgar songs, or click photos using their mobile phones.
“I was sitting one place for toilet some fellows came where I was seated;
they stood there, played vulgar songs and started to discuss bad issues
because they saw me. When I left that place they them self calling my
name indirectly so I feel shame to go open place”.
Avoid consuming Meals
Most of the responders are having health related problems because they do
not take sufficient food and drink enough water. It is affecting their health
especially at night because of lack of toilet they prefer not to take any food
and thus and some of responders complain of gastric and body pain but the
family do not consider its relation with to toilet. Sometimes the girls gets
their monthly period while they are out place and since lack of water they
have difficult to clean themselves properly and thus become infectious.
“One day suddenly I got stomach pain I told my family members, then we
consulted a doctor who said I have gastric problem because I am not
taking food
A big factor in making differences among family members
Most of the responder’s family are suspicious of them. Often for women
they look for lonely place for defecation and sometimes they need to go
longer way in order to keep their privacy. Sometimes it takes 15 to 20
minutes to come back and this questions people at home. Why late? Where
did you go and so on? Started to doubt them. And sometimes over suspicion
arise. When they explain to the family their need, they fail to understand
them. When requested to build toilet in order to avoid these problems the
answer is all these years it was the habit that people go to open defecation,
and why all of a sudden you demand of it. Sometimes this suspicion brings
women in to mental stress.
Domestic violence
In my interviews I found due to lack of toilet domestic violence takes place
for middle aged women. Normally it is difficult for them to find a deserted
place outside the village and thus often they come home late. Due to this
sometimes the husbands doubt them and unnecessary questions are being
asked and domestic violence also takes place... Some of my responders
faced this problem in families, misunderstandings take place and
sometimes they are beaten up as well. Once there is also a case of
separation because of this.
Relatives/Friends don’t prefers to stay
Problems faced by an adolescent who has lived in hostel, and friend had a
difficult time at home due to diarrhoeal episode but no access to toilet.
Guest decided not to visit her again.
2.1 Feeling of fear
The most of responders are going for open defecation. Due to lack of toilet
women have no privacy at all. And often it is quite dark; the presence of
animals scares them. Even fear of teasing and harassments. But in the
slums the toilets are far out and in the morning hours it is crowded and in
the evening it is dark and far, impossible to reach. Thus there is a constant
fear in these women when even thinking of toileting.
Women feels ashamed while defecation in open areas
One of our respondent, responded that during defecation if someone comes
around they are not allowed to stand at their place due to mythological
reasons.Due to this also many times women faces very uncomfortable
situations.While women going outside for open defecation they face more
problems and feels shame .Sometimes when it is dark one will not know
what is happening next to you. While defecating one is unable to stand
immediately because of shame or fear of others watching you. One cannot
also speak about these issues at home because one does not feel free to
speak of it. Teasing, taking photos, bad comments, suspicion are the
common reasons why a woman feels ashamed of open defecation. Specially
disabled persons depend on others, when they go with family members or
others they feel shame and they not feel comfortable to do toilet in front of
them. Such situation gives guilt feelings to that person
Thinking/Worried about next Morning
The study picked out most of them do not sleep well at night because often
they are worried of the open defecation, they face problems inside at family
and outside at the community, thus their suffering causes them reduced
sleep.
Low self Respect
Most of the respondents are burdened by due to lack of toilet, because
women cannot take decision without family person’s permission. In this
situation women get oppressed mentality and losing self confident in
herself and unconditionally accepting others decision, sometime she
confusing to think properly herself specially disabled they depended others
and nobody listen their views nobody encourage them in the family
therefore them self losing their self confident.
Development of suicidal thoughts
Most of responders are especially middle aged women and disabled peoples
facing psychological stress and depression. While going outside for open
defecation there is teasing, fear, no privacy, problems at family suspicion,
domestic violence, and cultural barriers. Because of this women get anxious
and having suicidal thoughts. Disabled face more difficulties, because of
their vulnerability. Most of my responders are truly anxious of their daily
activities; they feel shame to take others help even sometimes hesitate
them. They are neglected persons within the family, this problems push to
depression among the disabled; some of responders think to attempt
suicide, to get relief in this problem.
3. The determinants of poor access to toilets for women
Economic status
Financial problem is one of the main causes of access to toilet facility Most
of the villagers wage labours their economical status was not much
satisfied. in the responders families women and men daily wage labourers
in this context they not ready spend money to construct toilet they think
construction will require huge money so we not have enough money
therefore people not interesting to build toilet because of poverty. But most
of my responders discussed with their family’s majority responder views
were financial problem in this context. In urban community have public
pay toilet basically labours living in the slums from the morning to evening
they need to use 4 to 5 times toilet it will require more money for toilet
therefore people usually going for open defecation.
Cultural belief,Values,Behaviours,& Assumption system
Each community people have their own culture norms by birth they
maintaining individual norms and they have some kind of restrictions they
cannot go beyond that. Like in sanitation issue they believed toilet
construction out of the village because people believing that is bad human
urine& shit bad conception in the family usually people doing some pooja
,homa . Inside the home and village Therefore people do not giving
importance to construct toilet
, Patriarchal family system
Patriarchal family system which neglects the gender sensitive needs of the
women seems to be an important reason behind the lack of toilet in this
community. In the interviews most of respondents shared that in their
families commonly men were decision makers and the women uncritically
accept the decisions made by the men. Since, open defecation is a gender
specific issue that affect women due to their biological vulnerabilities and
stereotyped concept of gender in the community, men in the family are not
aware of the necessity of constructing toilet.
No of respondents
• 5 male
• 5 female
• 5 Mother(under 5 children)
DISCUSSION
Women faced teasing/harassment, a patriarchal system, absence of privacy,
poverty, cultural traditions, and problems at menstrual periods, suspicion
at home, and humiliation in public which are causing major impact on
women’s psychological problems. They are so deep that the women are
unable to share about them; as a result they suffer in silence from
psychological stress. The findings on the immediate problems faced by the
women due to lack of access to toilets is similar to that reported by earlier
studies.
The lack of access to toilets in turn leads to fear, reduced sleep, reduced
intake of food, lower self confidence, distress, confused state of mind and
constant worry about the future. The feelings of being worthless and
suicidal tendencies are also pointed out. From which we can conclude that
inaccessibility to toilets is an important determinant of mental health.
It was also ascertained that lack of access to toilets for women was related
to socio-economic status, cultural belief systems and patriarchal nature of
decision making. Of these, the latter two may be more important, as
currently there are programmer’s available for funding the construction of
toilets. There may be a need to empower the communities to adopt toilets
by challenging long held beliefs and also with information on the benefits of
using toilets. It is important to involve both men and women in this
exercise.
Strengths
• The researcher has chosen a quantitative study design because to
understand the issue there is a need to conduct in-depth interviews
and direct observations which are categorised under quantitative
research and would be helpful to understand problem scenario.
• Researcher divided samples of three age groups (Men,Women,Infants
Mother) which helped to identify the range of problems faced by
women from various backgrounds.
• Researcher interviewed most of women who lacked toilet either at
home or nearby to know problems affected at present scenario.
Weakness
• Absence of men interaction.
• Absence of interaction with local self government.
Recommendations
• Conduct behavioural change training programme for young men to
come the bad assumption about women, and for peoples to come out
the cultural (blind belief) system in toilet issue.
• Conduct sanitation awareness and training programmes for both men
and women to the problems by due to lack of toilet.
• The study brought out poor economic status one of the major reason to
construct toilet therefore if introduce appropriate technology method
for constructing toilet it will reduce this problem in rural area.
• In rural area people not much aware about importance of sanitation
and very only few organizations working this issue therefore to
promote sanitation workers (CBOs, NGOs) to focus this issue and
reduce the problem.
Knowledge Translation
• For local community?
Through the hand books (local language) street play, aware them and
conduct awareness programme regarding problems by due to lack of
toilet among women, promote them to solve their problems themselves
in rural areas.
• For community health workers and professionals?
Through the research publication (internet media) to aware the
women problems, current situation, problems of access to toilet facility
and identify the alternative solutions for this problems.
• For policy makers?
To conduct Presentations, Seminars and discussions, visual
documentary shows regarding women problems by due to lack of toilet
in rural areas and strengthen the current programmes on better way.
Conclusion
Sanitation is a neglected issue at the present situation in the nation
especially in rural areas where peoples faced more problems by lack of
toilet. Most of them are using open place for defecation, men & women
urinate and defecate in open place while women faced moral problems in
toilet issue, because of their gender identity. In many rural areas people
are practicing open defecation while women critically accept that situation
and face more problems. Going for open defecation is a problem affecting
the psychological conditions of women
.
Reference
• The great Indian sanitation crisis live mint and the wall street journal
http://www./livemint.com/opinion/zoKIf2URgrGT22qH6 or o/the indian-sanitation-crisis.html
• UN-HABITAT ASIA- Asia pacific ministerial conference on housing
and human settlements.(13-16th December 2006 new Delhi )
• India sanitation portal/absence of toilet expose rural women dangers.
(http://indiasanitationportal.org/18749)
• Sanitation: the hidden gender problem – absence of proper sanitation
is affecting women lives
(http://indiatogether.orgwomen/health/sanitation0702htm/
• (Defending the health of marginalized, chc1984-2009)Bangalore.
• Community health and sanitation awareness – 2013 SOCHARA
Bangalore.
• Lack of water and sanitation hurts women and girls themost,-
feb042013bylisaschechman.
(http://www.trust.org/item/20131004120551-omt32/)
AFTER
TAP TURNED MODULE
Community Health Learning Programme is the third phase of
the Community Health Fellowship Scheme (2012-2015)
(2012 2015) and is
supported by the Sir Ratan Tata Trust, Mumbai.
School of Public Health, Equity and Action (SOPHEA)
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Block, Koramangala,
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