PRACTICAL 9 IDENTIFICATION OF

SPECIFIC NATIONAL
HEALTH PROBLEMS
Structure
9.0 Objectives
9.1 Introduction
9.2 Purposes of Identification of Specific Health Problems
9.3 Tools and Resources
9.4 Points to Remember
9.5 Procedure
9.6 Let Us Sum Up.

9.0 OBJECTIVES
After going through this practical, you should be able to:
identify the specific National Health Problems;
identify the specific National Health Programmes in operation;
a explain the need for these Health Programmes;
a list the various equipments and resources required to identify the specific
health problems; and
follow the steps in identification of specific health programmes at various
levels of health care systems.

9.1 INTRODUCTION
As you are aware by now that the major health problems faced by India are
communicable diseases, nutritional problems, environmental sanitation problems,
medical care problems and population explosion. A large number of health
programmes have been launched by the Government of India to prevent, control or
eradicate these problems and improve the health status of the people. The Govt. of
India has planed these programmes with the assistance of state governments.
These programmes have been implemented at different levels of health care
through existing infrastructure e.g. State, District, BlockIPHC and Sub-centers.
The assistance has been provided by the Central Government to the states to
implement these programmes effectively. As a community health nurse you need to
identify the specific national health problems in your community and take
appropriate action for prevention, control and treatment.
You have to identify various health problems for:
Early detection of patients suffering from communicable diseases and other
problems.
Treat them, make referrals, if required, prevent complications and also ensure
that the health programmes are implemented.
In this practical you will learn about purposes, tools and procedure for identification
'
of specific National Health Problems.
For detailed study of the National Health Problems and Programmes refer
TI-TCI 4 - r \ n l r rr
Nursing Practices in
Community Health-I1 9.2 PURPOSES OF IDENTIFICATION OF
SPECIFIC HEALTH PROBLEMS
The purposes of identification are to:
Early detection of patients suffering from communicable diseas and treat them
effectively nearest to their homes.
Provide prophylactic treatment to prevent diseases among mothers and
children e.g. Folic acid tablets to prevent anaemia and Vit. A Suspension
against blindness.
Provide protection against diseases to mother and children through
immunizations e.g. TT,BCG
Help in improving the environmental sanitation and provision of safe water
supply to improve the health of the people.
Provide awareness among people about the causation of diseases,
transmission, prevention and treatment by means of health education.
Participation in implementation of the National Health programmes at different
levels of health care, e.g. Central, State, Block and Village, as health is closely
related to economic development of the country.
Reduce the morbidity and mortality among people due to various diseases and
raise their living status.
Make the health care services comprehensive and cost-effective through the
existing health insdtutions.
Provide preventive services, which are more economic for everyone
concerned - individuals, families, communities and the nation.

9.3 TOOLS AND RESOURCES

- - - - - - - -

The tools and resources to identify different health problems are:

- Proforma - printed checklist, questionnaire, growth chart, immunization
schedule card.
- Clinic records

- Family folders, Insert cards

- CHN - records and diaries
- Weighing Machine - Baby and adult
- B.P. apparatus and thermometer - (MCH and fever cases)
Measuring tape
- Lab facilities for;

Montoux Testing, Hb, ESR, Sputum testing and manpower and machine
for X- ray chest (for tuberculosis)
- Microscope - stains - swabs, etc. for (STD etc.)
- Sterile blades for skin scrapings (Leprosy)
- Slides, disposable needles and syringes (Malaria and Filaria) Identification of Specific
National Health Problems
- Cold chain equipment, disposable needles and syringes for immunization
- Water testing equipments (water and sanitation)
- Materials for safe transport of specimens
- Stationery; referral forms, reporting forms

- Drugs for specific programmes

POINTS TO REMEMBER
Use reliable sources of information on identification of specific health
problems.
Prepare yourself for identification by having propei knowledge of disease
conditions.
Take permission from health agencieslauthoritiesfor identification of cases
through surveys, interviews or observations.
Prepare proper records and notify the authorities e.g. case registration.
Educate the people about the existence of these programmes, their importance
and need.
Follow up the identified cases for treatment and nursing management.
Evaluate the effectiveness of the specific health programmes in operation.

9.5 PROCEDURE
The procedure adopted for identification of specific national health problems and
programmes is as follows:

i) Identify the health problems existing in the community and at National level:
The common health problems in the community and at the national level are
malaria, filaria, Tuberculosis, leprosy, ARI, Diarrhoea and nutritional problems,
etc. These problems can be identified by using the following sources:
Records and reports from:
- Clinics
- Family folders
- Insert cards, OPD cards, School health records
Observations:
- Patients attending clinics

- Home visits
Health Personnels in the agency:
- Doctors
- Health assisstants
- Lady Health Visitors
- CHN
- M.P.W.
Nursing Practices in From house to house surveys
Community Health-I1
Reports from community leaders
Members of health committee

Women's club

ii) Identify the health facilities available in dealing with these problems:
For example if we have to identify tuberculosis as a health problem existing in
the community, so you have to c o n f m whether facilities for the following
investigations are available:
Sputum testing for AFB (Acid fast bacullus)
Estimation of HB, ESR
hantoux Test
X-Ray chest

The above services can be availed from:

Primary health centers
Community health centers
District tuberculosis centers
District hospitals
Specialized hospitals
Direct observation treatment (DOT) centers

iii) Identify the services available at different health agencies:

Case finding
Diagnostic

Treatment
Health education
Domiciliary services
Follow up services
Referral services
Indoor facilities

iv) Identify the organizations providing these services:

Primary Health centers
Community Health centers
District T.B. centers (Hospitals)
D.0.T centers
Government Hospitals
Voluntary organisations
 Training and organisation centers Identification of Specific
National Health Problems
Private practioners

v) . Identify the health personnel involved in providing these services:

Doctors in Hospitals
T.B. officers and organizer from T.B. clinics

L.H.V. and CHN - PHC

M.P.W. - sub centers

Lab Technicians

X- Ray Technicians

Statistician

Nursing staff in Hospitals

vi) Identify how the care is given:

Through Clinics:
- Check ups

- Diagnosis
- Treatment - free drugs, through DOT centers
- Referrals

- Health education

Through Hospitals:
- Diagnosis

- Treatment

- Admission

- Surgical intervention

/ ' - Nursing care, Follow up

- Health education

Through Home visits:

- Case finding

- Contact surveys

Diagnostic services (collection of sputum for testing)

- Encourage contact examination

- Treatment

- Nursing care of patients

- Demonstrations
Nursing Practices in - Health education
Community Health-I1
- BCG Vaccination

- Follow up services

vii) Identify the referral system practiced:

The suspected cases screened

Diagnostic tests are done through PHC Hospitals

viii) Identify the method of recording and reporting:

Note the names and addresses of all sputum positive cases in your
register, family folders

Records and Registers maintained

Send them to District Tuberculosis Center

Reporting, Channels of sending reports

ix) Identify the Roles and responsibilities of the health staff:

To identify all suspected cases of T.B.

To arrange for sputum test and other investigations

To treat all infected cases until they are cured

Refer to DOT centers

To immunize all infants with BCG vaccine

To create awareness about T.B. through health education

To have knowledge of beliefs and customs of the people in that particular

community

To maintain proper records and reports

To make appropriate referrals.

In this section we have discussed about Tuberculosis and the procedure of

Identificaiton of Tuberculosis as a national health problem. Similarly you can
participate in identification of other health problems. For problems which
have high prevalence at the national level, the National Health Porgrammes
are launched. You as a community health nurse can participate in
identification of these problems.

Activity

Visit a nearest PHCMCH Centre1 Hospital under your study centre. Find out the
following interesting information by interviewing the staff, using registers, family
folders and insert cards:

Total population covered by this centre

Total number of under five children registered during the last six months

Total number of infants who received BCG vaccination during the last six
 Total number of children (under 5 years) who received Vit. A for the last six Identification of Specific
months. National Health Problems

Identify under which National Programme the above services have been
provided.

Guidelines
Name of the family1community
Place
Date and Time
1 Indentification Objectives Action ( Remarks and (
of Problems Taken Observation

Signature

9.6 LET US SUM UP

In this practical you have learnt that the identification of specific health
programme is important to provide comprehensive health care services to the
people and improve their health. Therefore as a CHN you have an important role
in early detection of diseases, getting patients diagnosed, providing regular
treatment, health education and proper referral. You also have the responsibility to
help achieve the goals set by Central Government through these National Health
Programmes.