RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALORE

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION.

1 NAME OF THE

CANDIDATE AND

ADDRESS

Ms. SHILPA N. KUGALI.

I YEAR M.SC. NURSING,

N.D.R.K. COLLEGE OF NURSING

B.M. ROAD HASSAN

2 NAME OF THE

INSTITUTIONN.D.R.K. COLLEGE OF NURSING,

HASSAN, KARNATAKA

3 COURSE OF STUDY

AND SUBJECT

MASTER OF SCIENCE IN NURSING

COMMUNITY HEALTH NURSING

4 DATE OF ADMISSION

TO THE COURSE

11th MAY 2007

5 TITLE OF THE TOPIC “COMPARATIVE STUDY TO ASSESS

THE KNOWLEDGE OF RURAL AND

URBAN PRIMARY SCHOOL

TEACHERS REGARDING SELECTED

COMMON HEALTH PROBLEMS”.

5.1 STATEMENT OF THE

PROBLEM

“A STUDY TO ASSESS THE

KNOWLEDGE OF RURAL AND

URBAN PRIMARY SCHOOL

TEACHERS REGARDING SELECTED

COMMON HEALTH PROBLEMS OF

SCHOOL CHILDREN AT HASSAN

DISTRICT”.

6. BRIEF RESUME OF THE INTENDED STUDY:-6.1. INTRODUCTION:-

The health of children & youth is a fundamental value. Health services for

schoolchildren are a must for building a healthy young India. Over one fifth of our

population comprises of children aged 5-14years which is the age group covering primary

and secondary education. Among these only about 80% of children are enrolled and

about 65% are regularly attending school on an average for 200 days in a year.1

Children between 5-14 years of age spend most of their time in the school. The

school is an ideal place for learning and growing up. If schools are to become power

house of health education, we need to go for a change in the curriculum. The World

Health Organization considers school as a health promoting one when it is constantly

strengthening its capacity as a healthy setting for living , learning and working. Health

education, health services, and healthy school environment are components of such

schools. “Schools can do more than any other institution in society to help young people

live healthier, longer and more productive lives”.2

The teacher has maximum opportunity for close observation of children’s health

and to find out the deviation from normal health. As school heath nurses are not

appointed in the schools, this responsibility falls on the teachers. This rich resource and

influencing factor must be tapped in the wider context of the situation and teachers need

to be helped to cope with health and illness of children.3

Various studies have been conducted on selected common school health

problems like worm infestation, oral hygiene and nutritional problem.

A study conducted on Dominican school children aged 4-12 years revealed that

infestation with gastrointestinal parasites was very common with Trichuris affecting 92%

of children, Ascaris in 38%, Necator in 11%, Giardia in18% and E.Histolytica in 1%.This

study concluded that 18 of the 1000 children were found to have a hemoglobin level

below 10g/dl. 4

A study conducted on “oral hygiene in the control of dental caries”, with sample

size of 207 and 197 control school children with mean age 6 years. After 24 months of

professional tooth cleaning and dental health education programme, 179 test and 156

control children were examined and found to have good oral hygiene. The study

concluded that oral hygiene measures may be effective in the control of dental caries of

permanent teeth.5

A study was conducted on impact of child health and nutrition on education in

developing countries. School performance was hampered in children with malnutrition.

This gives evidence that child health and nutrition has a significant impact on education

in developing countries.6

Health survey of Indian schools indicates that morbidity and mortality rates in

children were among the highest in World. Morbidity of school children’s has been

studied in small surveys in Tamilnadu, Kerala, Andhra Pradesh, Madhya Pradesh,

Punjab, Karnataka and Delhi. Most of the surveys yielded more or less similar findings

and the general prevalence of morbidity is as follows:

Dental Ailments (70-90%), Malnutrition (40-75%) Worm infestation (20-40%) Skin

diseases (10%), Eye diseases (4-8%) and Pulmonary Tuberculosis (4-5%). 5

The school health service comprises immunization, screening, surveillance,

counseling, early detection and treatment and referral services. Teacher will be trained

and equipped for recognition of sickness danger signals, giving first aid and referring the

children who need further care. For this purpose training programs have to be designed

jointly with health functionaries for present teachers and suitable changes made in the

training curricula for teachers. 7

The specific objectives of school health service are:

The promotion of positive health

The prevention of disease

Early diagnosis treatment and follow up of defects

Awakening health consciousness in children

The provision of healthful environment.

The aim of school service is to promote, protect and maintain health of school children

and reduce morbidity and mortality in them.8

Any discussion on school health services must be based on the local health

problems of the school child, the culture of the community and the available resources in

terms of money material and manpower. Another survey carried out in India indicates

that the main emphasis will fall on the following criteria: 9

1. Malnutrition

2. Infectious disease

3. Intestinal parasites

4. Diseases of skin, eye and ear.

5. Dental caries.

School health is common community health. Health care which begins at

home should be continued in school. Today’s Children are Tomorrow’s Citizen and

Healthy Citizen are the Nation Pride. Keeping the above facts in mind and growing

realization of importance of health of a school child, this study is under taken amongst

the schools of urban and rural areas of Hassan district.

6.2 NEED FOR THE STUDY:- Health problems of school children are very common, more over most of them

are preventable. Hence primary school teachers could play a significant role in

identifying these health problems among school children. This becomes the vital role of

primary school teachers because of inadequacy of health personnel in giving care to the

school children.9

As per 2001 census India has 375million who are between 5-14 years of age (school

age).10

School children are vulnerable section of population by virtue of their physical,

mental, emotional and social growth during this period. It is in this age their personality

develops .Also they are exposed to various environmental factors which might cause

problems and require health, guidance and care.11

Children coming to school belong to different socio-economic and cultural

backgrounds which affect their health and nutritional status. They require help and

guidance in promoting, protecting and maintaining their health and nutritional status.

Children in school age are prone to get specific health problems. The various

acute and chronic conditions which can be encountered during school period anywhere in

the world include Dental caries, Diarrhea, Worm Infestations, Hepatitis, Anemia,

Scabies, Eczema ,Acne, Influenza , Pneumonia, Diphtheria , Pertusis , Asthma, Fracture,

Measles, Mumps, Chickenpox ,Urinary Tract Infection, Meningitis, Tuberculosis, Eye

and Ear Infections.12

The school teacher is the most important person in whom a child sees the

“Parent figure” away from home .The teacher has tremendous influence on the child

because of the “Emotional Bonding” that takes place between him and the pupil. Many

children accept their teachers as their “Role Model”.13

Teacher’s observation of school children is of particular importance in India because

of the limited number of trained personnel for school health work.

A study was conducted, on participation of primary school teacher in oral health

education Rungwe District, Tanzania. Primary school teachers from 15 rural and 4 urban

schools participated for the provision of oral health education. Result was, teachers

teaching in lower grades were significantly more active in providing oral health education

than those who taught in higher grades. The study concluded that oral health education

seems to be given mainly to primary school pupil in lower grades .There is a need for

influencing teachers in higher grades to be involved in oral health education

programme.14

A study conducted on primary school teacher knowledge and practice of selected

common illness among the school children in Vellore revealed; illness-wise the teachers

knowledge was adequate in case of Vitamin-A deficiency (Causes, Etiology,

Management and Prevention), knowledge related to Vitamin-B deficiency was

moderately adequate and knowledge of teachers regarding prevention and management of

anemia was adequate but regarding causes of anemia knowledge was inadequate .15

A study conducted at Mayis University on 294 school sample (age group 7-13

years) of different social-status and environmental conditions was examined for Intestinal

Parasites. It revealed that parasitic incidence was high in village schools.16

The 9th conference of central council of health and central family welfare council

revealed that the teachers in primary classes should be trained for observing and

screening students for defects and deviations from normal health to maintain effective

surveillance and for providing supportive health education for the prevention of health

problems by developing desirable health habits.17

In the light of the above it is essential to assess the knowledge of primary school

teachers regarding the causes, identification, prevention and responsibilities towards

common health problems in this area .Keeping the above facts in mind and growing

realization of importance of the health of school child, the primary school teachers plays

an important role in providing appropriate school health. Hence, Investigator has

undertaken this study and titled as Comparative study to assess the knowledge of rural

and urban primary school teachers regarding selected common health problem of school

children at Hassan District.

6.3 STATEMENT OF THE PROBLEM:-“A study to assess the knowledge of rural and urban primary school teachers

regarding selected common health problems of school children at Hassan district.”

6.4 OBJECTIVES:-

1. To assess the knowledge of the rural and urban primary school teachers regarding

selected common health problem at Hassan district.

2. To compare the knowledge of the rural and urban primary school teachers regarding

selected common health problems of school children at, Hassan district.

3. To determine the relationship between selected demographic variables of the primary

school teachers and knowledge on selected common health problems of children at,

Hassan district.

6.5 HYPOTHESIS:-There will be significant difference in the knowledge regarding selected common health

problems between the rural and urban primary school teachers.

6.6 ASSUMPTION:-Urban teachers will be having adequate knowledge regarding selected common health

problems than the teachers working in rural area.

6.7. OPERATIONAL DEFINITIONS:-1. ASSESS:-To make judgment about the understanding level of the primary school

teachers regarding common health problems.

2. KNOWLEDEGE:-It refers to the correct responses of primary school teacher on self

administration knowledge questionnaire regarding causes, identification, prevention

and their responsibilities towards selected health problems as evident from the test

score.

3. PRIMARY SCHOOL TEACHER:-A person qualified with diploma in teacher

education or teacher training course or degree holder who has been teaching in a rural or

urban primary schools at Hassan district.

4. SCHOOL CHILDREN:- Referred to children those who are studying from I-V

standard at rural and urban primary schools of Hassan district.

5. SELECTED COMMON HEALTH PROBLEMS:- Referred to common health

problems occurring in school children from I-V Standards in the selected rural and urban

areas which includes nutritional problem, worm infestation and oral hygiene.

6. URBAN: It is an area in a town with better facility.

7. RURAL: It is an area where it does not have much facility and away from the city.

6.8 CRITERIA FOR SELECTION OF SAMPLES:-Inclusion criteria:-

1. Primary school teachers working in rural and urban areas of Hassan

2. Primary school teachers those who are present at time of study

3. Primary school teachers who are willing to participate in the study

Exclusion criteria:-

1. Teachers those who are working in the secondary school.

2. Primary school teachers who are not present at the time of study.

6.9 DELIMITATION OF THE STUDY:-1. Study duration limited to 4-6weeks.

2. Sample size limited to 60 teachers (rural 30 and urban 30).

6.10 SIGNIFICANCE OF THE STUDY:-This study explores the knowledge of the primary school teachers on selected common

health problems of school children.

6.11 CONCEPTUAL FRAME WORK:-“General System Theory”

6.12 REVIEW OF LITERATURE:-Review of literature is a critical summary of research on a topic of interest

generally prepared to put a research problem in context to identify gaps and lacunae in

prior studies so as to justify new investigation.

Literature review was done for the present study and presented in following heading,

1. Studies related to worm infestations.

2. Studies related to Nutritional problem.

3. Studies related to oral hygiene.

4. Role of teachers in caring the children with health problems.

Studies related to worm infestations:-

A study was conducted to assess the relationship between Vitamin-A, Iron status

and Helminthiasis in Bangladeshi school children. The result of study revealed that 20%

had a low level of Vitamin-A, 31% were anemic, 30% had iron deficiency and 14%were

suffering from iron deficiency anemia. The study concludes that proportion of iron

deficiency anemia was significantly greater among children with Hook worm

infestation.18

A study was conducted to assess, whether the physical activity and growth of

Kenyan school children with Hook worm, Trichuris, Ascoris, lubricoids infections were

improved after treatment with Albendazole. For the study 55 Kenya primary school

children’s with Hook worm (93% prevalence) T.trichura (84%prevelence) and

A .lumbricoides (29%prevelence) before and 9 weeks after treatment with three 400mg

doses of Albendazole of placebo, was examined .The revealed that, activity, reported

appetite and most incidence of growth were significantly greater for the Albendazole,

treated group than for the placebo group.19

Studies related to Nutritional problem:-

A study was conducted to evaluate the clinical health and nutritional status of the

most vulnerable segment, i.e. Ashram school children in Kalahandi district of Orissa. Out

of 224 children 4.5% of them had protein energy mal-nutrition in the form of moon face ,

15.2% had Vitamin-A deficiency in the form of Bitots spots (6.7%) and Conjunctival

Xerosis (8.6%).20

A study was conducted on awareness of teacher’s relationship between students

performance and nutrition at Egypt. Mal-nutrition disorder affects more than 30% of

school children in Egypt. School teachers perceive mal-nutrition only as low-body

weight. This lack of awareness, either about nutrition facts or the role of nutrition in

education, leads to miss diagnosis or delayed management of these children. This study

concludes that they suggested an integrated programme between teachers and parents to

over come mal-nutrition disorders through nutrition education and regular school feeding

programme to improve the health status and the education abilities of school children.21

Studies related to oral hygiene:-

A study was conducted to know the prevalence of Dental caries in 509 primary school

children in the age group of 3 to 7 years in Haryana. Prevalence of caries in age group

from 3 to 7 years was 33.8% while the prevalence among 6 years was 38.2%. Thus,

prevalence was significantly higher (p<0.05) at the age of 6 years as compared to 3

years.22

A study was conducted on prevalence of dental caries and risk assessment among

primary school children of 6 to 12 years, in the Varankala Municipal area of Kerala. This

study revealed that the prevalence of Dental caries was 68.5% with the highest decayed,

missed and filled teeth score found in 12 years age group .The study concluded that ,

statistically significant association was found with dental caries , oral hygiene , low –

socio- economic status and prevalence of caries .23

Role of teachers in caring the children with health problem:-

A study was conducted, to evaluate the effectiveness of teaching strategies for

primary school teachers on selected health problems in Anekal taluk, Karnataka state.

The problems selected for study includes Vitamin – A deficiency, Anemia, Dental

problem and Scabies. The major findings of the study were that the primary school

teachers had inadequate knowledge in the four selected health problems. Teaching

strategies increased the knowledge of primary school teachers in the areas of causes,

detection and prevention of selected health problem.24

A study conducted on Descriptive Elementary school teachers and skills in the

management of minor physical problems in Kaniambadi Block of North Arcot district

and Vellore town in TamilNadu, revealed that the urban and rural primary school

teachers were able to identify 32% of children suffering common cold, 47% from dental

caries, and 71% from Angular stomatitis. 48% of the teachers viewed the daily inspection

of students as necessary tool for health promotion and disease prevention. While 48% of

teachers considered themselves capable of carrying out this activity and only 44% viewed

the activity as part of their duty. 25

7. MATERIALS AND METHODS OF STUDY:- 7.1 SOURCES OF DATA COLLECTION: - Data will be collected from the

primary school teachers working in Rural and Urban primary schools of Hassan.

7.2 RESEARCH DESIGN:-Comparative design was chosen for the study to assess

the   Knowledge of primary school teachers regarding selected common health problems

of school Children.

7.3 METHOD OF COLLECTING DATA:-Data collection is planned through

using a structured questionnaire on selected common health problems (Nutritional

problem, Worm Infestations and oral hygiene).

 PART-A: - Demographic variables (Age, Sex, Educational qualification, Religion,      

Marital status, Exposure to school health programme, Different types of

schools- private, government, aided, Years of experience, Exposure to in-

service education, Influence of Mass media).

 PART-B: - Structured questionnaire regarding selected common health problems      

among school children.

 PART-B Divided into following sections

      Section 1:- Nutritional problem.

      Section 2:- Worm Infestations

      Section 3:- Oral hygiene.

 

7.4 SAMPLING PROCEDURE:- I. Population:-

Target population:-All the school teachers at Hassan District.

Accessible population: - Primary school teachers working in Rural and Urban area

II Sample:-The primary school teachers those who are working in primary school at          

Rural and Urban areas of Hassan District.

III Sample size: - 60samples divided in to two groups

30 sample from rural area.

                30 sample from urban area.

IV SAMPLING TECHNIQUE: - Multistage Sampling Technique (Lottery Method),

so that by lottery method the schools will be selected for the study from Rural and

Urban areas. All the teachers from the selected schools will be taken for the study based

on the Inclusion and Exclusion criteria.

V SETTING:-The setting will be the schools coming under Shantigram primary health

Centre for rural area and selected schools in the urban area at Hassan,

District. 

Number of primary schools in Hassan districts-238

Number of primary schools in shantigram primary health centre-10  VI PILOT STUDY:-10% of the population is planned for the pilot study in the Month of

June 2008.

8. VARIABLES:- 8.1 Independent variable: - Selected common health problems.

8.2 Dependent variable: - Knowledge of primary school teachers.

 

9. PLAN FOR DATA ANALYSIS: - It includes Descriptive and Inferential

Statistics.  

Descriptive statistics: - To describe the demographic variables and level of Knowledge,

number, Frequency, Percentage, Mean and Standard Deviation.

Inferential Statistics:-

1)  To associate the demographic variable with knowledge (Chi-square X2).

   2) To compare the knowledge of primary school teachers between rural and urban.

3) Student paired ‘t’ test.

4) ANOVA test.

10. ETHICAL CLEARANCE   1. Informed consent will be obtained from the chosen sample?

       -Yes.

   2. Has ethical clearance being obtained from the institution?

  - Yes, it has been obtained.

11. LIST OF REFERENCES :- ( VANCOUVER STYLE) 1. K.Raghavan Prasad, Indian Journal of Community Medicine School Health, Vol

30, No, 4(2005-10-2005-12).

2. Sowaminathan, School of Good Health, Health Action, June 2001.

3. Antony, K.R, “Health Action Special issue”. 1990, 135-139.

4. Grell, A et al; Dominican School Children aged four to twelve years infestation

With gastrointestinal parasites was very common; 1981 September; 1(3):155-60.

5. Arrow, P, “Oral Hygiene in the control of dental caries”, Community dent oral

Epidemiology .1998, (26); 324-30.

6. Glewwe P; Impact of school health and nutrition an education in developing countries,

Theory, econometric issue, and recent empirical evidence; Food Nutr Bull; 2005 June;

26 (2 suppl 2); S 235-50.

7. Central Health Education Bureau. Report of seminar on School Health Services 1965

, New Delhi.

8. Ideal, Report of workshop for the development of criteria for Health Aspect of a

School Programme, 1965, New Delhi.

9. Park K, Park Text Book of Preventive and Social Medicine, 18th edition M/s

Banarisdas Bhanat Publisher .2005; 425-429.

10. Internet resource “http//www.censusindia.net”, accessed on 14 Oct 2007

11. TNAI, Community Health Nursing Manual, 3rd edition, 1998, Academy press noida.

12. K.K.Gulani, Community Health Nursing, Principles and practice, 1st edition, Kumar

Publishing house; 433-435.

13. Turner.C.E et al, School Health and Education on Health, 1957, C.V.Mosby.

14. Mwangosis IE, Nyandindi U,Matem; Participation of primary school teachers in oral

Health education in Rungwe district, Tanzania; East Afr Med J, 2001 Dec;

78(12), 62-5.

15. Showpackiam. “Assess primary school teacher knowledge and practice of

Selected common illness among the school children in CONCH area”, CMCH,

Vellore; unpublished master thesis, university of madras Vellor, 1997, India.

16. Guruses, N et al,”Microbial Bulletine”.Jan 1991; 25(1); 57.-62.

17. Manjul Jos, 9th conference of central council of health and family

Welfare council, 1983.

18. Persoon, V, et al; Assess the relationship between Vitamin –A, iron status and

Helminthiasis in Bangladesh school children; Public health Nutr 2000.

19. Adamas, E, J et al; Assess whether the physical activity and growth of Kenya School

Children with hook worm, trichuris, and infection were improved after treatment with

Albendazole; Journal of Nutrition, August 1994; 124(8); 1199-1206.

20. Balgir.R.S et al; Evaluate the clinical health and nutritional status of the most

Vulnerable segment, Ashram school children in Kalahandi district of orissa; Indian

Journal of Pediatrics, 2000, 57(1); 550-51.

21. Ismail Ibrahim; Awareness of the teachers of relationship between students

Performance and nutrition status at Egypt’s; National Institute of nutrition of Egypt

2000.

22. Twari S, Prevelance of dental caries in primary school children in the age Group of

3-7years in Haryana; Journal of the India Soc Pedol.preve Dent-June 2001; 19(2);

52-6.

23. Ratna kumari; prevalence of dental caries and risk assessment among Primary school

Children of 6-12 years in the Varkala municipal area of kerala; Journal of Indian Soc.

pedodontics preventive dentistry (17). 1999; 135-42.

24. Esther Shirley S. “Effectiveness of the teaching strategies for primary school

teachers on selected health problems in Anekal Taluk, Karnataka staste”. unpublished

Master thesis, Bangalore University,1998, India.

25. Michel R M." Elementary school teacher’s knowledge and skill in the Management of

min or physical problems in Kaniambadi Block of North Arcot District and Vellore

town, in Tamilnadu”. Unpublished master thesis, University of Madras Vellore,

1998, India.

12 Signature of the candidate Ms.SHILPA .N. KUGALI

13 Remarks of the guideFORWARDED AND APPROVAL FOR REGISTRATION

14 Name and designation

PROF.BERNICE MARGARET HOD OF COMMUNITY HEALTH

NURSING

14.1 Guide PROF. BERNICE MARGARET

14.2 Signature

14.3 Head of the department PROF. BERNICE MARGARET

14.4 Signature

15 Remarks of the principal

FORWARDED AND APPROVAL FOR

REGISTRATION

15.1 Signature