SYNOPSIS TITLED

A STUDY OF AWARENESS LEVEL OF RURAL PEOPLE

ABOUT COMMUNICABLE DISEASES (IN BHARATPUR
DISTRICT OF RAJASTHAN)

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 INTRODUCTION

Communicable diseases are the diseases due to spread of

specific infectious agents capable of living directly or

indirectly transmitted from man to man, animal to man or from

the environment to man.

A disease is said to be communicable if it

spreads from one person to the other.

Communicable diseases are transmitted in many different

ways desponding upon the infectious agents, portal of entry

and the local ecological condition.

Communicable diseases are caused by very tiny organisms

called germs and parasites. These germs are present

everywhere- in air, water, soil, etc.

When germs enter a healthy body through infected food and

water, air, contact or insects, they multiply and upset the

normal functioning of the body, thus, producing the

symptoms of the diseases.

Out of the total death in India, communicable diseases are

responsible for a significant proportion of deaths.

COMMUNICABLE DISEASE IN RAJASTHAN

Rajasthan is located in North-West India, and is the largest

state in terms of size in India. Rajasthan has made a

remarkable comeback in communicable diseases.

Tuberculosis was a main problem in the mid sixties. Now it

has been cured and is declining in the state day by day.

Now, in Rajasthan there are hundreds of villages where there

are no doctors and roads too. Roads are also not present for

easy and fast communication with nearly hospitals in some

remote areas.
Fifty five years of Independence have not meant anything for

hundreds of villages of Rajasthan. For lakhs of villagers life

begins and ends in this secluded villages. Mobile surgical

Units were a great success in Rajashan which was for doing

surgical operation in field of eye and tooth related disorders.

MAP OF RAJSTHAN (DISTRICT MAP)
 OBJECTIVE OF THE STUDY

i) To analyze a group of people’s awareness about level

towards communicable diseases.

ii) To know the nutritional intake of the people in the district.

iii) To establish a relationship between the diseases and their

nutritional intake of food.

iv) To study the reason behind the spread of there diseases.

v) To know what are the communicable diseases.

vi) To know about the communicable diseases implementing.

 HYPOTHESIS

i. Generally the programmes for rural people for

communicable diseases are not properly implemented.

ii. Women are not open to man, generally researchers in villages.

iii. Generally the people have the perceptions that

diseases are curable themselves, so they avoid modern

medicines and also use ancient and traditional

methods.
 CHAPTER - 2

RESEARCH METHODOLOGY

RESEARCH DESIGN

In this study descriptive research design will be used with a

view to bring the light on the inter linkages and social

dynamics responsible for the effective functioning of rural

health related people.

DATA COLLECTION

The primary data will be collected through:

a. Structured scheduled interviews having both close and

open-ended questions with the rural people.

b. Through observation.

UNIVERSE OF THE STUDY

The universe of study will be 4 villages of Kumher Tehsil

under Bharatpur district.

SAMPLING

Here Purposive sampling will be done in the data collection.

Since the focus group is the women and men of rural parts,

this study will also include some children.

SAMPLE UNIT

The sample unit will consist of rural people of Hingoli,

Sabore, Astawan and Maharawar Villages.

SAMPLE SIZE

The researcher will collect the data from about 40

respondents. That will include all poor and well established

persons of the village only.

 LIMITATIONS OF THE STUDY

The study of awareness of rural people for communicable

diseases and this nutritional level is very vast and spread in a

wider area. The present study will be conducted at Bharatpur

District where local people understand and speak only Hindi

Language. The researcher will face some trouble in taking the

opinion from local people.

Secondly, the reluctance of the respondents to share their idea

due to their rural and backward attitude will be a major difficulty.

 CHAPTER – 3

REVIEW OF LITERATURE

The review of research on awareness of people on communicable

diseases and nutrition in rural areas is an endeavour to highlight the

aspects, which in spite being the crux were relegated and could not get

the due emphasis. An in depth analysis reveals that what the Alma Ata

conference of 1978 had projected is being implemented or not. It is in

this backdrop, an attempt has been made in this paper, to highlight

the fact whether the people in rural areas are really aware about the

communicable diseases prevention and condition of nutritional status

or not.

As per the census of 2001, it shows that the approximate increase in

population in last ten years (1991-2001) is 27.05%. Ministry of Health

and Family Welfare constitutes an important role in the overall

development of the country in the field of medical facilities. Moreover,

VO’s and NGO’s have been playing an equal role in the development

process of the world. The people of rural areas are neglected a lot.

Therefore, to ensure that they get this right full share of the

development and rightful role in the society in the present socio -

economic and political milieu of the country, they must be given some

special attention. As a result to begin with, policy makers have decided

to uplift the awareness level of rural people towards

communicable diseases and nutritional conditions in rural areas. For all this

reason, this work is completed under three broad areas.

Objectives: The objectives which were related to the awareness of

rural people towards communicable diseases were club in the first

category. This section covers the socio-economic and political profile

of the rural households; some literature has also been reviewed from

books regarding condition of villagers before and after the Alma -Ata

conference on health status held at Khazakistan. Mahajan Gupta

(1991) has critically evaluated the preventive and Social Medicines in

rural and Urban areas. Some empirical studies such as Park K, (1994)

and Malaria Research centre (1994) highlights the existing reality on

the condition of communicable diseases in Rural India.

The three primary objective of health education which are closely inter

related are:

i. Provisional Information: An important objective of health

education is the provision of need based and accurate

information regarding health promotion; disease prevention,

detection and treatment and rehabilitation, health education

messages in any community must be acceptable,

understandable and possible for persons to act upon. This can

lead to an increased level of awareness regarding the nature of

health problems, needs and associated responsibilities.

 ii. Motivating people: Provision of information must necessarily

be directed to motivating people to make choices and decision

that bring about relevant changes in their behaviour and life

styles. Health education can provide learning experiences to

influence attitudes, information and practices to motivate

change.

iii. Facilitating Action: Persons should be encouraged to utilize

existing services in a health / development project,. Services,

schemes and facilities are only useful when well utilized by

motivated individuals in communities who undertake action for

self help to improve their own health status.

Methodology

Methodology in the reviewed studies, remain by and large similar with

minimum variation. Very few of the researchers have specified the

research design they have followed. The best being described by Park.

K (1994) and Mahajan, Guppy (1991), who has used mixed

methodology combining conventional and participatory methodology.

Maximum have used exploratory or descriptive. Except few who have

used experimental, [Mahajan, Gupta(1991)]. The sample size varies

from the minimum of 33 (Mukherjee, A and Agnihotri, V.K. 1993) to the

maximum of 4395 Malaria Research Centre, 1994).

 Most of the researchers have used random and purposive sampling. Few of

them have used mouth stage proportionate sampling. Almost all types of

tools have been used for the collection of data which includes interview,

interview schedule, focus group discussion and observation. Only one

researcher [Mac Mohan, B. and Pugh T.F. (1970)] has used structured

questionnaires as the tool of data collection.

Findings

The review presented above being forth the point that despite

professed ideal and scores of policies and programmes, rural people

on whole are lagging far behind the other urban people in the

development race. The findings given by researchers concludes that

certain variables like annual income, education, occupation and family

status are pivotal in making a structural analysis of awareness of rural

people towards basics of communicable diseases and nutrition.

The literature review [World Health Organization (1988)] opined that

improving the health (nutritional) at the rural areas is certainly a positive

development but to make it work, sincere efforts more are needed from

different quarters. Some empirical studies [Pradip K. Ghosh (1984)] says

that awareness of rural people in India was very low but the role of

Government, Voluntary organizations ( VO’s) and Non-Governmental

organizations (NGO’s) bring successful results.

Further Research Avenues: Though the studies conducted have

covered various aspects of awareness of rural people towards

communicable diseases, there are quite a few areas that are still in dark

and needs to be probed in the energizing social scenario so as to

further prove the importance of awareness of rural people in

communicable diseases. These are as follows:

i. Policy research to analyse that whether DOTS, NMEP, NLEP are

implemented properly or not.

i. Studies to cover the involvement of each and every member of

the household.

ii. More emphasis on action and intervention research and on

descriptive rather purely exploratory research with qualita tive

analysis of data could be taken up for getting an in depth

understanding of the different aspects of these issues.

Communicable Diseases: Communicable diseases due to their potential of

transmission from one person or species to another by a replicating agent.

Transmission of an Communicable disease may occur through one or

more of diverse pathways including physical contact with infected

individuals. These infecting agents may also be transmitted through

liquids, food, body fluids, contaminated objects, airborne inhalation, or

through vector-borne spread. Communicable diseases which

 occur through contact with an ill person or their secretions, or objects

touched by them, are especially infective, and are sometimes referred

to as contagious diseases. Communicable diseases which usually

require a more specialized route of infection, such as vector

transmission, blood or needle transmission, or sexual transmission,

are usually not regarded as contagious, and thus not are not as

amenable to medical quarantine of victims.

The term infectivity describes the ability of an organism to enter, survive and

multiply in the host, while the infectiousness of a disease indicates the

comparative ease with which the disease is communicable to other hosts.

An infection however, is not synonymous with an communicable disease, as

an infection may not cause important clinical symptoms or impair host

function.

Typhoid: most common communicable disease in India

Typhoid is a severe, infectious and life-threatening disease. It is spread

through unhygienic food, drinks and water where bacteria S.typhi develop

which make person ill. Person who consume contaminated water exhibit

symptoms of fever with severe complications. Various drugs used to treat

typhoid are unsuccessful against resistant strains of typhoid bacteria. In

developing country such as India, it is a great threat and a major cause of

death. Typhoid disease mainly hit on children who are in school-going age.

It is not very common in adults and older people.

Typhoid is a communicable disease and it is transmitted in many ways

in India. Bacteria of typhoid are survived in unhygienic conditions.

These bacteria are spread by typhoid patients and carriers in large

quantities through stools and vomit. The bacteria then travel to food,

drinks and water through house-flies and other insects. Such foods are

contaminated. When these contaminated food or drinks, are taken by

healthy person, bacteria enter in to the body of person and causes

typhoid fever. Person may get typhoid fever by consuming food or

drink that has been carried by someone having the bacteria, or if

sewage contaminated with S. typhi gets into water used for drinking or

washing food. A person infected with S.typhi may infect others, as the

bacteria remain in the body for months. There are 107 different strains

of this bacterium. Paratyphoid is caused by Salmonella enteritidis

paratyphi A, B or C. It is generally a less infection than typhoid. A very

low percent of typhoid patients remain chronic carriers regardless of

treatment. Most common complications are intestinal bleeding and

perforation. The source of fever is polluted water. In India, due to

population explosion, water is polluted and this disease is matter of

worry especially in disaster areas, where water supply and sewage

disposal are disrupted. Raw vegetables grown on sewage fields also

spread infection. The bacteria can survive in soil and water for several

months. They grow rapidly in milk and milk-products.

Unhygienic conditions in surroundings are mainly responsible for the

prevalent infection.

Common Symptoms When person is infected with typhoid, in the early

stages he/she shows high fever, persistent headache, abdominal

discomfort, constipation, diarrhea, nasal bleeding, weakness, dizziness and

nausea and loss of appetite. These symptoms can be very severe and if

proper treatment is not given immediately there is a risk of mortality. Patients

suffer from: Constant high fever, diarrhea and constipation, variable degrees

of unconsciousness in later stages. Typhoid sometimes shows several

confusing symptoms, which are difficult to diagnose by physicians.

Treatment As it is said for all diseases, prevention is the best remedy.

For typhoid, proper antibiotics have to be used. There is a growing

frequency of resistant strains of the bacteria. Other treatment is to

reduce symptoms through drinking more fluids. This prevents the

dehydration that results from a prolonged fever and diarrhea. If a

patient is severely dehydrated, he may need to receive fluids

intravenously. Patient must take a healthy diet. Non bulky, high-calorie

meals can help replace the nutrients he loses when people are sick.

Even after treatment with antibiotics, some people who recover from

typhoid fever continue to carry the bacte ria in their intestinal tract or

gallbladder for years. Such people called chronic carriers. They carry

the bacteria in their feces and are capable of

infecting others, although they no longer have signs or symptoms of the

disease themselves.

People must take medical advice when they suspect that they have

typhoid fever. If they become ill while traveling in a foreign country,

immediately search for the list of doctors. It is always better to know in

advance about medical care in the areas they have to visit, and keep

a list of the names, addresses and phone numbers of recommended

doctors. Doctor whether local or state medical society can help

provides the required information. If someone develops signs and

symptoms on his return to home, consider consulting a doctor who

focuses on international travel medicine or infectious diseases. A

consultant will recognize and treat illness more quickly than a doctor

who is not trained in these areas can. Person must seek immediate

assistance if he feels some symptoms of typhoid no matter where he is

staying.

Prevention Today government of India is focusing on such dreaded disease

and organizing many programs, generating awareness through media to

prevent it. In many developing nations, the public health goal is to prevent

and control typhoid by safe drinking water, improved sanitation and adequate

medical care but it is quite difficult to achieve. Because it is a tough task to

change the living style of people in short span. On this ground, many

professionals believe that vaccinating high-risk populations is the best way

to control typhoid
fever. Clean hygienic habits, drinking only purified water, abstaining

from eating raw leafy vegetables and food left in the open. Vaccination

is also necessary to avert the disease. A single injection given 2 years

onwards gives protection against typhoid for 3 years. It will shield

person who is traveling to a country where typhoid fever is prevalent.

Doses can be choosen between a four-dose oral vaccine and a single-

dose injection. Both are up to 75 per cent effective at preventing the

infection. Two types of vaccine- an oral typhoid vaccine and a single-

dose injectable vaccine that produces fewer side effects than the older

two-dose injectable vaccine. Both vaccines are similarly effectual and

offer great protection against the illness. The oral vaccine (Vivotif)

contains a live but weakened strain of the Salmonella bacteria that

causes typhoid fever.

The vaccine consists of four capsules that are taken every other day

over a one-week period. The capsule protects the vaccine against

stomach acid so it remains active when it reaches the intestine where

the immunity develops. The oral vaccine can be given either as a first-

time dose or as a booster dose. The protection should last abou t

5 years, at which time another booster dose would be needed if

traveling again. The oral vaccine is not recommended for children

under 6 years old. The single-dose injectable vaccine (Typhim Vi)

containing capsular polysaccharide antigen is available. The

protection offered by this vaccine is effective starting 2 weeks after

injection and should last for 2 years. Subsequent booster doses are
recommended at 2-year intervals. This vaccine can be used in children

as young as 2 years old. Side effects, while greater than those of the

oral vaccine, are much less than those experienced with the old 2-dose

injectable vaccine.

People must know that if they have to avoid such disease, it’s their duty to

create awareness program. Only few people can not control the threat.
 CHAPTER – 4

RECOMMENDATIONS

On the basis of the finding and the conclusions of the study for strengthening

villagers view towards communicable diseases and nutrition, the following

interventions in the villages are suggested:

a. Education and awareness :

• Education for other women, backward castes, marginalised

section of society and elders for improvement in health.

• Organization focus group discussion with panchayat members,

self – help groups and youth groups.

b. Training

Training for the women, especially for the newly mothers for their children

for post natal care. Diarrhoea, titanus, preunonia are fatal and can cause

death, if not taken proper care.

c. Action

Developing a cadre of 10-15 members of local youths from the respective

area who will carry out literacy, education, development work and awareness

in their respective village.

 CHAPTER - 5

Suggestions

1. Plans and estimates are prepared for sanction, should be binding

upon the administration to initiate action on the plan submitted.

2. Policies that underpin women’s requirements for capacity building

is the need of the hour.

3. Joint collaboration between voluntary organizations, CSO’s and

government in building the capacities of the women regarding their

roles to curb the basic diseases.

4. Given that illiteracy runs high within villagers, different forms of

communication would help to increase awareness and inform the

villagers.

5. Government officials working directly with women need to be

sensitized to support and respect the women and villagers. In first

time, they need time to adapt the things.

6. Gram panchayats need to be given control over natural, physical

resources to augment and generate “own revenue” to translate the

developmental plans onto the ground.

7. Information dissemination channels must ensure timely, regular,

easy, smooth access to relevant information regarding schemes /

 programmes the state should think of instituting pancahyat

resource centre for regularly disseminating information at the local

level people.

8. Devolution of knowledge to the villagers about health must be

through a proper channel i.e., it should have high authority to

employ staff, appoint them supervise their work and take

appropriate disciplinary action if required.

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