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Introduction to Family health




            Kishor Adhikari,
            Asst. Prof., Com. Med.,
            National Medical College and Teaching
            Hospital, Birgunj, Nepal
Introduction

• The family is the unit of service in all health care
  delivery.
• The health of one member affects the welfare of
  other members in the family.
• Every family is unique and it is affected by every
  aspect of community life.
• The health service providers has to understand
  family ways, traditions, customs and beliefs of the
  family.
Family health
• Is part of community health
• Is more than the sum of personal health of
  individual
• Is a unit of health care
Definition of Family
“Family is a group of biologically-related persons
living together and sharing the common kitchen and
purse.”


“Family is group of two or more persons related by
birth, marriage, or adoption and residing together in
a household”
                       US Bureau of Census 1980
The term “family” has been viewed in
number of ways:
• Biologist view:
• Psychologist view:
• Economics views:
• Sociologist views
Family Health:
“a state of positive interaction between family
members which enables each members of the family
to enjoy optimum physical, mental, social and
spiritual well being.”

“The health status of the family as a unit including the
impact of the health of one member of the family on
the family as a unit and on individual family
members; also, the impact of family organization or
disorganization on the health status of its members.”
                        Online medical dictionary
Functions of the family:
• Socialization of family members.
• economic stability.
• sexual needs.
• care of dependent members.
• emotional support for members.
• satisfy social, intellectual, emotional and
  psychological needs of members.
Contd.
• Teaches children rules for behaviour and
  socially approved conduct.
• Provides members with sense of family
  identifications.
• Sickness role, interactions among family
  members in health, disease, counselling and
  rehabilitation.
Determinants of family health

 • Living and working conditions
 • Physical environment,
 • Psycho-social environment
 • Education and economic factors
 • health practices
 • Cultural factors
 • Gender etc.
Scope and components of family health

1. Problems faced by family:
   Broken homes, drug abuse, juvenile
   delinquency, disability and
   rehabilitation, unmarried mothers, teenage
   pregnancy
2. Reproductive health
• Safe motherhood, ANC, delivery
   care, PNC, Family planning, Nutritional
   deficiencies, LBW
• STIs/RTIs/HIV/AIDS, legal abortion, infertility
   services,
• Adolescent health
Contd.

3. Child health
•        Child bearing, rearing,
•        Child health services: nutrition, immunization,
         Growth monitoring
•        Mortality and mortality of children
•        Social problems of children:
    ▫   Child abuse
    ▫   Abandoned or street children
    ▫   Child labour
    ▫   Juvenile delinquency
    ▫   battered baby syndrome
Contd.

4. Gender issues in family:
 GBV, Girls trafficking, Gender mainstreaming,
 Female Genital Mutilation (FGM), female
 feoticide (sex-selective abortion),
5. Aging:
 Problems of ageing, active ageing
6. Mental health:
 situation of mental health, its causes and
 prevention, National mental health policy
Roles of family and peer group in health

  As there is a famous proverb, “The secret of
  health lies in the family”, a family can plays
  various roles to uplift the health status of its
  members. The family role may be summarized as
  bellow:
 Family as a teacher:
 Family as a health service provider:
 Family as a counselor:
Contd.
Family as a motivator:
Family as a monitor:
Family as a trainer:
Family as a controller:
Family as a care taker:
peer group
• A group of friends or associates usually of similar
  background social status and age who are likely to
  influence a person's beliefs and behaviour
• Members of a particular peer group often have
  similar interests and backgrounds, bonded by the
  premise of sameness.
• Peer groups offer the chance to discuss interests
  that adults may not share with their children
Role of Peer group in health

• Serve as a source of health information
• Help to reduce mental stress and anxiety
• Help to be acquainted on physical and emotional
  changes
• Give support in acute as well as chronic illness
• Give support to during disability
Contd.



• Though Peer group may have very positive roles
   on health but in may circumstances there may
   be very harmful consequences on health like -
     substance abuse, involvement in criminal
             activity and sexual abuse.
Responsibilities of family in health and
disease:
1.   Child rearing
2.   Socialization
3.   Personality formation
4.   Care of dependant adult:
  1. Care of sick and injured
  2. Care of pregnant and childbirth
  3. Care of aged and handicapped
5.   Stabilization of adult personality
6.   Familial susceptibility to diseases
7.   Broken homes
8.   Problem family
Responsible parenthood
• Responsible Parenthood is the core
  responsibilities of parents to provide the needs of
  the children they have in terms of the aspects in
  life.
• It refers to the will, ability and commitment of
  parents to respond to the needs and aspirations of
  the family and children.
• It is the act of putting the needs of the child over
  self.
Parenting
Definition:
  “Parenting or child rearing is the process of
  promoting and supporting the
  physical, emotional, social and intellectual
  development of a child from infancy to adulthood.”
• Parenting is usually done by the biological parents of
  the child although governments and society take a
  role as well.
• In many cases, orphaned or abandoned children
  receive parental care from non-parent blood relations.
• Parenting may be influenced by various factors
  as:
 ▫ Social class
 ▫ Economic status
 ▫ Education etc.
Parenting styles
•   Authoritarian (very rigid and strict)
•   Authoritative ( positive reinforcement)
•   Permissive (freedom & autonomy)
•   Uninvolved (physically, emotionally not
    supportive)
Role and responsibilities of parent:
A parent must:
• Protect his/her young from physical harm.
• Provide physical necessities, such as food, water,
  clothing protection from the ailments.
• Provide emotional necessities.
• Assist with education in preparation for the child
  to become a productive adult.
• Provide moral guidance so that the child can turn
  out to be a responsible adult.
Parenting education

• Parenting education is a course or programme
  which is given to raising successful
  children, creating competent, confident
  parents, and building strong families and
  communities.
• With love, limits, and lots of
  involvement, parents can have a major influence
  in developing happy, healthy and well-behaved
  children.
Contd.
• A parent education program is a course that
  can be followed to correct and improve a
  person's parenting skills, such courses may be
  general, covering the most common issues parents
  may encounter, or
  specific, for infants, toddlers, children and teenager
  s.
• These courses may also be geared towards parents
  who are considering having a
  child, or adopting one, or are pregnant.
Positive deviance



 Meaning of Positive Deviance?
 • Positive Déviance menas Positive Exception.
 • Positive Deviance is an initiative for reduction and
   prevention of problems among children in the age
   group of 0-3 years by the UNICEF.
 • Positive Deviance also means replication of good
   practices.
Contd.

• Positive Deviance is an approach which reflects a
  positive social attitude resting on the belief
  that, there are certain individuals(positive
  Deviants) in every community whose special or
  uncommon beneficial practices and behaviours
  enable them to find better ways to prevent
  problems in their children then their neighbours
  who share the same resources and face the same
  risks.
Definition of PD:
“Positive deviance (PD) refers to a phenomenon
 that exists in many resource-poor
 communities, that is, the finding that a few
 individuals and families employ
 uncommon, beneficial practices that allow them
 and their children to have better health as
 compared to their similarly impoverished
 neighbours.”
Key concept of Positive Deviance


• Members of the community get opportunities to
  observe & learn from the PD caregivers &
  practice PD behaviours for improving nutritional
  status of their children.
• These behaviours are likely to be acceptable &
  affordable and sustainable by the wider
  community as these are already being practiced.
Contd.
• The presence of Positive Deviants demonstrates
  that it is possible to find successful solutions
  TODAY before all the underlying causes are
  addressed!
Life cycle perspective in health

• The meaning of the term “life-cycle‟ is two-fold: “Firstly,” it
  reflects a continuum of age-stages where the needs of an
  individual changes through their life, from conception to
  death.
• Secondly, it‟ refers to the different stages and events of life
  which an individual or household passes through, and which
  often bring with it a different status given to individuals such
  as becoming a widow/er, a single mother, an adolescent, or
  unemployed.
Life cycle perspective in health
• A life cycle perspective suggests that different
  intervention packages should be developed and
  disseminated by considering various phases of
  an individuals life-cycle starting from early
  neonate to old age.




•
Assessment of Risks to Poor at Critical Life-Cycle Stages
A life cycle perspective in health
 • Actions, both positive and negative, taken at one
   stage in a woman’s life can and will affect her
   throughout her life.

For example:
  Exclusive breastfeeding during the first 4-6 months provides infants
  with the antibodies and nourishment needed to begin a healthy life.
  A woman who develops a reproductive tract infection and does not
  receive appropriate treatment can become infertile.
  Girls fed inadequately during childhood may have stunted
  growth, leading to higher risk of obstructed labor.
  A child who got appropriate caring during his/her childhood may
  develop intellectually as well as physically throughout life.
A example of life cycle perspective in MCH issues
• Over the years, women’s health needs have been
  addressed through maternal and child health
  programmes, focusing primarily on narrow aspect of
  their lives.
• With this perspectives, women’s health is now being
  viewed holistically – as a continuum of care that starts
  before birth and progresses cumulatively throughout
  her life.
• This lifecycle approach extends beyond women’s
  reproductive role to encompass women’s health at
  every stage and in every aspect of their lives.
• Through this approach, other health issues affecting
  women that were previously overlooked, or thought not
  to exist, have become more apparent.

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Family health

  • 1. Introduction to Family health Kishor Adhikari, Asst. Prof., Com. Med., National Medical College and Teaching Hospital, Birgunj, Nepal
  • 2. Introduction • The family is the unit of service in all health care delivery. • The health of one member affects the welfare of other members in the family. • Every family is unique and it is affected by every aspect of community life. • The health service providers has to understand family ways, traditions, customs and beliefs of the family.
  • 3. Family health • Is part of community health • Is more than the sum of personal health of individual • Is a unit of health care
  • 4. Definition of Family “Family is a group of biologically-related persons living together and sharing the common kitchen and purse.” “Family is group of two or more persons related by birth, marriage, or adoption and residing together in a household” US Bureau of Census 1980
  • 5. The term “family” has been viewed in number of ways: • Biologist view: • Psychologist view: • Economics views: • Sociologist views
  • 6. Family Health: “a state of positive interaction between family members which enables each members of the family to enjoy optimum physical, mental, social and spiritual well being.” “The health status of the family as a unit including the impact of the health of one member of the family on the family as a unit and on individual family members; also, the impact of family organization or disorganization on the health status of its members.” Online medical dictionary
  • 7. Functions of the family: • Socialization of family members. • economic stability. • sexual needs. • care of dependent members. • emotional support for members. • satisfy social, intellectual, emotional and psychological needs of members.
  • 8. Contd. • Teaches children rules for behaviour and socially approved conduct. • Provides members with sense of family identifications. • Sickness role, interactions among family members in health, disease, counselling and rehabilitation.
  • 9. Determinants of family health • Living and working conditions • Physical environment, • Psycho-social environment • Education and economic factors • health practices • Cultural factors • Gender etc.
  • 10. Scope and components of family health 1. Problems faced by family: Broken homes, drug abuse, juvenile delinquency, disability and rehabilitation, unmarried mothers, teenage pregnancy 2. Reproductive health • Safe motherhood, ANC, delivery care, PNC, Family planning, Nutritional deficiencies, LBW • STIs/RTIs/HIV/AIDS, legal abortion, infertility services, • Adolescent health
  • 11. Contd. 3. Child health • Child bearing, rearing, • Child health services: nutrition, immunization, Growth monitoring • Mortality and mortality of children • Social problems of children: ▫ Child abuse ▫ Abandoned or street children ▫ Child labour ▫ Juvenile delinquency ▫ battered baby syndrome
  • 12. Contd. 4. Gender issues in family: GBV, Girls trafficking, Gender mainstreaming, Female Genital Mutilation (FGM), female feoticide (sex-selective abortion), 5. Aging: Problems of ageing, active ageing 6. Mental health: situation of mental health, its causes and prevention, National mental health policy
  • 13. Roles of family and peer group in health As there is a famous proverb, “The secret of health lies in the family”, a family can plays various roles to uplift the health status of its members. The family role may be summarized as bellow: Family as a teacher: Family as a health service provider: Family as a counselor:
  • 14. Contd. Family as a motivator: Family as a monitor: Family as a trainer: Family as a controller: Family as a care taker:
  • 15. peer group • A group of friends or associates usually of similar background social status and age who are likely to influence a person's beliefs and behaviour • Members of a particular peer group often have similar interests and backgrounds, bonded by the premise of sameness. • Peer groups offer the chance to discuss interests that adults may not share with their children
  • 16. Role of Peer group in health • Serve as a source of health information • Help to reduce mental stress and anxiety • Help to be acquainted on physical and emotional changes • Give support in acute as well as chronic illness • Give support to during disability
  • 17. Contd. • Though Peer group may have very positive roles on health but in may circumstances there may be very harmful consequences on health like - substance abuse, involvement in criminal activity and sexual abuse.
  • 18. Responsibilities of family in health and disease: 1. Child rearing 2. Socialization 3. Personality formation 4. Care of dependant adult: 1. Care of sick and injured 2. Care of pregnant and childbirth 3. Care of aged and handicapped 5. Stabilization of adult personality 6. Familial susceptibility to diseases 7. Broken homes 8. Problem family
  • 19. Responsible parenthood • Responsible Parenthood is the core responsibilities of parents to provide the needs of the children they have in terms of the aspects in life. • It refers to the will, ability and commitment of parents to respond to the needs and aspirations of the family and children. • It is the act of putting the needs of the child over self.
  • 20. Parenting Definition: “Parenting or child rearing is the process of promoting and supporting the physical, emotional, social and intellectual development of a child from infancy to adulthood.” • Parenting is usually done by the biological parents of the child although governments and society take a role as well. • In many cases, orphaned or abandoned children receive parental care from non-parent blood relations.
  • 21. • Parenting may be influenced by various factors as: ▫ Social class ▫ Economic status ▫ Education etc.
  • 22. Parenting styles • Authoritarian (very rigid and strict) • Authoritative ( positive reinforcement) • Permissive (freedom & autonomy) • Uninvolved (physically, emotionally not supportive)
  • 23. Role and responsibilities of parent: A parent must: • Protect his/her young from physical harm. • Provide physical necessities, such as food, water, clothing protection from the ailments. • Provide emotional necessities. • Assist with education in preparation for the child to become a productive adult. • Provide moral guidance so that the child can turn out to be a responsible adult.
  • 24. Parenting education • Parenting education is a course or programme which is given to raising successful children, creating competent, confident parents, and building strong families and communities. • With love, limits, and lots of involvement, parents can have a major influence in developing happy, healthy and well-behaved children.
  • 25. Contd. • A parent education program is a course that can be followed to correct and improve a person's parenting skills, such courses may be general, covering the most common issues parents may encounter, or specific, for infants, toddlers, children and teenager s. • These courses may also be geared towards parents who are considering having a child, or adopting one, or are pregnant.
  • 26. Positive deviance Meaning of Positive Deviance? • Positive Déviance menas Positive Exception. • Positive Deviance is an initiative for reduction and prevention of problems among children in the age group of 0-3 years by the UNICEF. • Positive Deviance also means replication of good practices.
  • 27. Contd. • Positive Deviance is an approach which reflects a positive social attitude resting on the belief that, there are certain individuals(positive Deviants) in every community whose special or uncommon beneficial practices and behaviours enable them to find better ways to prevent problems in their children then their neighbours who share the same resources and face the same risks.
  • 28. Definition of PD: “Positive deviance (PD) refers to a phenomenon that exists in many resource-poor communities, that is, the finding that a few individuals and families employ uncommon, beneficial practices that allow them and their children to have better health as compared to their similarly impoverished neighbours.”
  • 29. Key concept of Positive Deviance • Members of the community get opportunities to observe & learn from the PD caregivers & practice PD behaviours for improving nutritional status of their children. • These behaviours are likely to be acceptable & affordable and sustainable by the wider community as these are already being practiced.
  • 30. Contd. • The presence of Positive Deviants demonstrates that it is possible to find successful solutions TODAY before all the underlying causes are addressed!
  • 31. Life cycle perspective in health • The meaning of the term “life-cycle‟ is two-fold: “Firstly,” it reflects a continuum of age-stages where the needs of an individual changes through their life, from conception to death. • Secondly, it‟ refers to the different stages and events of life which an individual or household passes through, and which often bring with it a different status given to individuals such as becoming a widow/er, a single mother, an adolescent, or unemployed.
  • 32. Life cycle perspective in health • A life cycle perspective suggests that different intervention packages should be developed and disseminated by considering various phases of an individuals life-cycle starting from early neonate to old age. •
  • 33. Assessment of Risks to Poor at Critical Life-Cycle Stages
  • 34. A life cycle perspective in health • Actions, both positive and negative, taken at one stage in a woman’s life can and will affect her throughout her life. For example: Exclusive breastfeeding during the first 4-6 months provides infants with the antibodies and nourishment needed to begin a healthy life. A woman who develops a reproductive tract infection and does not receive appropriate treatment can become infertile. Girls fed inadequately during childhood may have stunted growth, leading to higher risk of obstructed labor. A child who got appropriate caring during his/her childhood may develop intellectually as well as physically throughout life.
  • 35. A example of life cycle perspective in MCH issues
  • 36. • Over the years, women’s health needs have been addressed through maternal and child health programmes, focusing primarily on narrow aspect of their lives. • With this perspectives, women’s health is now being viewed holistically – as a continuum of care that starts before birth and progresses cumulatively throughout her life. • This lifecycle approach extends beyond women’s reproductive role to encompass women’s health at every stage and in every aspect of their lives. • Through this approach, other health issues affecting women that were previously overlooked, or thought not to exist, have become more apparent.