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Swasthya Vidya Vahini

Department of Health Medical & Family

A Health Education initiative of Government of Andhra Pradesh

Additional material for the students participating in Swasthya

Vidya Vahini in addition to the SVV booklet.

The initiative led by the department of Health Medical & Family Welfare, implemented
at the field by students of Medical, Ayush, Dental, Nursing and Home science colleges
with support from the field staff of the HM&FW, WCD&SC and Panchayat Raj

The students are provided with checklists for all the activities they take up in the field.
However, this being the first time ever for most of the students to visit a village, not
only interact with strangers but also to tell them about the determinants of health.

This guide is to enable them to be a little more knowledgeable to deal with the
questions that might be asked in the field. The relevance of each of these questions
is explained so that they can feel confident in asking or in framing the questions.
Student & Field visit details
The student and field visit table is to know the details of the village that the children
have visited as their observations will be shared with the concerned departments if
there is need for any intervention to be taken up. This is also required for the student
when they are submitting their project report at the end of the year.
Transect walk checklist
1. Availability of Transport facility: Transport facility may be available for most
of the main villages of the Gram Panchayat (GP) but might not be available for
the hamlets under the GP. Availability of transport either for medical reasons or
for the children to go to schools, if a school is not available in the village is a
measure of meeting the minimum need of the population.

2. Electrification of the village: Non-availability of electric supply will affect many

other necessities of the village; pumping of drinking water from the Panchayat,
availability of street lights and lights in the homes of people. Usage of lamps
with kerosene will lead to indoor air pollution.

3. Terrain of the village: Different kinds of terrain are associated with varied kind
of health, nutrition, education & livelihood issues, hence the relevance of the

4. Educational Institutions in the village: Education being one of the key

determinant of health, the accessibility to education is the first step one needs
to consider.

5. Type of Housing: The type of majority of the houses indicates the economic
status of the village and has an impact on health. Economy is a major factor in
determining the kind of nutrition the villagers can afford to consume. This will
also help in counselling for nutritive diets.

6. Major occupations in the village: This will once again give an insight to the
socioeconomic status and the education levels of the population. This will also
determine the kind of health conditions that the villagers are prone for.

7. Available Health services: This Measures the accessibility to health services.

Not all the villages have sub-centres, but the accessibility of the primary care
should be within half an hour’s reach to all the villages.

8. Availability of Anganwadi centre: Anganwadi centres provide early learning

for children under six years of age, provide nutrition to specified population
groups and are the outreach locations for delivery of primary health services.

9. Availability of Banks in the village: Presence of a Banking facility in the
village indicates an active economy status of the village.

10. Availability of Post office in the village: Indicates that the villagers are aware
of availing Govt. communication systems before the advent of personal
telephones into the market.

11. Any Mosquito breeding sites: Presence of mosquito breeding sites indicates
two things; one is that the Gram Panchayat is not taking up any preventive
activities for mosquito breeding and the other is that the people are not aware
of the diseases that can occur due mosquito bites and that there might be cases
of Malaria / Chikungunya / Dengue / Filarial disease / Japanese Encephalitis
reported from the village.

12. Sources of drinking water facility: Based on the available drinking water
sources, the counselling for WASH will vary. Lakes and rivers as sources will
have more environmental pollutants, if not treated well this water may cause

13. Is there any factory near the village: A factory close to the village will have
some positive effect on the economy of the villagers but the waste that is
released from the factory, is it a threat to the environment, soil, water or air?

14. Greenery around the houses & along the roads in village: Greenery around
the houses and in the village, reduces the heat, improves the air quality in the

15. Open defecation Sites present: Open defecation sites are a threat to public
health as diseases are spread from these sites through flies. Presence of such
sites indicates that not all the houses in the village have ISLs or if they have,
they are not using them.

16. Percentage of villagers using Indoor Sanitary Latrines: This is a general
question which the ASHA can tell. Find the reason for not using the ISL, if

17. Garbage dumps around houses: if there are garbage dumps around the
houses, this indicates that solid waste management is not in place in the village.
Usual practice is to collect the garbage through rickshaws etc. and dump it in a
dump yard.

18. Any Mines in the villages: Any mining activity in the village surroundings will
have temporary settlements of populations with the associated vulnerabilities.
The environmental pollution of mining activity will lead to chronic lung diseases.

19. Disposal of waste: The collected garbage from all the houses of the village
should be either dumped in a dump yard or a manure pit. The garbage cannot
be dumped in Manure pits if the use of plastic is high in the village.

20. Condition of Roads: The interior roads in the village can be by Cement &
Concrete, Gravel, Tar or a kutcha road. The maintenance roads in the village
is the responsibility of Gram Panchayat.

21. Keeping peri-domestic animals (cows/buffaloes) inside the houses: This

is more commonly noticed in the villages of Rayalseema districts, some may
have the animals within the same compound as the residence in other places
also. This will also create mosquito breeding sites.

22. Any play grounds / Vyayamshalas in the village? Presence of such places
indicates that the Gram Panchayat is interested in improving the health of the
villagers and the community is physically active.

23. Occurrence of any disease outbreaks/ disaster in the village in the past 1
year: It is important to note this because the conditions that have led to the
occurrence of such conditions will repeat unless the underlying conditions are
24. Is it a known hot spot for any disease: This information is also important in
the sense that if time and again the same health conditions are recurring, the
underlying factors responsible for such an occurrence must be identified and a
permanent solution is to be arrived at.

Brief notes on the Thematic areas of Swasthya Vidya Vahini

1. Water And Sanitation Hygiene (WASH):

a. WASH is access to improved water sources and basic sanitation
b. The relevance of WASH is to prevent the related diseases as the health
of village community depends upon a clean environment and safe
drinking water.
c. Water from improved source is piped water, tap/pumped water, covered
wells. Water is safe only after treatment. Water from rivers, lakes,
shallow wells is unsafe (as this is contaminated with pollutants).
d. Water contamination can occur at the following situations:
i. At source: water sources with unclean surroundings
ii. While collecting water: unclean containers
iii. Improper or no Treatment of water
iv. Improper storage
e. Safe storage at the household level is as follows:
i. In narrow mouthed containers (kooja)
ii. Covered with lids
iii. By using a scoop / cup if the container is wide mouthed (kunda)
iv. Should not let the hands/ fingers touch the water or inner side of
f. Basic Sanitation is access to facilities for safe disposal of human excreta
(faeces & urine)
g. Hygienic activities include:
i. Garbage collection,
ii. Solid waste management (including industrial) and
iii. Waste water treatment and disposal.
2. Environmental Hygiene

Environment is living things and what is around them, which may include other living
beings, non-living things, physical, chemicals and other natural forces. Environmental
hygiene is a group of activities that aim to protect people from the dangerous
conditions arising from unhealthy environments like unsanitary water supplies, waste
disposal systems, Open defecation sites, food sources and housing structures.

Environmental Hygiene is important because unclean environment can cause:

a. diarrheal diseases from

i. unsafe drinking water or
ii. spreading through flies from Open Defecation Areas or garbage
b. Malaria and Dengue spreading through mosquitoes from
i. Breeding sites in unclean surroundings/ garbage dumps &
stagnant water pools.
c. Stunting (inadequate height and weight) due to frequent diarrhoeas
causing malabsorption.

3. Communicable diseases
Communicable diseases are those that spread from one person to another through
various means and many people in the state are suffering or dying due to
communicable diseases. Communicable diseases spread through different modes:

a. By contact with contaminated object / surface / food / water / blood &

body fluids
b. By contact an infected person through touch / fecal-oral transmission /
droplets / sexual intercourse
c. Through vectors like mosquitoes, fleas etc.
d. Air borne infections like TB

4. Personal Hygiene:
Personal hygiene describes practices that are required for maintaining cleanliness of
the body and preserving health. Personal hygiene practices not only keep a person
healthy but also improve the self-esteem and confidence. Following are some of the
personal hygiene practices:

a. Brushing the teeth immediately after waking and before going to bed
b. Washing the hands with soap after going to the toilet.
c. Washing hands before preparing and eating food
d. Bathing at least once every day with soap. Washing the hair with
shampoo/soap at least once a week.
e. Comb the hair every day.
f. Changing in to clean clothes, dirty clothes should be washed with
detergent soap before wearing them again.
g. Clothes should be dried in the sun to kill the germs
h. Turning away from other people while coughing or sneezing and
covering the mouth & nose with a handkerchief / tissue to prevent spread
of respiratory infections. If the mouth and nose are covered with hand
the hand should be washed with soap and water.
i. Clip the nails of both hands and scrub under the nails every time hands
are washed to prevent spread of infections.
j. Use sanitary napkins during menstruation.
k. Use foot wear to walk outside the house to prevent hook worm

5. Anaemia

Anaemia is a condition that develops when the blood lacks enough Red Blood Cells
(RBC) or Haemoglobin. Haemoglobin is that component of the RBC that binds oxygen.
Anaemia is very common (60-70%) across all age groups in A.P. especially among
women, children and aged populations.

Most common causes for anaemia are:

a. Nutritional or Inadequate dietary factors
b. Blood loss either due to menstruation or other causes
c. Worm infestations (that can be prevented by personal hygiene
d. Chronic disease
b. Anaemia can be suspected
a. when one is feeling tired very easily, has pallor
b. Confirmed by estimation of hemoglobin in the sub-centre / PHC
c. Anaemia can be prevented by
a. Healthy diet with
i. Foods containing Iron: lentils, beans, dark green leafy vegetables,
meat, liver and dry fruits
ii. Foods containing B12 and Folic acid: eggs, dairy products
bananas, spinach
iii. Foods containing Vit. C for better absorption of Iron: Fresh fruits
and vegetables

6. Reproductive & Child Health

Reproductive and child health is a programme launched by Government of India in

1997 to achieve a status in which women will be able to regulate their fertility, go
through their pregnancy and child birth safely leading to an outcome of survival and
wellbeing of the mother and the child. The objectives of the program were to reduce
total fertility rate, infant mortality rate and maternal mortality ratios.

The importance of the programme is that in A.P

a. Many pregnant women are still losing their lives due to pregnancy related
causes and many children are dying before attaining one year of age.
b. Many women suffer from reproductive tract infections and only a small
percentage seek treatment.
c. Adolescent girls with menstrual issues do not seek medical advice.

7. Nutrition

Nutrition refers to provision of adequate quantity and quality of food to suit body’s
requirements which is different at different stages of life. It is the science that interprets
the interaction of nutrients and other substances in food in relation to maintenance,
growth, reproduction, health and disease of an organism. It includes food intake,
absorption, assimilation, biosynthesis, catabolism and excretion.
Consuming adequate healthy food is required for people / children to stay health and
prevents one from falling sick. Some important factors for nutrition are
a. Nutritional requirements change at different age groups
b. Colostrum is the first nutrition of a new born and has the following
i. It is the first form of milk produced by the mother during late
pregnancy and early postnatal period.
ii. It is rich in protein and has growth factors which helps the
development of the intestines and antimicrobial factors provide
immunity to the new born.
iii. The baby should be breast fed within the first hour of birth
c. Babies should be fed on Breast milk exclusively for six months after
which complementary feeds should be started
d. Most commonly given complementary feeds to babies from six months
onwards are:
i. Homemade baby foods: uggu, ragi etc
ii. Market foods: Baby cereals
e. After one year of age the baby should be taking the food that is prepared
in the house.
i. Balanced diet should be followed for all children and adults in
the house which is defined as a diet which adequately provides
all the nutrients that are required for a person to function
f. the components of balanced diet are:
i. Whole cereals (suggest addition of ragi in the diet for its high
calcium content)
ii. Pulses/ beans/ meats/fish
iii. Vegetables: Green leafy and others & fruits
iv. Dairy products: curds, milk etc.
g. Unhealthy eating habits and Lack of exercise will cause Obesity which
leads to hormonal imbalances in childhood and is a risk factor for
Diabetes and Hypertension in adulthood.

8. Physical Literacy

Physical literacy can be described as the motivation, confidence, physical

competence, knowledge and understanding to value and take responsibility for
engagement in physical activities as defined by International Physical Literacy
Physical literacy is important because:

a. It would lead to adoption of active and healthy life styles during the
b. Develops the confidence and competency in wide activities and
environments and aid to holistic (physical, attitudinal and social)
development of children.
c. In Adults:
i. reduces osteoporosis
ii. reduces premature deaths due to cardiovascular risk factors like
obesity, Hypertension, Type II diabetes mellitus
d. The options available for children and adults which include fundamental
abilities to run, throw, jump, hop, strike and balance in the village are:
i. All kinds of Sports, Games & Yoga in schools
ii. Fine arts like dancing
iii. Martial arts

9. Non-Communicable diseases

Non-communicable diseases are chronic conditions that do not result from an

infectious process and do not spread from person to person. They are also called as
life style diseases, develop and progress over long periods. The prevalence of Non-
Communicable diseases especially Diabetes, Hypertension and Obesity are
increasing in the State. Following are the some of the commonly reported NCDs:

a. Cardiovascular diseases (Diabetes, Hypertension)

b. Cancer
c. Chronic lung disease
d. Arthritis / Musculoskeletal disorders
e. Chronic neurological diseases
2. The cause for these NCDs are:
a. Life style related – reduced physical activity
b. Tobacco use
c. Alcohol use
d. Unhealthy diet
e. Heredity

10. Substance Abuse:

Substance abuse refers to the harmful or hazardous use of psychoactive substances,

including alcohol and illicit drugs (WHO). Talking about it is important because the use
of the licit (alcohol, tobacco) and illicit (cannabis, opioids etc) substances is increasing
rapidly across the State and the Country.
a. The risk factors that may lead to substance abuse among the
children/ youth are:
i. Chaotic home environment
ii. Lack of significant relationship with a caring adult
iii. Parents / care givers who abuses substances
iv. Peer pressure in schools & colleges
b. The consequences of substance abuse are
i. Problems at school, work place & home
ii. Problems with interpersonal relationships leading to broken
iii. Violent behaviours
iv. Poverty
c. Measures that can be taken up at home to stop the growing
prevalence of substance abuse are:
i. Discouraging impulsive and aggressive behaviours in
ii. Protective and nurturing home environment
iii. Parental involvement in child’s life, keeping the
communication open always at all ages
iv. Measures that can be taken up by the community do to
prevent substance abuse are:
1. to Identify the existing problem families, and
2. provide social support and counselling services