FAMILY HEALTH CARE

Our guide:
Dr. Priyanka Mukhopadhyay

Department of Community medicine ,

N.R.S.M.C.H
 TEAM MEMBERS
Roll no. Name
43 ARNAB BISWAS
44 ARKAPRABHA MANGAL
45 ARITRA PAUL
46 ANKUR DAS
47 ANKITA DEBGUPTA
48 ANKIT BHAGAT
49 ANAMIKA SINGH
50 AJIJUN NAHAR BEGUM
51 ABHINAY PUNDIR
52 ISHAN DASGUPTA
53 SHIVAM DUTTA
54 SHOURJOMOY GHOSH
55 SHREEJITA DUTTA
56 SHREYA BHADRA
 INTRODUCTION
❖ FAMILY-
Family is a group of individuals living together related
either biologically or by marriage or by adoption and sharing
the same kitchen.
❖ TYPES OF FAMILY-
i. Nuclear Family- It consists of the married couple and
their dependent children.
ii. Joint Family-It consists of the married couple and their
children living in the same household.
❖ HOUSEHOLD-

An aggregate of persons, generally but not necessarily, bound by ties of

kinship, which live together under the same roof and eat together or share in
common the household food. Members comprise the head of the household,
relatives living with him/her , or other persons who share the community
life for reasons of work or other consideration.
PURPOSES OF THE FAMILY
Sharing of
Inheritance Social
Cultural
Pattern Protection

Decent FAMILY Division

Home of Work

Bridging
Emotional between
bonding generations
Economic
Function
 OBJECTIVES
During field posting in the community, we acted
as family physicians to the allotted family under
supervision of the faculties of community
medicine. Therefore, the present family health
care program in the community will be
undertaken with the following objectives :
❖ General Objectives-
To make a medico social diagnosis of the family.

❖ Specific Objectives-
i. To study the demographic , socioeconomic and
environmental conditions of the family.
ii. To asses the health status of individual family members.
iii. To asses the maternal health.
iv. To determine the immunization status ,feeding practices,
health and nutritional status of children.
v. To asses health knowledge ,family planning and dietary
practices of the family.
vi. To take appropriate remedial measures for the problem
identified.
 MATERIALS
&
METHODOLOGY
⮚Type of study: Descriptive observational
study
⮚Study Design: Cross sectional
⮚Study Area: Mallickpur (Rural)

⮚Duration of study: 22.5.19 From 10am

to 11am (1 hour)
⮚Tools:
⚫Proforma ( Pre-designed and Pre-tested
Schedule)
⚫Measuring tape
⚫Weighing machine
⚫Sphygmomanometer
⚫Stethoscope
⚫Torch
⚫Medical records

⮚Techniques:
• Briefing- A brief description of the study was
given by our respected teachers.
⚫Fixation of criteria-
Type of family
Joint Family – It consists of married couple and their children living in the same household .
Nuclear Family – Married couple and their dependent children only

Housing Type
Pucca House – Floor paved , Walls stone/Brick built , roof (tin or asbestos or concrete )
Kutcha House –Floor packed with earth ; Walls dried mud or thatched , Roof thatched , slate or
other stones .
Mixed House – Any combination of the above two types .

Adequate ventilation
Unless mechanical ventilation and lighting are provided every room must have at least two
windows and one of them open directly into an open space .
The windows should be not more than a height of 3feet from the ground.
Window should be 1/5 of the floor area doors and windows combined should be 2/5 th of the
total floor area .
Adequate Lighting
After opening all the doors and windows of the room if we are able to read the smallest
letter of the newspaper at the centre of the room without any artificial light , then we
say natural light is adequate .

Overcrowding :
Overcrowding is said to be present if any one of the following three criteria exists :
1. Persons per room : The accepted standards above which overcrowding is considered
to be present is
• 1room – 2 persons
• 2rooms – 3persons
• 3rooms – 5 persons
• 4rooms – 7persons
• 5rooms – 10persons
+2 for each further room
2. Floor Space : The accepted standards are :
• 110sq.ft. or more – 2 persons
• 90 -110sq.ft. – 1½ persons
• 70-90sq.ft. – 1 person
• 50-70sq.ft. – ½ person
• Under 50sq.ft. – nil
A baby under 12months is not counted ; children between 1 to 10 years of age counted as half a unit .
3. Sex separation : Overcrowding is considered to exist if 2 persons over 9 years of age , not husband and
wife of opposite sex are obliged to sleep in the same room .
Prasad Scale of Socioeconomic status
classification(2018) :

Social class 2018

Upper ≥6574
Upper Middle 3287-6573
Middle 1972-3286
Lower Middle 986-1971
Lower ≤985
⚫Allotment of family: A family was allotted in
our rural practice area by the department.
⮚ Data collection:
⚫Interview: Using predesigned and pretested schedule.
⚫Observation: Done for environmental characteristics,
like housing, water supply, sanitation, overcrowding etc.
⚫Anthropometric measurement: Done for height and
weight (Additionally Waist hip ratio for adults and MUAC
for children) .
⚫Clinical examination: Done on individual family
members. Included both general survey & systemic
examination.
 ⚫Dietary survey: Done on the basis of 24-hour recall method.
⚫Analysis of records: Done after collection of all the data.
⮚Data Compilation and Analysis: After collection, data was
compiled, analyzed and prepared for presentation.

⮚Presentation: Done before the faculty members.

⮚Writing of final report: Final report will be made after

necessary corrections as suggested by faculty members.
 FAMILY IDENTIFICATION
• Head of the family: Pratap Chandra Chanda

• Address: Mallickpur , Beniadanga , Kol- 700145

Table No.1 : Details of family members

NAME RELATION AGE SEX MARITAL EDUCATION OCCUPATIO

WITH HOF STATUS LEVEL N
PRATAP HOF 54 M MARRIED Graduate Govt.
CHANDRA Service
CHANDA
SIMA WIFE 52 F MARRIED - HOUSEWIFE
CHANDA
PRASENJIT SON 33 M MARRIED Graduate PRIVATE
CHANDA SERVICE
MOUMITA DAUGHTER 24 F MARRIED Graduate HOME
CHANDA IN LAW TUTOR
TIYASHA GRAND 30months F NA - -
CHANDA DAUGHTER
 Family Tree
PRATAP
SIMA
CHANDRA CHANDA
CHANDA

MOUMIT
PRASENJIT
A
CHANDA
CHANDA

TIYASHA
CHANDA
 Type of family :JOINT FAMILY
 Religion : HINDU
 Caste :GENERAL
 Place of origin : MALLIKPUR
 Length of stay :SINCE BIRTH
 Mother tongue : BENGALI
 Other Languages :- HINDI
PHYSICAL ENVIRONMENT
 HOUSING :-

• Site/location: Elevated.
• Type: Pucca
• Ownership: Owned
• No of living rooms: 2
• Total area of living rooms (floor space): 12.5
X11X2 sqft (275 sqft)
• Per unit floor space : (275/4.5=)61.11sq.ft
• Persons per room: 4.5/2 = 2.25
• Sex separation: Present
• Area other than living room utilized for living
purpose: Drawing room
• Overcrowding – Present according to the
persons per unit floor space criteria
• Combined Window Area: 5ftX3ftx8
(120sqft)
• Combined windows and door space :
4ftX5.5ft + 120sqft = 142sqft
• Ventilation: Adequate(Window and
door space more than two-fifth of
house area)
• Cross-ventilation: Present
• Lighting: Adequate
• Kitchen: In separate room
• Type of fuel used: LPG
 Smoke nuisance: Absent
 Storage of food: 1. Raw food – Uncovered

2. Cooked food – Covered

 Kitchen garden: Absent

 Comment on separate cattle shed: No
 Comment on drainage system around the
house: Present (Kuccha Drain)
 Comment on drainage of household waste
water: Same as above
 Observe and comment on breeding places of
mosquitoes: Present (Pond)
 Fly nuisance : Present
 Comment on Housing
1. They lived in a pucca house with 2 living rooms, with adequate
lighting and adequate ventilation.

2.Cross ventilation was present , overcrowding was present ,

kitchen was in a separate room .

3.Fly nuisance was present along with breeding places of

mosquito.
 WATER
AND
SANITATION
 WATER SUPPLY :-

 Source of water:
i. Drinking purpose: Deep Tube Well and
Pipe water supply . (Regular inspection of
arsenic in water )

ii. Cooking Purpose: Tube Well

iii. Washing-Bathing Purpose: Tube Well

 Distance of drinking water source: 150

metres from the house.
 Nature of Supply: Continuous
 Adequacy of supply: Adequate.
 Whether drinking water given any special
treatment for household purpose- No.
 Comment –
1. The water was brought in uncovered buckets from the water
source.

2. They stored it in covered plastic buckets.

3. Water was drawn from the containers by mugs.

4. Water was not treated in household before drinking.

 EXCRETA
DISPOSAL

 Latrine:
❑ Present.
❑ Within house
❑ Sanitary
❑ All family members go to sanitary
latrine to defecate.

 Arrangements for regular

cleaning:
❑ Present.(once a week)
 REFUSE DISPOSAL :-

Disposal of refuse: Municipal service

Disposal of kitchen wastes:

▪ Solid wastes: Along with other waste .
▪ Sullage (liquid wastes): Into the
kuchha drain (seepage into ground and into a pond 200metres
away )
 Comment on Disposal

1. They used sanitary latrine which was inside the

house.
2. Solid wastes were collected and disposed off with
the municipal service . Sullage (liquid wastes) was
disposed with the municipal service too , too.
 16.5ft
N
MAIN ENTRY

W LIVING 11ft
ROOM1
Drawing Room

S 14ft

Olive green Living room

Light Orang Bedroom KITCHEN

BATHROOM
LIVING
Light red = Kitchen ROOM2

Grey = Bathroom

Light green = Staircase

Schematic diagram of House
12.5ft
Dark green Doors

Grey = Windows
SOCIOECONOMIC STATUS
 DETERMINATION OF THE APPROXIMATE
MONTHLY INCOME, EXPENDITURE AND BALANCE
OF THE FAMILY
 Number of earning members:
Male – TWO
Female - ONE
 Number of dependents:
Male - ZERO
Female - TWO
 Any other source of economic help from outside (excluding loans): None
 Family income per month: Rs25,000 + Rs15,000 + Rs3000
 Per capita income : Rs 43,000
 Social Class of the family according to the Prasad scale = 43,000/5 = Rs8600 (Upper Class)
 MONTHLY EXPENDITURE OF THE FAMILY
Item Expenditure Percentage Item Expenditure Percentage
(₹) (%) (₹) (%)
Food 7600 /- Housing (Maintenance) 500/-

Fuel 800/- Social function 800/-

Clothing 900/- Health and illness 300/-

Education 0/- Travel & Transport 1000/-

Electricity 1200/- Recreation (Cable TV, 750/-

Phone)

Substance Abuse 0/- Others (Soap, 300/-

(Alcohol and Shampoo, Oil etc.)
Tobacco)

Total expenditure of the family: 14,150

Balance of income over expenditure :Rs43000 – Rs14150 = Rs28,850
Savings : Rs28,850
 SOCIO-CULTURAL PROBLEMS
• Orphans: None
• Children above 6 years not going to school: No
• School dropout/Not enrolled: Not enrolled
• Child labour: Not applicable
• Addiction/Substance Abuse : NA
• Any handicapped or chronically ill family members: None
• Broken family: No
Others :

 l. Domestic violence : None

 ll. Child marriage : None

 lll. Teenage pregnancy : None

HEALTH KNOWLEDGE
 TABLE :Knowledge and practice regarding causation ,mode of transmission , preventive
measures and availability services with respect to communicable diseases.
{Name of Respondent: Sima Chanda (wife of head of the family)}
Disease Heard of Mode of Knowledge of preventive measures Knowledge of
the transmission availability of
disease services
Diarrhoea Yes Contaminated hands, water Washing hands before eating BPHC, Hariharpur
and food

Malaria Yes Mosquito bites Mosquito nets , repellent, coils BPHC, Hariharpur

Tuberculosis Yes Through cough of infected Keep distance from infected person BPHC, Hariharpur
person
ARI Yes Cold exposure , sneezing Avoiding contacts with patients having ARI , warm BPHC, Hariharpur
clothes

RTI No Not known Not known NA

HIV/AIDS Yes Sexual contact Condom BPHC, Hariharpur

Leprosy Yes Not known Not known NA

Comments:-

• The respondent had no idea about the mode of transmission, knowledge of

prevention and availability of services regarding Leprosy, and RTI.

• She had inadequate knowledge about Diarrhoea.

Health care seeking behaviour: BPHC, Hariharpur.

 TABLE : Knowledge and practice regarding risk factors , preventive measures and
availability of services with respect to non-communicable diseases.
(Respondent – Mrs. Sima Chanda)
Disease Risk factors Knowledge of Knowledge of
prevention availability of
services
Diabetes Intake of excessive amount of Restricted sugar and sweet intake BPHC, Hariharpur
sugar and sweets

Hypertension Intake of salts and fatty foods. Avoiding such foods BPHC, Hariharpur

Coronary heart Not known Not known NA

disease

Cancer Tobacco chewing and smoking To quit smoking and refrain from BPHC, Hariharpur
tobacco

Mental disease Not known Medication Not known

Comment:-
The respondent had idea about the risk factors , knowledge of
prevention and availability of services regarding most of the non-
communicable diseases .

Health care seeking behaviour :

BPHC hariharpur
 Under 5 Child examination

 Name: Tiyasha Chanda

 Date of birth: 19/8/16
 Sex: Female
 Age:30 months
 History of present illness: No history of present illness
 History of Past Illness : 1. Physiological Jaundice on 2nd day after birth for which
the baby was kept in an incubator and discharged on the 3rd day after birth .
2. Common cold (Upper respiratory infection ) – Two or three episodes of common
cold (Upper respiratory tract infection )(not exactly recalled by mother) , treated by
private practising paediatrician .
 Birth History:

Birth weight: 2.5 kg

Gestational age: Term
Type of delivery: Caesarean (Elective)
Place of delivery: Institutional (Rajpur Matrisadan Hospital)
Delivery conducted by: Doctor
Condition of baby at birth: Normal
Need of resuscitation : No
Congenital abnormality: Absent
Feeding history :

Time of initiation of breast feeding after delivery: Immediately after birth

Colostrum given: Yes

Prelacteal feed given: No

Exclusive breast feeding: Yes

Complementary feeding : Started after 6 months ( with mashed rice and milk

{semisolid food})

Amount of food given during illness: Same

• Current Feeding Practice(24hrs recall)-

• Whether child breast feed now- No

• No. of times breast fed in last 24hrs- NA
• Breast feeding during night – NA
• Bottle feeding – Yes
• Any other food given apart from breast fed- chapati
+rice+milk ( Also fruits {mango and apple] and fish )
•
 Type of food taken by child presently(in last 24 hours ):

 Consistency- semisolid

 Amount - 1 cup rice + milk + fish

 No of times- 4

 Responsive feeding- No

 Visit to ICDS- No

 Taken prophylaxis of iron/folic acid in last one year: No

 Deworming : Not Done

IMMUNISATION
SCHEDULE
(As per the National
Immunisation Schedule)
 VACCINE AGE OF PLACE OF REMARKS
VACCINATION VACCINATION
BCG At birth Hariharpur PHC Immunised as per age

Pentavalent 1 6 weeks -do- Immunised as per age

Pentavalent 2 10 weeks
Pentavalent 3 14 weeks

DPT Booster (1st dose) 17 months -do- Immunised as per age

DPT Booster (2nd dose) 4-6years -- (Given according to
mother but not
recorded)
OPV - 0 At birth -do- Immunised as per age
OPV - 1 6 weeks
OPV - 2 10 weeks
14 weeks
OPV - 3
16 months
OPV Booster
Vitamin A 9 months -do- Immunised as per age
16-18 months
 VACCINE AGE OF VACCINATION PLACE OF VACCINATION REMARKS

IPV 14 weeks Hariharpur PHC Immunised as per

age

HEPATITIS B birth dose At birth -do- Immunised as per

age
MR - 1 9 months -do- Immunised as per
MR - 2 16 months age

JE - 1 9 months -do- Immunised as per

JE - 2 16 months age
Other vaccines received ( Other than NIS ):
Vaccine Age of Place of Vaccination Remarks
Vaccination
PCV1 18weeks Private Facility Immunised but
PCV2 22weeks later than
PCV3 26weeks recommended age
Rotavirus 1 18weeks Private facility Immunised but
Rotavirus 2 22weeks later than
recommended age
Typhoid conjugate 11 months Private facility Immunised as per
vaccine age
Hepatitis A 12 months Private facility Immunised as per
age
Varicella 1 13 months Private facility Immunised as per
age
 Developmental Milestones
Ideal age of Motor Attained by Language , Attained by
attainment Development the child Adaptive and the child
Milestones sociocultural
development
milestones
6-8 weeks -- -- Looks at Yes
mother and
smiles
3 months Holds head Yes -- --
erect
4-5 months -- -- Begins to Yes
reach out of
objects
4-5 months -- -- Recognises Yes
mother
6-8 months Sits without Yes Transfers Yes
support objects hand
to hand
9-10 months Crawling Yes Releases Yes
objects
10-11 months Stands support Yes First words Yes

12-14 months Walks with Yes -- --

wide base
18-21 months Walks with Yes Joining words Yes
narrow base together
24 months Runs Yes Speaks short Yes
sentences
 CLINICAL FINDINGS
 Activity: Normal
 Anterior fontanelle : Normal
 Neck rigidity : Absent.
 Abnormal Movement : Absent.
 Vitals :
A)Temp : Normal.
B) RR : 45/min.
C)HR : 120/min.
 Palmar pallor : No
 Cyanosis/clubbing /pedal edema/generalized lymphadenopathy : Absent.
 Jaundice : Absent.
 Respiratory Distress : Absent.
 Ear discharge : Absent
 Eye ( pus / bitots spots / corneal involvement ) : Absent
 Pustules : Absent
 Umbilical discharge : Absent
 Skin (depigmentation /desquamation /petichae /purpura
/ecchymosis) : Absent
 Abdominal Distension : Absent
 Cardiovascular system : not done
 Anthropometric measurements :
a) Weight : 16 kg
b) Height : 91.2 cm
c) Mid upper arm circumference : 16.5 cm
• Malnutrition:
a)Severe wasting /edema of both foot : Absent
b)According to WHO growth chart : Normal
c)Any other sign : absent
• Lab investigations : NA
• Remarks : The child is normal and healthy and has attained
all developmental milestones as per age . She is fully
immunised .
INDIVIDUAL
HEALTH
CHECKUP
HEALTH CHECKUP OF 1st INDIVIDUAL

• Date of Examination : 22 February 2019

• Identification : Name : Sima Chanda

Age : 52yrs
Sex : Female
• Presenting complaints : Increased frequency of urination
● History of present illness : Patient has Diabetes
Mellitus for the last 4 years and is on regular oral drugs

● History of past illness : Tympanoplasty surgery

(2006)

 Drug history: Metformin 500mg 2 tablets daily

 Family History : No significant medical and
surgical history

 Personal history :
Bowel and Bladder habits –Normal
Sleep – Normal
Appetite –Normal
Addiction – Normal

 Marital History : Married at the age of 21 yrs

Menstrual History :

● Menarche – 13 years
● Menopause – 49 years

Obstetrics History:
 Parity – 1
 Living issue – 1
 Abortion – 0
Findings on clinical examination :
a) General examination

Height : 147cm

Weight : 41kg

BMI : 18.97kg/m2

Waist - hip Ratio : 0.78

Pallor : absent

Cyanosis : absent
Clubbing : absent
Icterus : absent
Temperature : Normal
Oedema :Absent
Pulse : 81/min
B.P. : 130/90 mm of Hg
Neck veins : Not engorged
Neck glands : Not palpable
b) Systemic Examination :
• G.I. System : No abdominal distension ,liver &
spleen not palpable, no ascites

• Respiratory System: Normal bilateral vesicular

breath sounds on auscultation ,no adventitious
sound, Respiratory Rate : 15 breaths/min

● CVS System :S1 and S2 audible , no murmur or

abnormal sounds heard

● CNS System :Alert, conscious, cooperative ,

normal reflex, no musculoskeletal weakness
Significant laboratory findings –
Blood Glucose level (PP ) – 140mg/dl
Blood Glucose level (Fasting ) – 95mg/dl
(Done 1month ago)

Provisional diagnosis:
• Diabetes Mellitus diagnosed 7yrs back and
controlled.
• The patient has stage 1 hypertension.
Treatment and management of the case:
• Continue with the current dose of metformin as
blood glucose levels are under control.
• Life style modifications are suggested for diabetes
mellitus and hypertension.
• Consultation of a physician for hypertension is
suggested.
HEALTH CHECKUP OF 2nd INDIVIDUAL (Mother)

• Date of Examination : 22.02.2019

• Identification : Name Moumita Chanda

Age : 24 Years
Sex : Female
• Presenting complaints : Irregular menstruation
● History of present illness : Irregular menstrual cycle , Acne problems

● History of past illness : She was diagnosed with PCOS at age 18 years .
Family History : Diabetes Mellitus (Father)

 Personalhistory :
Bowel and Bladder habits – Normal
Sleep – Normal
Appetite – Normal
Addiction – None

 Marital History : Married at the age of 19 years

 Contraceptive History : Use of condoms (By husband)

Menstrual History :

● Menarche – 13yrs
● LMP – 3/5/19
● Cycle – Irregular
● Duration – 3-4 days
● Flow – Normal (3-4 pads per day)
● Dysmenorrhea – Absent

Obstetrics History:
● Parity - 1
● Living issue – 1
● Abortion – 0
History of previous pregnancy:

Order of Age of Outcome Type of Place Conducted Complications

pregnancy pregnancy delivery of delivery by if any

20 Live Birth Caesarea Institutional , Doctor NIL

1 n section Rajpur
Matrisadan
hospital

Mrs. Moumita Chanda has availed >4 antenatal visits, 2 tetanus toxoid injections,
IFA prophylaxis for 100 days and calcium tablets for the last pregnancy.
Findings on clinical examination :
a) General examination :

Height : 152cm

Weight : 79 kg

BMI : 34.19 kg/ m^2

Waist hip ratio : .87

Pallor : Absent

Cyanosis : Absent
Clubbing : Absent
Icterus : Absent
Temperature : Normal
Oedema : Absent
Pulse : 69 / min
B.P. : 110 / 80mm of Hg
Neck veins : Not engorged

Neck glands : Not palpable

b) Systemic Examination :
G.I. System: No abdominal distension, liver
and spleen not palpable.
Respiratory System : : Normal bilateral
vesicular breath sound on auscultation.
Respiratory Rate- 18/min

● CVS System : S1, S2 audible. No murmur or abnormal

sound.
● CNS System : Alert, Conscious,
Cooperative
Significant laboratory findings – Nothing significant

Provisional diagnosis:1. PCOS from age 18 years .

2. The individual has obesity (according to Indian
standard of BMI range .)
Treatment and Management of Case

 Patient is advised to reduce fat intake , increase consumption of

fruits and vegetables , and to moderate exercise regularly (45mins
per day 3-5 days a week) to reduce weight.
 She is asked to attend regular check ups for PCOS .
DIETARY ASSESSMENT
 24 hours Recall based daily consumption of
nutrients by family members:

Vit
AMOUNT(gm Calories( Protein(g A(Microgram Vit.
Foodstuff /ml) Kcal) m) Fat(gm) Fe(mg) Ca(mg) ) B1(mg) Vit.B2(mg) Vit. C(mg)

Rice 400gm 1384 26 16 4 36 0 0.8 0.2 0

Wheat 250gm 850 30.25 4.25 12.25 120 9.06 1.225 0.425 0

White Bread 50gm 170.5 6.05 0.85 2.45 24 1.81 0.245 0.085 0

Puffed rice 60gm 195 4.5 0.06 3.96 13.8 0 0.13 0.006 0

Lentil 60gm 205.8 15.06 0.36 4.56 41.40 20.25 0.27 0.234 0

Onion 200gm 100 2.4 0.2 1.2 94 0 0.2 0.02 22

Carrot 200gm 96 1.8 0.4 2.06 160 472.5 0.08 0.04 6

Potato 600gm 582 9.6 0.6 2.88 60 0.18 0.6 0.06 1.02
 AMOUNT Calories Vit
Foodstuff (gm/ml) (Kcal) Protein (gm) Fat(gm) Fe(mg) Ca(mg) A(Microgram) Vit. B1(mg) Vit.B2 (mg) Vit. C(mg)

Fish 400 gm 460 83 7 5 2650 0 0.25 0.35 110

Milk 800ml 536 25.6 32.8 1.6 960 53 0.4 1.5 16

Sugar 50gm 199 0.05 0 0.08 6 0 0 0 0

Eggs 40gm 69.2 5.32 5.32 0.84 24 21 0.04 0.16 0

Mustard Oil 130ml 1170 0 130 0 0 0 0 0 0

Lady’s Finger 300gm 105 5.7 0.6 1 198 2.43 0.21 0.3 39

Spinach 300gm 78 6 2.1 3.42 219 2092.5 0.03 0.78 84

Total
Consumption 6200.5 221.33 200.54 45.3 4606.2 2672.73 4.58 4.16 262.02
 Daily requirement of nutrients
by family members
Family Members Calories(Kcal) Protein(gm) Visible Fat(gm) Fe(mg) Ca(mg) Vit A(microgram) Vit. B1(mg) Vit. B2(mg) Vit. C(mg)
Pratap Chandra
Chanda(ADULT
MALE
SEDENTARY
WORKER) 2320 60 25 17 600 600 1.2 1.4 40
Sima
Chanda(ADULT
FEMALE
SEDENTARY
WORKER) 1900 55 20 21 600 600 1.0 1.1 40
Prasenjit
Chanda(ADULT
MALE MODERATE
WORKER) 2730 60 30 17 600 600 1.4 1.6 40
Moumita
Chanda(ADULT
FEMALE
SEDENTARY
WORKER) 1900 55 20 21 600 600 1.0 1.1 40
Tiyasha
Chanda(CHILD) 1060 16.7 27 09 600 400 0.5 0.6 40
Total 9910 246.7 122 85 3000 2800 5.1 5.8 200
 Comparison of consumption and daily
requirement of nutrients:

Visible Retinol
Nutrient Calories(Kcal) Protein(gm) Fat(gm) Fe(mg) Ca(mg) (microgram) Vit. B1(mg) Vit. B2(mg) Vit. C(mg)

RDA 9910 246.7 122 85 3000 2800 5.1 5.8 200

Consumption 6200.5 221.33 130 45.3 4606.2 2672.73 4.58 4.16 262.02

Excess 8 1606.2 62.02

Deficit 3709.5 25.37 39.7 127.27 0.52 1.64

Excess Percentage 0.065% 53.54% 31.01

Deficit Percentage 37.43% 10.28% 46.7% 4.54% 10.01% 28.27%

Comment:

The diet of the family is deficient in calories ,

protein , iron , VitA , VitB1 and VitB2 .

It has excess of visible fat , calcium and VitC

 SUMMARY
• The family allotted to us was a 5 membered joint Hindu family , residing at
Natunpara , Beniadanga , Mallickpur (P.O.) , Baruipur , South 24 Paraganas ,
headed by Mr Pratap Chandra Chanda
• The family consists of three generations , 2 adult male , 2 adult female and 1
female child .
• Mr Pratap Chandra Chanda does Govt service and his wife , Mrs Sima Chanda is a
Homemaker . Their son is Prasenjit Chanda does private service and is married to
Moumita Chanda who is a homemaker . They have a daughter Tiyasha Chanda 2yrs
6months old .
• They reside in a Pucca house which is adequately lighted and adequately ventilated
having overcrowding , with fly nuisance present .
• The family used deep tube well water for drinking , cooking , washing and bathing
purposes . Water was stored in covered plastic buckets and drawn using mugs . It
was not treated before drinking .
• All the members of the family used sanitary latrines present inside the house .
• The disposal of the household waste was proper , using the municipality waste
disposal service , and liquid wastes draining to a kuchha drain
• The family belongs to the upper middle class according to the B. G. Prasad Scale 2019
.
• There is no domestic violence , child marriage, teenage pregnancy and school droup
outs .
• Mrs. Namita Dutta had heard about leprosy but had no knowledge about the disease,
but she was aware about the rest of the communicable diseases.
• Mrs. Namita Dutta had no idea about the risk factors, knowledge of prevention and
availability of services regarding coronary heart disease. She knew the risk factors but
had no knowledge of prevention regarding mental diseases and availability of
services.
• Mrs Sima Chanda is a diabetic on anti diabetic drugs with blood glucose under control
.
• 2.5yrs old Tiyasha Chanda was completely healthy and immunised as per age .
• The diet of the family is deficient in Calories , Protein , Iron , VitA , VitB1 , VitB2 .
 PROBLEM IDENTIFICATION
HOUSING: The housing was overcrowded .The uncooked food was not properly
covered . There was fly nuisance and breeding places of mosquitoes .

INDIVIDUAL HEALTH PROBLEMS:

• WIFE OF HOF - Had history of diabetes mellitus for which she is under medication
now. She was found to be stage 1 hypertensive.

• Daughter in law of HOF – Had PCOS from age of 18 years . She is also obese .
• Under 5 child Problem – Deworming not done and she had not received IFA
prophylaxis .

• Health knowledge – The wife of the head of the family had inadequate knowledge
about cancer , leprosy , mental diseases .
 HEALTH KNOWLEDGE:

Family had inadequate knowledge regarding both

communicable and non communicable disease.
The wife of head of the family had no idea about the risk
factors, knowledge of prevention and availability of services for
leprosy and RTI.

 WATER

• Water was taken from a narrow mouthed mug which can

contaminate the drinking water.
No special treatment(boiling ,chlorination , domestic filtration
etc. )at household was done to the drinking water
 Medico-social Diagnosis
The allotted family was a 5 membered Hindu joint family
consisting of three generations , 2 adult males , 2 adult
females and 1 female child , belonging to the upper middle
class , living in an adequately lighted and ventilated
overcrowded pucca house having fly nuisance and mosquito
breeding places. They have adequately safe drinking water
and presence of drainage system in and around the house and
proper waste disposal system . The 30 months child is
clinically healthy and completely immunised as per age . All
the members are normal except the wife of the HOF who is a
diabetic under control with drugs and stage 1 hypertensive
and his Daughter in law who is a sufferer of PCOS . Family
diet according to 24 hour recall method was deficient in
calories , protein , iron , vitA , vitB1 , and vitB2.
 ACTIONS TAKEN
1. Mrs Moumita Chanda was demonstrated the steps of hand
washing and was advised to follow this before feeding the
child and after defaecation and waste disposal .
2. They were advised to take their child , Tiyasha Chanda to the
ICDS centre which was nearby to their house .
3. Basic knowledge about the prevention of diseases like
Coronary heart disease and cancer .
4. Mrs Moumita Chanda was told about other safer and more
reliable methods of contraception like OCPs and IUDs .
5. They were asked to include more of fresh fruits ,
green leafy vegetables and calorie rich foods like
cereals in their diet (Except the wife of HOF who is diabetic ).
6. They were informed about the various health
programmes of the government like RNTCP ,
NVBDCP and were suggested to avail them if needed
.
RECOMMENDATIONS
INDIVIDUAL LEVEL
 For under 5 child :-
✔ To boil the water at least as they are not purifying the
water by any means .
✔ 1ml of IFA syrup containing 20mg of elemental iron and
100mcg of folic acid to be given biweekly till 60 months
age by ASHA or ANM .
✔ Deworming is required .
PHYSICAL ENVIRONMENT :-
✔ Fly nuisance was advised to be prevented by suitable measures .
✔ Removal of stagnant water was advised .
✔ While bringing water from tubewell (source) to place of storage , buckets were
advised to be covered .
✔ The family was advised that drinking water should preferably be stored in
metal containers .
✔ A mug with a long handle should be used for drawing out water .
FAMILY LEVEL : -
 The wife of the head of the family was advised to undergo sugar
restriction and exercise to improve glycaemic control . She was also
advised to restrict salt intake.
 The daughter in law of the head of the family was advised to carryout
moderate physical activities at least 3 times a week to reduce her weight .
 Mother was following cafeteria choice for family planning measures and
was acknowledge for the same.
COMMUNITY LEVEL :-
✔ They were recommended to talk to the respective governing body regarding
the spraying of insecticides and DDT around their house .
✔ They were acknowledged for their practice of disposing the garbage along
with the municipality and were encouraged to continue the same in future .
NUTRITIONAL

 The family was advised to consume low fat diet .

 They were advised to consume diet rich in calories
(except diabetic individual) , protein , iron , vitA , VitB1
and vitB2 like milk , fresh fruits , more of red meat etc.
 The daughter in law of the head of the family and the
child was advised to take IFA prophylaxis each according
to their respective ages .
 LIMITATIONS

 All the members of the family were not present(HOF and Son of HOF) hence
their clinical checkup could not be done
 The diet survey was done based on 24hrs recall method. So its accuracy is
limited by recall bias.
 Individual consumption cannot be determined by this method as 24 hours
recall method does not fully reflect one dietary cycle.
 Time constraint was a limitation .
 Income details were recorded as said and no proof was produced , hence not
reliable .
 Medical Documents and Lab. Reports of previous diseases could not be
obtained .
REFERENCES

 Family health care - A practical guide book

 Park’s Textbook of preventive and social medicine – 25TH
edition
 ACKNOWLEDGEMENT

❑ We wish to express our sincere gratitude to Prof. Dr. Indira Dey, HOD, Dept.
of Community Medicine, NRS Medical College, for giving us an opportunity to
do this family visit.
❑ We sincerely thank our guide for her guidance and encouragement in
carrying out this study.
❑ We are also thankful to our guide Dr. Priyanka Mukhopadhyay for her
guidance .
❑ And last but not the least a very sincere thanks to the family we were
allotted for this study.
THANK YOU