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SCHOOL OF NURSING AND MIDWIFERY.

DEPARTMENT OF GENERAL NURSING PERSONAL HYGIENE AND ENVIRONMENTAL HEALTH.

Hygiene: Generally refers to the set of practices associated with the preservation of health and healthy living.

• Hygiene; The degree to which people keep themselves or their environment clean, especially to remain healthy and prevent diseases. • This therefore means that hygiene is a question of creating the physical conditions and personal practices to stay healthy 5 Definitions cont’d • The term cleanliness should not be used in place of hygiene. • Cleaning in many cases is removing dirt, wastes or unwanted things from the surface of objects using detergents and necessary equipment. • Hygiene practice focuses on the prevention of diseases through the use of cleaning as one of several inputs. 6 Definitions cont’d • The first definition of health: •In 1948, the world health organization (WHO) defined health as “a state of complete physical, mental and social wellbeing of an individual and not merely the absence of disease or infirmity”. 7 Definitions cont’d • Second definition of health: •They defined health as a “dynamic state, in which the individual adapts to changes in internal and external environments to maintain a state of wellbeing”. Potter and Perry (2014): 8 Concept of Health • An understanding of health is the basis of all the health care. • The perception of health vary greatly among the members of a community including various professional groups like biomedical scientists, social scientists, ecologists • This has given rise to confusion about the concept of health. 9 Concept Of Health • An understanding of health is the basis of all the health care. • Concept of health is perceived differently among people in the same community and among various professions like biomedical scientists, social scientists, health administrators, ecologists etc. • Giving rise to confusion about the concept of health. 10 Concept Of Health cont’d • To some health may mean absence of disease or infirmity and to others it may mean sound body and sound mind and sound function of the body. • Initially, the focused was on the body's ability to function normally which could be disrupted from time to time by disease. • Later, health was seen as a well-being as in ‘physical, mental, and social well-being, and not merely the absence of disease and infirmity’. 11 Concept of Health cont’d • Health has evolved over the time, from the concept of individual concern to a worldwide social goal. • The various changing concepts of health are as follows: 1. Biomedical concept 2. Ecological concept 3. Psychosocial concept 4. Holistic concept Changing concepts of health • Biomedical Concept • Health was viewed as an “absence of disease”, and if one was free from disease the person was considered healthy. • This concept is known as biomedical concept, and it is based on the “germ theory of the disease.” • Health means “absence of disease.” Biomedical Concept cont’d • The medical profession viewed the human body as a machine and disease is an outcome of the breakdown of the machine, and one of the doctor’s responsibility was to repair the machine. • This concept has minimized the role of the environment, social and cultural determinants of health. • Developments in medical and social sciences led to the conclusion that the biomedical concept of health was inadequate, which gave rise to other concepts. Ecological Concept • Ecological Concept (Health implies the relative absence of pain and discomfort and a continuous adaptation and adjustment to the environment to ensure optimal function). • Ecologists viewed health as a dynamic equilibrium between man and his environment, and the disease as a maladjustment of the human organism to environment. Psychosocial Concept • Advance in social sciences showed that health is not only a biomedical phenomenon, but one which is influenced by social, psychological, cultural, economic and political factors of the people concerned. • These factors must be taken into consideration in defining and measuring health. • Thus health is both a biological and social phenomenon Holistic Concept • This concept is the combination of all three where health is seen as a sound mind in a sound body, in a sound family, in a sound environment, all sectors of society have an effect on health. • The concept is described as a multidimensional process involving the wellbeing of a person as a whole. • This concept recognizes the strength of social, economic, political and environmental influences on health. Dimensions of Health 18 Dimensions of Health • Health is multidimensional, WHO definition envisages three (3) specific dimensions, however there are many more dimensions; 1. Physical 2. Social 3. Mental/Intellectual 4. Spiritual 5. Emotional 6. Etc. Physical Health • Physical health is the perfect functioning of the body. • It means the body structures are perfectly functioning within the normal range • Having a recommended anthropometric measurements (body weight, height, blood pressure, respiratory rate etc.) • The individual is able to perform activities of daily living (ADLs) such as eating, movement, maintaining personal hygiene while avoiding activities that will hinder good health such as drugs, alcohol, disease and sickness etc. Social Health • It implies the quality of relationships and the ability of a person to adjust with others in his/her social life, with family, friends, colleagues, neighbors, co workers and others in contact with. • Is about social networking, social groups, the individual is a part of a family and a wider community and focuses on social and economic conditions. • Having good social standards (good behavior, community involvement) Mental /intellectual health • Is ones ability to recognize reality and cope with the demands of daily life. • The individual should have a balance between reality and the surrounding world or environment. • A sense of harmony and coexistence between self others, and the environment. • Mental health is focus on these three; cognition, perception, and behavior. Mental /intellectual health cont’d • It also determines how an individual handles stress, interpersonal relationships, and decision making • A mentally healthy person may should be Well adjusted not at war with self and others, accepts criticism (thinks positive). • Has good self control, balances rationality and emotionality and has normal development and contributes productive to society and nation. Spiritual Health • Spiritual health includes the individual faith and beliefs • They strives for meaning and purpose in life by having spiritual direction. • It includes: integrity, ethics and values, purpose in life, commitment to some higher being etc. • Also, a belief in concepts that can not be scientifically proven. • Others, create their purpose in life. • A person who have purpose in life is said to be healthier than hose without purpose. Emotional Health • Emotional health refers to “Feeling”. • It refers to expressing one’s emotions in a positive and non-destructive way. • Emotional (Initially mental and emotional dimensions were seen as the same but research have shown the difference is emerging. • Mental health can be seen as “Knowing” or “Cognition”, while Emotional health refers to “Feeling”. The relationship between these dimensions of Health • There is an interrelationship between these dimensions of health • Physical health can affect the other dimensions of health as a decline in physical health can result in a decline in other forms of health. E.g. a person who suffer Covid-19 is often isolated socially in order not to infect others. • Mental health can also affect the other dimensions of health. Good mental health can lead to an increase in self-esteem and social acceptance. 26 The relationship between the dimensions cont’d • Spiritual health can affect emotional and mental health as having a purpose in life can help one to achieving goals. • Social health can affect the other dimensions of health. A bad social life can lead to a person to question their purpose in life or feel isolated and unwanted. Such feelings can demotivate a person from physical activity which can further leads to depression 27 The relationship between the dimensions cont’d • There are several factors combine together to affect the health of individuals and communities. • Whether people are healthy or not, is determined by their circumstances and environment. • To a large extent, factors such as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family all have considerable impacts on health, whereas the more commonly considered factors such as access and use of health care services often have less of an impact (WHO, 2017). 28 Determinants of health  The determinants of health may be biological, behavioral, sociocultural, economic, and ecological.  Broadly, the determinants of health can be divided into four core categories:  Nutrition,  Lifestyle,  Environment,  Genetics,  These are like four pillars of the foundation. 29 Determinants of health  When any one of the pillars of health determinants becomes weak, a support system is needed.  This is considered the fifth determinant of health and involves medical care 30 Determinants of health 31 Determinants of health • Genes: • Gene is a unit of heredity which is transferred from a parent to offspring and is held to determine some characteristic of the offspring. • Our genes are one of the biggest factors in deciding the way in which our health get deranged. • Children inherit the physical and mental makeup from their parents. • They also inherits the tendencies and susceptibilities to acquire diseases like obesity, hypertension, peptic ulcer • With the help of powerful technology and screening methods, many disorders of genetic origin can be prevented. 32 Determinants of health • Nutrition: • This has individual, family, and community dimensions. • The rural/urban regions have remarkably different challenges related to nutrition. • Generally, at one end of the spectrum, in urban spheres, there is less physical activity, calorie overload, but poor nutrition mainly due to junk food consumption 33 Determinants of health  Lifestyles and social factors:  Today, lifestyle is another biggest factor accounting for the failing health of people around the world.  Increasing sedentary habits, long working hours, increased anxiety and tension related to education, career, job etc are some of the factors that are responsible for decreasing health status  There is a growing consensus that lifestyle modifications should be the foundation of any health care system. 34 Determinants of health  Environmental factors:  In general, urban communities face problems related to environmental degradation, and air and water pollution; rural communities face problems related to sanitation, hygiene, insecticides, pesticides, and agrochemicals.  Thus, the poor are most likely to suffer because of the interplay of the deranged determinants of health.  There is an increased in pollution of water, air and land and these also increases the level of many diseases 35 Determinants of health Health services: Availability, accessibility, affordability and acceptability of health services are considered an important determinant /input to health. Medications and other pharmacological products may be very useful in the restoration and protection of health. However, drugs may pose a significant threat today due to misuse 36 Determinants of health In the interconnected, borderless world, determinants of health cannot be considered in isolation. They will always be interdependent. The substantial health inequity in different parts of the world is today’s reality. This inequality of health is due to inequalities in income, education, gender, and availability of resources. 37 Reading assignment  Read on;  Natural History of Disease 38 Promotion of health Health promotion • Health promotion was defined in the Ottawa Charter in 1986 as “the process of enabling people to increase control over, and to improve, their health’’ (Ottawa Charter,1986) • In order to reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and understand their health needs, ways to address those needs, and to change or cope with the environment. Health promotion cont’d • Health is seen as a resource for everyday life, not the objective of living. • Health is a positive concept emphasizing on social, personal resources and physical capacities. • The interventions are designed to benefit and protect the health of individuals and ensure quality of life by focusing on preventive measures and not focusing on treatment and cure. Health promotion cont’d • Health promotion is a responsibility of all, the individual (self-care), community, nation and global. • According to WHO ‘health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being’ (WHO 1986). The goal Health promotion • The goal of health promotion is to combine the approach for addressing the social determinants with the resolution and commitment to motivate and encourage the individuals and the community for their active approach toward health and embracing healthy lifestyles. The Aim of health promotion • Health promotion program/interventions aim to engage and empower individuals and communities to choose healthy behaviours, minimizing risk behaviours, workplace health and safety, healthy environment creating supportive environments and networks for people as well as providing access to health care etc. • It seeks to change the social determinants of health (or empower the individual to change the determinant), the socioeconomic, sociocultural, environmental and individual determinants to help and enable the individuals to improve their own health. Responsibilities of individuals in health promotion • Individuals have various roles at different levels of responsibility for health promotion. • At the most basic level individuals have the responsibility to promote their own health. This means that; I. Having knowledge about health, particularly the risky and healthy behaviours. II. Individuals should make choices that promote their own health. Responsibilities of individuals in health promotion III. Individual is responsible to promote health to those around them. This includes promoting health at family, work place, school, among peers, and the community at large. IV. Also, some individuals such as health personnel, opinion leaders, political leaders etc. have the responsibilities to educate and help promote health, Responsibilities of the Community in Health Promotion Responsibilities of the community in health promotion • Health promotion has moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions. • Health promotion helps individual, communities and governments, to cope with and address health challenges. • This is accomplished by planning and developing healthy public policies, creating supportive environments, and strengthening community action and personal skills. Responsibilities of the community in health promotion • Community is a group of people living in the same place or having a particular characteristic in common • Any community-based action that seeks to promote health and wellbeing is deemed as the contribution of the community to health promotion. Responsibilities of the community in health promotion • Community participation is the active involvement of the people concerned in planning, decision making, analysis, and implementation of programmes that the people will have a greater control over their health and wellbeing. • Community participation is the basis of successful health promotion. Responsibilities of the community in health promotion • Communities can contribute to health promotion through the following ways; 1. Collaboration 2. Advocacy 3. Support 4. Self Help Initiatives 5. Community participation Importance of health promotion 1. It improves the health status of individuals, families, communities, and the nation. 2. It enhances the quality of life for all persons. 3. It reduces morbidity and mortality rate 4. With a focus on prevention, health promotion reduces the costs (both financial and human) that individuals, employers, families, insurance companies, medical facilities, communities, the state and the nation would have spend on medical treatment •