Community Health

To carryout activities to bring improvement in an individual and environmental health with the help of community members, by identifying community health problems and to solve them for the community, of the community and by the community is called community health.

Aspects of health education

• Preventive: Taking preventive measures not to get sick
• Curative: Getting proper treatment
• Promotive: Maintaining and promoting health
• Rehabilitation: Providing training, skill, knowledge, to people, regarding health.

Importance of community health

1. To create healthy environment

   

   Community health deals with the various health problems of the community and nation. If we know that various diseases are due to unhealthy environment, we start keeping our environment neat and clean. For this, individual effort doesn't work. So, We should launch a campaign to clean the environment by creating public awareness and increasing participation of community people.

2. To create healthy manpower

   It is necessary to have the healthy manpower for the development of a country. Healthy manpower is only possible with healthy behaviour. However, a single effort of a person is not adequate. If every member of the community understands the importance of community health, then individual health is easily attained because of the joint effort to fight against the cause of disease. When a man is healthy, he can contribute to the national environment.

3. Availability of health services

   The community health emphasises that health services must be available in every corner and grassroots level of the country for good health. Health services can be available everywhere if suitable plans are prepared and effectively implemented.

4. Feeling of social service

   If people know about community health, they will realise that a single person cannot solve community health problems. Mobilization of the whole community is essential. The establishment of Paropakar Association, Nepal Red Cross Society, various local clubs, national and international clubs and other institutions are the outcome of the feeling of community effort.

Major health problems of Nepal

Without solving various health problems, healthy manpower is almost impossible to prepare. Health problems vary from community to community. Remedies must be adopted according to these problems. The major health problems of Nepal are as follows:

1. Prevalence of infectious diseases

   The infectious diseases, which are not taken as problems in under -developed countries, are still major health problems in our country. We can get rid of several such diseases by maintaining sanitation in our surrounding, food and water. Cleanliness ensures safety from diseases like diarrhoea, cholera, typhoid, leprosy, etc. infectious diseases are still increasing because of the prevalence of illiteracy, lack of health knowledge and social traditions. Therefore, it can be taken as a serious health problem.

2. Malnutrition

   

   Malnutrition is the condition produced because of under-nutrition. Sometimes, over nutrition also causes malnutrition. The main reason behind malnutrition in Nepal is inadequately balanced diet. Malnutrition is the consequence of Nepal’s geographical features, poverty, illiteracy, social customs and traditions, the inefficiency of health services and prevalence of communicable diseases. Due to the transportation problem, foodstuff produced in the Teraiis not easily available to the people in different parts of Nepal. Cultural traditions are also responsible for the malnutrition in Terai. Various diseases easily affect malnourished people hindering their physical and mental development. Malnutrition affects especially growing children. Consequently, infant and child mortality rate are still high in our country.

3. High infant mortality rate

   One of the major health problems of Nepal is high infant mortality rate. Owing to infant mortality, parents are in doubt in the survival of their children. Consequently, they produce more children for possible compensation. This leads to population growth and problems in proper care for mothers and children.

4. High maternal mortality rate

   High maternal mortality rate is another major health problem of Nepal. About 500 thousand women die of the complication of pregnancy in a year in the world. About 99% of this death occurs in developing countries like Nepal. The challenge of maternal mortality is more threatening in the developing countries than in the developed ones.

5. Poverty

   

   Nepal is one of the poorest countries in the world. More than 30% of the people here are living below absolute poverty line. They are hardly able to fulfil their hunger in time. They lack essential clothes and food. They don't get necessary health services and facilities. The overall education and health status of the country are miserable due to the lack of adequate investment in those areas.

6. Lack of health education

   Because of the poor educational level and high illiteracy in Nepal, the access to health education is very low. Lack of education is the cause of superstitions. Sick people go to Dhami/Jhankri instead of health institutions. It has degraded the health status of people. Because of superstition, many people die of various diseases. If the level of education is improved, many health related problems can be solved easily.

7. Lack of health service

   Basic health service is inadequate in comparison to the annually increasing population in Nepal. Only 10 to 15% people have been getting health services. Hospitals have not been established according to the need of people. Existing government hospitals are not well-managed. Private hospitals and nursing homes are expensive and available only in major cities. Therefore, the problem of health services is extremely severe in rural areas. Some remote villagers neither see hospitals, nor doctors. In the lack of health services and facilities, people are not acquiring good health. This is another problem in public in Nepal.

8. Rapid population growth

   Among various health problems in Nepal, rapid population growth is very challenging and serious. It causes lack of the facilities for food supply and health services. Apart from this, it creates the problems like diseases, malnutrition and morbidity.

9. Nepalese lifestyle

   One of the major causes health problems in Nepal is typical Nepalese lifestyle. It denotes food habits, tobacco chewing, smoking, alcoholism and hard physical work with little rest in the majority of the people. WHO has explained these things as the causative factors for non-communicable diseases. In Nepalese meal, high content of carbohydrate, spicy food, fried and instant food are included. They cause diabetes and heart diseases.

10. Sanitation problem

    Poor sanitation is another health problem in Nepal. More than one-third of the total households do not have toilets as per the census 2011. Lack of proper management of solid waste and wastewater becomes the cause of communicable diseases. In urban areas, shortage of water is a severe problem in Nepal. Shortage of water creates sanitation problem.

11. Lack of medical care

    The health services and facilities are not adequate in Nepal. Most of the district hospitals lack doctors despite availability. The health institutions are also not adequate and easily accessible to the people in remote villages. Besides, available health institutions are not equipped with the required medicine and equipment. The specialist’s service is even rare.

12. Superstition

    Nepalese societies are rather traditional and have strong faith in religion as well as socio-cultural values and norms. There is high prevalence of social and cultural superstition. Illiterate people believe on Boksi, Dhami-Jhankri, Bhagya (luck), Shrap (curse) of God, Jharfuk, etc. They lose time and money at first and only in severely deteriorated condition of the patient, they seek modern medical treatment. Some of the patients die because of such superstitions.

Roles of individual, family and community in the solution of major health problems

An individual can not solve health problems. Family, community and nation should also try their best. International organisations, too, have to play the vital role in it. The problems are difficult without the cooperation of all of them.

1. Role of an individual

   An individual is a member of family and community. If he is conscious, he can lead the family and community on the right track. If he undervalues his ability, health problems cannot be solved. He can be a pioneer, and if he succeeds, others will follow him. Therefore, the main responsibility for the solution to health problems lies on his shoulder. If he commits, he will find thousands helping hands to follow him. Similarly, the society or the nation is composed of individuals. If each individual becomes healthy, the entire community and the nation will have healthy people.

2. Role of a family

   The role of the family in solving health problems is very important. It is considered as the first school in the process of socialisation and civilisation. The people who are from a good family background can guide the community. When a person initiates solving community health problems with the co-operation of the co-operation of the members of his family, the other families are also inspired. Then, the community will get rid of health problems as a result of joint effort. The betterment of the family health problems like malnutrition, infant and child mortality , etc comes up with achievements for the community.

3. Role of a community

   There are various health problems which cannot be prevented only by an individual or a family. Drinking water supply, management of sewage, cleanliness of public places, construction of public toilets, the establishment of hospitals, playgrounds, parks, etc. are the things which a single person or a family cannot do. They all depend on the co-operation and assistance of the society. In this way, a society can play a very significant role for the solution of health problems. Public awareness and environmental sanitation cannot be carried out unless the community operates. The community must find appropriate ways to solve community health problems.