LIVELIHOOD TRAINING
particular trade. Livelihoods may or may not
OBJECTIVE:
To minimize poverty and inequality by
generating employment among poor
households and by moving highly vulnerable
households into sustainable livelihoods and
toward economic stability
LIVELIHOOD DEFINITION:
Livelihood comprises the capabilities, assets
(including both material and social resources)
and activities required for a means Of living.
A livelihood is sustainable when it can cope with
and recover from stress and shocks and
maintain or enhance its capabilities and assets
both now and in the future, while not
undermining the natural resource base.
(Chambers & Conway, 1991)
Livelihoods are ‘means of making a living’, the
various activities and resources that allow
people to live.
“Livelihood comprises the capabilities, assets
(including both material and social) and
activities required for a means of living.
(Chambers and Conway, 1992)
A livelihood is sustainable when it can:
 cope with, and recover from stress and
shocks (drought, flood, war, etc.),
 maintain or enhance its capabilities and
assets, while not undermining the
natural resource base”.
Livelihood and Income generation
Livelihood
A livelihood, on the other hand, is engagement
in a number of activities which, at times, neither
require a formal agreement nor are limited to a
involve money. Jobs invariably do. Livelihoods
are self-directing. .... . Livelihoods are based on
income derived from "jobs", but also on
incomes derived from assets and entitlements. "
Income generation
“A income generation connotes one particular
activity or trade that is performed in exchange
for payment. It is also a formal agreement, as
manifested by a contract, between an employer
and employee....... An income generation can,
however, comprise part of an overall livelihood,
but does so only to complement other aspects
of a livelihood portfolio.
Principal of livelihood
People-centred: beginning by understanding
peoples’ priorities and livelihood strategies.
Responsive and participatory: responding to
the expressed priorities of poor people.
Multi-level: ensuring micro-level realities
inform macro-level institutions and processes.
Conducted in partnership: working with public,
private and civil society actors.
Sustainable: environmentally, economically,
institutionally, and socially.
Dynamic: ensuring support is flexible and
process-oriented, responding to changing
livelihoods.
Holistic: reflecting the integrated nature of
people's lives and diverse strategies.
Building on strengths: while addressing
vulnerabilities.
Components of the livelihoods V. Utilization of informatics and modern
technology in community health nursing.
 HUMAN
 NATURAL Definition of CHN
 SOCIAL
A synthesis of nursing practice and public health
 FINANCIAL
practice applied to promoting and preventing
 PHYSICAL
the health of populations.

Requires a comprehensive understanding and

knowledge of the framework of the community,
its resources and the sociocultural issues
impacting people within a community.

CHN System Development

CHN agencies used computers since the late

1960s.

Mostly functioned for regulatory compliance,

billing applications, and statistical reporting
related to community health.

Grew primarily due to consumer choice, cost

control initiatives, and the increase of numbers
of healthcare recipients with chronic illness.

The CHN System Development contributes to

management information system (MISs)

>transforms data into information to measure

Sustainable Livelihoods Approach
 People centred
 Holistic — multiple strategies across
sectors
 Builds on strengths and opportunities
 Dynamic
 Evidence base for policy
 Emphasises sustainability
outcomes, track client progress, exchange
healthcare information among physicians,
nurses, insurers, Managed care companies,
regulatory agencies and public reporting, and
analyze financial data.
These systems supported clinical care delivery,
electronic billing, and had the potential for
multiple user access.
Home Health Information Systems
 Time-sharing Systems
  Stand-Alone systems  Improved patient and provider
 Portability of Data satisfaction
 Point of Care Systems  Patient time savings in tracking and
 Reimbursable Models receiving info
 Managed Care  Reduced need to see a healthcare
 Scheduling Systems provider personally
 Reduced info calls
Telemedicine - More cost-effective care
Being implemented to replace face-to-face  Telemedicine Devices
home visits. Refers to electronic transfer of Community Health Network Systems
medical info and services (voice, data, and
video) from one site to another using An innovative ambulatory care system
telecommunications technology. developed to provide services via computer

Technology includes:  Performs actions but not diagnoses:

 Download the patient record from
 Telemonitors with peripheral biometric hospital to the home database
attachments
 Enter a series of questions about
 Videophone with two-way audio-video symptoms
connectivity
 Track self-care
 In home message devices with disease
 Provide additional info on the condition
management education, advice, and
if self- care is chosen to assist the client
vital sign monitoring
to resolve the problem
 Video cameras for monitoring all
aspects of care delivery particularly on Home High-Tech Monitoring Systems
focusing on wound management and
Using computers to link patients at home to
home care aide supervision
healthcare facilities
 PCs with internet connectivity
 Video conferencing  Monitors biophysical parameters
 Remote defibrillator
Community Health Telemedicine Systems
 Digitalized x-rays, ECG, electronic
Internet Applications stethoscopes, and interactive video
equipment
 Assist in self-diagnosis and preventive
 Alert systems
medicine
 Reduce unnecessary outpatient visits Educational Technology Systems
 Provide self-directed triage
Applications of these systems provide
 Eliminate the “worried-well” aspects of
communication linkages, information access,
many patient-provider interactions
and educational materials
Benefits:
Meets the need for clients to reach beyond retarding the progress of the disease and
their environment to see and hear(experience, disability.
view, visualize)

Healthy Town (program of VNAHPO)

Healthy town is a unique program of the

VNAHPO. It is a partnership with the Area
Agencies on Aging (AAA) who serve seniors at
neighbourhood nutrition sites.

+ Website: www.vnaneaithytown.org

Baby Care Link is a multifaceted telemedicine

communication application of Beth Israel
Deaconess Medical Center design to provide
individualized information to families of very
low birth weight infants.

Future Trends Primordial prevention:

Community health information networks will Primordial prevention is defined as prevention

link multiple providers, patient info, and
regulatory bodies on a single system allowing
for integration of data, continuity of care, and
the tracking of outcomes across service
providers.
of risk factors themselves, beginning with
change in social and environmental conditions
in which these factors are observed to develop,
and continuing for high risk children,
adolescents and young adults.

Decision support systems will become more It is the prevention of the emergence or
sophisticated development of risk factors in countries or
population groups in which they have not yet
Geographic information system technology will appeared.
also be incorporated
The main intervention in primordial prevention
VI. Prevention and Management of is through individual and mass education.
complications
Primordial prevention, a relatively new concept,
PREVENTION is receiving special attention in the prevention
of chronic diseases. For example, many adult
The management of those factors that could
health problems (e.g. obesity, hypertension)
lead to Disease so as to prevent the occurrence
have their early origins in childhood, because
of disease. (MOSBY DECTIONARY)
this is the time when lifestyles are formed (for
Prevention is the action aimed at eradicating, example, smoking, eating patterns, physical
eliminating or minimizing the impact of disease exercise).
and disability, or if none of these are feasible,
Primordial prevention begins in childhood when
health risk behaviour begins. Parents, teachers
and peer groups are important in imparting
health education to children.
EXAMPLES
 National policies and programs on
nutrition involving the agricultural
sector, the food industry, and the food
import- export sector
 Comprehensive policies to discourage
smoking
 Programs to promote regular physical
activity
 Making major changes in lifestyle
Primary prevention:
Primary prevention can be defined as the action
taken prior to the onset of disease, which
removes the possibility that the disease will
ever occur.
It signifies intervention in the pre-pathogenesis
phase of a disease or health problem.
Primary prevention may be accomplished by
measures of “Health promotion” and “specific
protection
Approaches for Primary Prevention
The WHO has recommended the following
approaches for the primary prevention of
chronic diseases where the risk factors
areestablished:
— a. Population (mass) strategy
— b. High -risk strategy
High -risk strategy:
The high -risk strategy aims to bring preventive
care to individuals at special risk.
This requires detection of individuals at high risk
by the optimum use of clinical methods.
Secondary prevention
It is defined as “ action which a the progress of a
disease at its incipient stage and prevents
complications.”
The specific interventions are: early diagnosis
(e.g. screening tests, breast self examination,
pap smear test, radiographic examinations, case
finding programme, etc) and adequate
treatment.
Secondary prevention attempts to arrest the
disease process, restore health by seeking out
unrecognized disease and treating it before
irreversible pathological changes take place,
and reverse communicability of infectious
diseases.
It thus protects others from in the community
from acquiring the infection and thus provide at
once secondary prevention for the infected
ones and primary prevention for their potential
contacts.
Early diagnosis and treatment
WHO Expert Committee in 1973 defined early
detection of health disorders as “ the detection
of disturbances of homoeostatic and
compensatory mechanism while biochemical,
morphological and functional changes are still
reversible.”
The earlier the disease is diagnosed, and
treated the better it is for prognosis of the case
and in the prevention of the occurrence of
other secondary cases.
Tertiary prevention:

It is used when the disease process has Rehabilitation

advanced beyond its early stages.
Rehabilitation is “the combined and
It is defined as “all the measures available to coordinated use of medical, social, educational,
reduce or limit impairments and disabilities, and and vocational measures for training and
to promote the patients’ adjustment to retraining the individual to the highest possible
irremediable conditions.” level of functional ability.”

Intervention that should be accomplished in the

stage of tertiary prevention are disability
limitation, and rehabilitation.

Impairment:

Impairment is “any loss or abnormality of

psychological, physiological or anatomical
structure or function.”

DISABILITY:

Disability is “any restriction or lack of ability to

perform an activity in the manner or within the
range considered normal for the human being.”

Handicap

Handicap is termed as “a disadvantage for a

given individual, resulting from an impairment
or disability, that limits or prevents the
fulfilment of a role in the community that is
normal (depending on age, sex, and social and
cultural factors) for that individual.”