COMMUNITY MEDICINE :-

It is a discipline which deals with the population and

comprises of those doctors who try to measure the need of the population both
sick and the well with the administration of the service to meet the need and
also engage in research and training.
COMMUNITY :-
A community is a group of individual and families living
together in a defined geographical area and usually linked by some common
interest and value.

FAMILY :-
Basic unit of community comprising of a group of
biologically related individuals or related by marriage or adoption living together
and eating from same kitchen.
TYPES OF FAMILY :-
Has a married couple and their dependant
Nuclear family
children

Joint family Which consists of multiple married couple , their

children and their parents.

Broken family
Family where parents are divorced or living separate .

Family which lags behind rest of the community and

Problem family their standard of living is below expected level with their
parents unable to provide physical and emotional needs
to the children
Head of the family :- Is that member of the family who is the principal decision
maker of the family and the family obeys him/her.

Family physician :- treats all the member in a family both ill and well and
assess the state of health of whole family. Thus, he plays a major role in
preventing and curing disease , promoting health and giving knowledge about
national programme , provides health education as well as referral in
complicated cases.
FUNCTION OF FAMILY :-
Residence Family provides suitable residence to its member

Division of labour Proper duration of labour for family members by

sharing up of responsibility among individual of family

Socialisation Forms a bridge between generation .Hence, it is

regarded as the transfer point of civilisation .
Cultural pattern related to eating , cleanliness etc.
are transmitted.
Socio-economic Family provides status in society along with
protection of member from insult and defamation
along with that Inheritance of the property and
ownership are controlled by family .

Reproduction and bringing up of children

 RELEVANCE OF THE FAMILY
HEALTH CARE

This family study programme is instituted by the Community Medicine

department of I.P.G.M.E & R. for several purposes as follows :-

Family being the basic unit of the society or community provides the first
platform for identification of problems in the community and solving them
by a family wise approach.

Since disease occur through interaction between agent , host , and

environment. Thus , prevention of disease occur through ecological or
environmental manipulation or intervention is more effective and rational.

To provide proper health education to the family members

 OBJECTIVES
GENERAL OBJECTIVES=>
-To make a family diagnosis.
-To take necessary action to solve
their health problem , to prevent their health
problem and to promote their health.

SPECIFIC OBJECTIVES=>
-To assess their housing and
environmental condition.
-To assess the socio-economic condition of
the family.
-To assess the health status of the family.
- To assess the nutritional status of the family.
-To assess the knowledge , attitude and
practice of the family regarding common
health related issue(i.e.; common
communicable disease , child feeding
practice and family planning.)
 METHODOLOGY
TYPE OF STUDY=> Descriptive type of
Observational study.
STUDY DESIGN=> Cross-sectional.
STUDY POPULATION=> Family member of the
study family.
STUDY AREA=> Staff Quarter of SSKM Hospital
STUDY PERIOD=> 29th March to 23rd April 2013
STUDY TOOLS=> Pre-designed semi structured
schedule using Stethoscope ,
Sphygmomanometer , Measuring Tape , Weighing
Scale, Torch and Hammer.
 TECHNIQUE OF DATA COLLECTION=>
-Interviewing the family members.
-Transect walk.
-Spot Observation.
-Clinical Examination and Anthropometric
measurements.
-Dietary Survey.
-Review of Records.
 DRUG H
SHOP
EMERGENCY A
R
I
DARGAAH S
H
M
of nursing Main block
U
COLLEGE K
OF
H
NURSING
A
FSM R
DEPTT J
E
HOUSE E
HOUSE R
N MANDIR O
A
D
E
HOUSE STUDY
HOUSE
 FAMILY IDENTIFICATION AND PARTICULARS
A) Identification
Name of the head of the family -Mita Devi Tripathi .
Address -S.S.K.M . Staff quarter ,S.S.K.M. Hospital Kolkata- 20
Family type-joint
Religion -Hindu
Caste - General
Length of stay -30 years
State of origin - Uttar Pradesh
Mother tongue - Hindi
 B) Family Composition -

SI . Name Age Sex Relation with Marital Literacy occupati Income Nature of
NO. H.O.F. status status on work

1 Mita Devi 58 F H.O.F. Widow Primary Homema NA Sedentary

Tripathi ker

2 Sachidanand 35 M Son of 1 Married Second Small 7000 Sedentary

Tripathi ary business

3 Bebi devi 22 F Wife of 2 Married Illiterate Homema NA Sedentary

Tripathi ker

4 Aviraj nand 17 M Son of 3 NA NA NA NA NA

Tripathi mont
hs
5 Vikkinath 28yrs M Son of 1 Married Second Group D 5000 Moderate
Tripathi ary

6 Dipika devi 20yrs F Wife of 5 Married Primary Homema NA sedentary

Tripathi ker
Total number of family members : Male -3
Female-3

Number of infants Nil

Number of 1 to 5 years Male - 1

Female- nil

Number of adolescent Male nil

Female nil

Number of pregnant women 2

Number of lactating women Nil

 PLAN OF THE HOUSE (SCHEMATIC DIAGRAM)

SANITARY LATRINE

11.FT

BED ROOM WINDOW

K

KITCHEN 1ST FLOOR

9.FT
 5f.t

BED ROOM
7.ft

WINDOW

GROUND FLOOR
Type of house:-Pukka

No of Living rooms /bedrooms:-2

Area of other space utilized for living purpose:-N.A.

Total area of the space utilized for living purpose:-134 sq.ft.

Per capita floor space available :24.36sq.ft.

Overcrowding:-Present.
Lighting:-Adequate.

Ventilation:-Inadequate.

Cross ventilation:-Absent.

Dampness:-Absent.
Kitchen:-In verandah

Smoke outlet in Kitchen:- Absent.

Type of fuel used:-Kerosene

Whether pets are kept:-No

Water Supply:-

Source of water:-
Water for Drinking- K.M.C water supply

Water for cooking - K.M.C water supply

Water for cleaning/bathing/washing- K.M.C water supply

 Distance of Drinking water source from the house _
90ft

Mode of supply:-INTERMITENT

Storage water:- Narrow mouth

Method of drawing drinking water from the storage

container:- safe
 Excrete disposal
Latrine type:-community sanitary latrine

Location :-within in premises

Used by :-community
Distance from water source:-3 meter
No. of users:- 48 users

Flushing facility:- Absent (hand flushed toilet)

Water supply for flushing :-adequate

Cleaning done:- weekly

Excreta disposed of under five :-in the sanitary latrine

 Refuse Disposal
Method of
Solid waste disposal :-It is collected in a
bucket & then dumped into the K.M.C VAN
Kitchen waste :-It is disposed at outside the
house indiscriminately
Fly nuisance :- Present
Breeding places of mosquitoes :-Present
(out side the house)
 Socio Economic Characteristics
Total family income per month : Rs.12000
Per capita monthly income of family : Rs. 2000
Modern amenities present in the family : Television , Mobile phones ,
Refrigerator , DVD player

EXPENDITURE BREAKUP OF THE FAMILY (PER MONTH)

Food Rs.4000
Fuel Rs.1000
Rent Rs.500
Health Rs.200
Miscellaneous Rs.500
Addiction Rs.3000
Total Rs.9200

Income and expenditure :Saving

Net saving per month : Rs.2800
 Pie diagram showing the expenditure pattern of the
family
Miscellanous
5%
Rent
5%
Food
44%
Addiction
33%

Fuel
11%

Health
2%
 Socioeconomic status (As per modified Kuppuswamy scale)

Education of head of family : Primary Educational score:2

Occupation of head of family: Unskilled Occupational score :2

Family income per month : Rs. 12000 Score for family income : 10

Thus total score 2+2+10 = 14

The family belongs to lower middle class(class III) in

socioeconomic status.
 Socio-cultural problems
1. Addiction to smoking and drinking in elder son
of Head of the family for the last 16 years and 7
years respectively.

2. Addiction to khaini in younger son of Head of the

family for the last 9 years.

3. Illiteracy of wife of elder son of Head of the

family.
HEALTH STATUS OF INDIVIDUAL FAMILY MEMBERS
(>FIVE YEARS AGE)
Sl. No. 1 Date of Examination: 9/4/2013
Name: Mita Devi Tripathi Age: 58 years Sex : Female
History of present illness: Low back pain
Dizziness
Pain in left knee
History of past illness: No significant history
Personal history: No significant history
Menstrual history: Menopausal for last 14 years.
GENERAL EXAMINATION
Height : 150 cm Weight: 51kg Body mass index: 22.67

Pulse:68/min BP: 118/74 mm of Hg

Pallor :Absent Cyanosis: Absent Jaundice: Absent Clubbing: Absent Edema: Absent

Tongue /Teeth/Gums : Normal

Neck glands: Not palpable Neck Veins: Not engorged

Condition of eye /ear : Normal

 Systemic Examination: No significant finding

Significant laboratory findings: None

Provisional diagnosis : Cervical and lumbar spondylosis

Management: Maintain proper posture

Avoid work which involves bending down
Avoid lifting heavy objects
Refer to orthopaedic OPD
Sl. No. 2 Date of Examination:9/4/2013
Name : Sachidanand Tripathi Age: 35years Sex:Male
History of present illness : No significant history
History of past illness: No significant history
Personal history: addicted to smoking for the last 16 years

addicted to alcohol for the last 7 years

GENERAL EXAMINATION
Height : 180cm Weight: 73kg Body mass index:22.53

Pulse:80\min BP:112/80 mm of Hg

Pallor :Absent Cyanosis: Absent Jaundice: Absent Clubbing: Absent Edema: Absent

Tongue /Teeth/Gums: Brownish stained teeth and gums

Neck glands: Not palpable Neck Veins: Not engorged

Condition of eye /ear : Normal

 Systemic Examination: No significant finding

Significant laboratory findings: None

Provisional diagnosis : Discoloration of teeth and gums

Management :
Counseled about the health hazards of smoking and alcohol and asked to
stop smoking and drinking.
Maintain proper oral hygiene with regular brushing of teeth.
Refer to Dental OPD.
Sl. No. 5 Date of Examination:9/4/13
Name : Vikkinath Tripathi Age:28 years Sex : Male
History of present illness : No significant history
History of past illness: No significant history
Personal history: Khaini addiction for the last 9 years

GENERAL EXAMINATION
Height : 173 cm Weight:60 kg Body mass index:20.05

Pulse :74/min BP: 116/72 mm of Hg

Pallor :Absent Cyanosis: Absent Jaundice: Absent Clubbing: Absent Edema: Absent

Tongue /Teeth/Gums: Brownish stained teeth , gums

Neck glands: Not palpable Neck Veins: Not engorged

Condition of eye /ear : Normal

 Systemic Examination: No significant finding

Significant laboratory findings: None

Provisional diagnosis: Discoloration of teeth and gums

Management:
Counseled about the health hazards of khaini addiction and asked to stop
consuming khaini.
Maintain proper oral hygiene
Refer to Dental OPD
 Check up of under five children
Name- Aviraj Nand Tripathi
Age- 18 months
Date of birth- 17/10/ 2011
Birth weight- 2.85kg
Present weight- 10kg
Disability (if any)- none
Developmental milestone-No developmental delay

Neck holding sitting Crawling standing walking

support Without support Without
support support

3 month 6 months 9 months 10 11 12 15

months months months months
 H/O past illness-Acute bronchiolitis at 4 and months of age.

H/O present illness- no such illness.

Immunisation status of child- upto date.

BCG scar mark- present.

 FEEDING PRACTICE

Prelacteal feeding No
Breast feeding Initiated an hours after birth
Colostrum given Yes
Exclusive breast feeding Given for 6 months
Initiation of complementary feeding After 6 months
Type of food given
Rice, dal , cerelac
Current diet Family diet
Child feeding practice during illness Same quantity of food offered
 Anthropometric Examination
Height/ Length - 80 cm
Weight - 10 kg
Mid arm circumference - 14 cm
Nutritional status(grade)- normal as per
new WHO Child Growth Standards (2006).
 General examination
General appearance- normal
Teeth- normal
Gum- normal
Condition of eyes and ear- normal
Palor/edema/ jaundice- nil
Neck gland- not palpable
Sign of nutritional deficiency- not present
Any other abnormality- not present
Systemic examination-No significant findings.

Significant laboratory diagnosis- NA

Provisional diagnosis-normal healthy child

Management-Mother was advised to avail the

service of ICDS for her child .
ANTENATAL RECORD
Name Of The Mother-Bebi Devi Tripathi
Husbands Name-Sachida nand Tripathi
Age(yrs)- 22 Age at marriage-19 yrs
Gravida-2 LMP-20.12.12 EDD-27.9.13
Date Of Registration-5.3.13
No. Of Antenatal Visits made-1
Tetanus Toxoid Given-Booster Dose-given on 5.3.13

IFA Tablets/Iron-Capsule/Syrup Consumed : No

If No, Reasons : IFA tablet was not started because of nausea,

vomiting
Other Treatment Received : No

H/O present illness :Nil

H/O past illness : Nil

Any significant illness: Diabetes/HTN/TB/STD/Heart

Disease/any other(specify)-No significant illness

Any significant family H/O of illness:-No significant illness

 H/O of Previous Pregnancy

Order of Age at Outcome: Type of place of Conducted Complic Present

pregnancy pregnancy live delevery by
delivery ations if health
birth/still any status of
birth/abo
child
rtion
One 20yrs 6 Live Normal S.S.K.M Doctor Not Normal
month birth labour Hospital significa
nt
Height : 147cm Weight : 55kg Pulse : 78/min BP : 118/82 mm Hg
Pallor: Nil Jaundice : Nil Oedema : Nil Others : No significant other
findings
CNS : Jerk , Tone, Power, Reflex all are normal
CVS : S1 and S2 are audible
Respiratory System : No significant illness
G.I : Liver and Spleen are not palpable

OBSTETRIC EXAMINATION
Fundal height : bellow umbilicus
FHS : Not applicable

LABORATORY EXAMINATION
Hb% : 11.5gm% Blood group/Rh : AB, Rh+ve
PP Blood sugar :75mg/dl VDRL : not reactive
Urine : protein : nil sugar : nil pus cells : nil

Antenatal advice received

Folic acid tablet taken daily at night
 NAME OF MOTHER- DIPIKA DEVI TRIPATHI
HUSBANDS NAME- VIKKINATH TRIPATHI
AGE- 20YRS AGE OF MARRIAGE- 19YRS
GRAVIDA-1 LMP-24/10/12 EDD-31/7/2013
DATE OF REGISTRATION-22/12/12
NO. OF ANTENATAL VISIT MADE-4
TETANUS TOXOID GIVEN-
1st DOSE-22/1/13
2nd DOSE-26/2/13
 IFA TABLETS CONSUMED- YES
NO. OF TABLETS CONSUMED-18 TABLETS
TAKEN
OTHER TREATMENT RECEIVED-NO
H/O PRRESENT ILLNESS-NOT SIGNIFICANT
H/O PAST ILLNESS ANY SIGNIFICANT ILLNESS-
NIL
ANY SIGNIFICANT FAMILY H/O OF ILLNESS-NOT
SIGNIFICANT
 HEIGHT-145cm WEIGHT-56kg PULSE-78/MIN
B.P-116/80 mm.Hg PALLOR-NIL EDEMA-NIL
JAUNDICE-NIL OTHERS-NIL
 CNS-TONE, POWER, REFLEX, JERK, ALL ARE
NORMAL
CVS-S1 & S2 ARE AUDIBLE
RESPIRATORY-NOT SIGNIFICANT
G.I-LIVER AND SPLEEN NOT PALPABLE
 FUNDAL HEIGHT-LOWER ONE-THIRD AT THE
JUNCTION BETWEEN UMBILLICUS AND XIPHI-
STERNUM
FHS-126/MIN
 Hb%-14gm% BLOOD GROUP - O+
PP BLOOD SUGAR-72mg/dl
VDRL- NOT REACTIVE
URINE: PROTEIN-NIL
SUGAR-NIL
PUS CELLS-NIL
 TO
TAKE IFA TABLETS DAILY AT NIGHT AFTER
MEAL
 Antenatal advice given during family visit

1. Attend Gynecology and obstetrics OPD for check up and advised to take
Iron and folic acid tablets
2. Dietary advice -Diet should enriched with green leafy vegetable ,fruit
lemon , iron containing food etc
3. Advised to take one extra meal per day
4. If any pain in abdomen, swelling of feet or per vaginal bleeding then
should go emergency as soon as possible
 Antenatal advice given during family visit

5. Advised to practice exclusive breast feeding

6. Mother was educated about essential newborn care

7. Advised on the importance of immunization and asked to take the
child for immunization as per schedule
8. Advised to adopt permanent method of family planning after
delivery.
HEALTH KNOWLEDGE OF THE
FAMILY
 HEALTH SEEKING BEHAVIOUR
THEY TAKE IMMUNIZATION, ANTENATAL CARE,
DELIVERY, POST NATAL CARE, FAMILY PLANNING,
BELOW 5 YEARS CARE, EMERGENCY AND OTHER
TREATMENTS FROM S.S.K.M. HOSPITAL.
INFANT FEEDING KNOWLEDGE PRACTICE

PRELACTEAL FEEDING SHOULD NOT BE GIVEN NOT GIVEN

COLOSTRUM SHOULD BE GIVEN GIVEN

EXCLUSIVE BREAST KNOW GIVEN FOR SIX MONTH

FEEDING WITH
DURATION
COMPLEMENTAY NOT SPECIFIC STARTED AFTER 6
FEEDING MONTH
FEEDING DURING SHOULD BE OFFER THE CHILD
ILLNESS CONTINUED AS NORMAL DIET
BEFORE
DISEASES CAUSE TRANSMISSIO PREVENTION TREATMENT
N

DIARRHOEA BAD EATING NOT NO HOME MADE

HABIT CONTAGIOUS FLUID,
MEDICINE, ORS
WORM SWEET NOT DECREASE GO TO DOCTOR
INFESTATION TRANSMITTED INTAKE
MALARIA MOSQUITO BREED IN DIRTY MORTEIN, MEDICINE
WATER CLEAN WATER
TUBECULOSIS MALNUTRITIO SPREAD BY KEEP SEPERATE MEDICINE
N COUGHING
LEPROSY CURSE OF GOD, NOT RELIGIOUS DO PUJA
CONGENITAL CONTAGIOUS
HIV/AIDS SEXUAL SEXUAL SAFE SEX NO
INTERCOURSE INTERCOURSE TREATMENT
MEASLES CURSE OF GOD CONTAGIOUS DO PUJA DO PUJA
CHICKEN POX SEASONAL CONTAGIOUS DO PUJA DO PUJA
 HEALTH KNOWLEDGE OF ELIGIBLE COUPLE
ABOUT FAMILY PLANNING

MINIMUM INTERVAL BETWEEN TWO 3 YEARS

PREGNANCIES

KNOWLEDGE ABOUT BIRTH PREVENTION YES

PREVENTION METHOD OF BIRTH CONDOM

SOURCE OF KNOWLEDGE HOSPITAL

MTP SERVICES AVAILABLE AT HOSPITAL

 ATTITUDE TOWARDS FAMILY PLANNING

NUMBER OF CHILDREN THE FAMILY

DESIRES

HUSBANDS OPINION BOY - 1 GIRL - 1

WIFES OPINION BOY - 1 GIRL - 1

 ATTITUDE TOWARDS FAMILY PLANNING

SUITABLE SPACING BETWEEN CHILDREN

HUSBANDS OPINION 3 YEARS

WIFES OPINION 3 YEARS

 ATTITUDE TOWARDS FAMILY PLANNING

PLACE OF PROCURING THE SHOP

CONTRACEPTIVES

DECISION TAKEN FOR PERMANENT NO

METHOD

IF NEEDED WILL THEY AVAIL MTP SERVICES YES

 PRACTICE REGARDING FAMILY PLANNING

AGE OF MARRIAGE 20 YEARS

AGE AT FIRST PREGNANCY 20 YEARS

TOTAL NO. OF CHILDREN IN THE FAMILY 1

INTERVALS BETWEEN CHILDREN NOT APPLICABLE

PRESENT PRACTICE OF FAMILY PLANNING NO

ABOUT CONTRACEPTION
Nutritional status of the
family was assessed by
anthropometric measures
and diet survey by 24hrs
dietary recall method .
FOOD GROUP REQUIREMENT CONSUMPTION DEFICIT/ DEFICIT/ EXCESS
(gm) (gm) EXCESS (gm) (%)

CEREALS 2395 1625 770 32.15

PULSES 265 200 65 24.52

ROOTS & 260 700 440 169.23

TUBERS
GREEN LEAFY 420 300 120 28.57
VEGETABLES

FATS & OILS 155 400 245 158.06

SUGER & 170 50 120 70.58

JAGGERY
 Figure 1: COMPARISON BETWEEN CONSUMPTION AND
REQUIREMENTS OF DIFFERENT FOOD GROUPS BY
FAMILY
300
DIFFERENT FOOD GROUPS BY FAMILY

269.23
258.06
PERCENTAGE CONSUMPTION OF

250

200

150

100 RDA
75.48 71.43
67.85

50
29.42

0
CEREALS PULSES ROOTS AND FIBRES GLV FAT/OIL SUGAR

DIFFERENT FOOD GROUPS

 Figure 2: COMPARISON BETWEEN CONSUMPTION AND
REQUIREMENTS OF DIFFERENT NUTRIENTS BY FAMILY
PERCENTAGE CONSUMPTION OF ENERGY

300

262.11

250
AND NUTRIENTS BY THE FAMILY

200

150

100
81.33
RDA

56.43
50
31.5 27.8
11.11
2.85
0
ENERGY PROTEIN FAT IRON VIT.A VIT.C CALCIUM

ENERGY AND NUTRIENTS

SUMMARY
 IDENTIFICATION OF THE FAMILY
The study family is a six membered,Hindi
speaking,Hindu,joint family,originating from Uttar
Pradesh,residing in staff quarter of SSKM Hospital
for the past 30 years.

The head of the family Mrs.Mita Devi Tripathi,58

year old literate widow home-maker.

Her elder son Mr.Sachidanand Tripathi,35 year

old married man,having a small business.
His wife Mrs.Bebi Devi Tripathi,22 years old
illiterate home-maker and mother of an 18
month old boy,Aviraj Nand Tripathi.
Younger son of Mrs.Mita Devi Tripathi is
Mr.Vikkinath Tripathi,28year married literate
man,Gr.D staff at SSKM Hospital.
His wife Mrs.Dipika Devi Tripathi is a 20 year
old literate home-maker.
 HOUSING AND ENVIRONMENTAL
CONDITION
The family dwells in a pukka rented house
comprising of 2 living rooms and verandah is used
for cooking purpose (without any smoke outlet).

The house has a total of 134sq.ft floor space.

Thus per capita floor space is 24.36sq.ft. Hence
OVERCROWDING is present.

Adequate lighting,absence of cross ventillation

and no dampness were found.
 They use KEROSENE OIL as the source of fuel.

They use corporation piped water for cooking,bathing

and other purposes.

They use narrow-mouthed well covered containers for

storage of water and drawing of water for them is safe.

They use common sanitary latrine with

neighbours,which is cleaned weekly.
 Excreta of the under five child was disposed
off in the nearby drain.

Solid and kitchen wastes were disposed off in

the corporation vat.

Fly nuisance and breeding places of the

mosquitoes were present.
 SOCIO-ECONOMIC CONDITION
Total family income per month was Rs.12000.
Thus per capita monthly income was Rs.2000.

Total expenditure was Rs.9200. Thus total

monthly savings was Rs. 2800.

As per Modified KUPPUSWAMY Scale, the

family belonged to LOWER-MIDDLE socio-
economic class.
 SOCIO-CULTURAL PROBLEMS
The elder son of the head of the family was
addicted to smoking and alcohol drinking.

The younger son of the head of the family was

addicted to khaini.

The wife of the elder son of the head of the

family was illiterate.
 HEALTH STATUS OF THE FAMILY
HEAD OF THE FAMILY=> Mrs.Mita Devi
Tripathi,58 years old, post menopausal, having
satisfactory general health was suffering from
lumbar and cervical spondylosis.

MR. SACHIDANAND TRIPATHI=> Elder son of

the head of the family have satisfactory
general health. He was addicted to smoking
and alcohol drinking.
 MRS.BEBI DEVI TRIPATHI=> Wife of Mr.
Sachidanand Tripathi had satisfactory general
health. She was in 16th week of gestation.

MR.VIKKINATH TRIPATHI=> Younger son of the

head of the family had satisfactory general
health. He was addicted to khaini.

MRS.DIPIKA DEVI TRIPATHI=> Wife of

Mr.Vikkinath Tripathi had satisfactory general
health. She was in 24th week of gestation.
AVIRAJ NAND TRIPATHI=> Son of Mrs.Bebi Devi
Tripathi was 18 months old..
-As per new WHO Child Growth
Standards, his weight-per-age was normal.
-He was predominantly breast fed. His
current diet included family diet.
-He has a past history of acute
bronchiolitis.
-His immunisation status was upto
date(except Vitamin A).
 MATERNITY RECORD
MRS.BEBI DEVI TRIPATHI=> Aged 22years,married
for 3years,is now Gravida =2.
-She has received a booster dose
of Tetanus Toxoid. She had no significant present
or past illness.
-She had one previous pregnancy
, normal delivery was done ,live birth occurred
with no significant complication.
-On obstetric examination , fundal
height was found to be below umbilicus.
-Routine laboratory examination
(Hb %,PP Bl sugar , Bl group ,Rh ,
VDRL,
Urine Protein , sugar ,Puscells)
were done and no significant illness
was found.
-She was advised to attend G & O
OPD for regular check up.
MRS.DIPIKA DEVI TRIPATHI=> Aged 20 years,
married for 1year,was Gravida =1. -
She was given 2 doses of Tetanus Toxoid and
IFA tablets were taken regularly.
-OBSTETRIC EXAMINATION=>
Fundal height - at the lower 1/3rd between
umbilicus and xyphisternum.
Foetal Heart Rate - 126/minute.
On routine laboratory investigation , no
significant illness was found.
HEALTH KNOWLEDGE OF THE FAMILY
HEALTH SEEKING BEHAVIOR=> They prefer
allopathy system of medicine and take treatment
from Government hospital for immunization ,
ante-natal care , delivery , post-natal care , under-
five care , emergency and other illnesses.
HEALTH KNOWLEDGE ABOUT COMMON
ILLNESS=> Their knowledge about diarrhoea ,
worm infestation , Tb and AIDS were satisfactory.
They consider measles , chicken pox and leprosy
as curse of god.
KNOWLWDGE,ATTITUDE AND PRACTICE OF THE
ELIGIBLE COUPLE ABOUT FAMILY PLANNING=>
They know about various contraceptive
methods like barrier method, terminal
method , etc.
Presently they practice barrier method and
they know that MTP services are available at
Govt. hospitals.
They desire 2 children and know that the
spacing between children should be 3
years(but did not practice that).
 KNOWLEDGE AND PRACTICE REGARDING
INFANT FEEDING=> They know that pre-lacteal
feeding should not be given.
-They know that Colostrum is healthy for
the baby and have practiced that.
-They know about exclusive breast feeding
and have practiced that.
-They had no specific knowledge about
complementary feeding but gave it after 6
months.
-They know that diet should not be
reduced during illness and have practiced
that.
 DIET AND NUTRITIONAL STATUS OF
THE FAMILY
DIET SURVEY=> Diet Survey was done by 24
hours recall method.
-Food item wise , the diet was
deficient in Cereals(67.85%),Pulses975.48%),
Green Leafy Vegetables(71.43%) and
Sugar(29.42%).
-But , diet was excess in
roots(269.23%) and fat/oils(258.06%).
 On analysis of the data , we found that the
diet was deficient in Energy(81.33%),
Protein(31.50%), Iron(27.80%), Vitamin
A(2.85%), Vitamin C(56.43%) and
Calcium(11.11%).
- But the diet was excess in
Fat(262.11%).
 FAMILY DIAGNOSIS
The study family was a six-membered , Hindi
speaking, Hindu, joint family consisting of 5 adult
and 1 under-five members, belonging to the
lower-middle socio-economic class, living at the
staff quarters of SSKM Hospital, Kolkata.

They live in a pukka rented house with poor

environmental condition like over-crowding,
absence of cross-ventillation, kitchen without any
smoke outlet, presence of nuisance and breeding
places of mosquitoes.
 Drinking water drawing method was safe.
Under-five child was fully immunized(except
vitamin A) and had a past health problem of
acute bronchiolitis.
The elder son of the head of the family was
addicted to smoking and drinking alcohol. The
younger son was addicted to khaini.
The knowledge of the eligible couples about
child feeding and family planning was
satisfactory.
 The knowledge of the family about the cause ,
prevention and treatment of various
communicable diseases were inadequate.
The dietary pattern assessed by 24 hour recall
method reveals that food items were deficient in
Cereals , Pulses, Green Leafy Vegetables and
Sugar , whereas intake of Roots and Fat were in
excess.
-Thus , the diet was deficient in Energy,
Protein, Iron, Vitamin A, Vitamin C and Calcium
whereas excess in Fat.
 ACTIONS TAKEN
Head of the family Mrs. Mita Devi Tripathi was advised to attend
orthopaedics OPD for treatment of low back pain.

Ante-natal mother Mrs. Bebi Devi Tripathi was advised to attend G&O OPD
for regular check up.

Proper health knowledge regarding measles , leprosy and chickenpox were

given.

Adult male member were informed about the adverse effect of smoking and
alcohol intake and they were motivated to quit the same.

Importance of balance diet were discussed and advised to reduce fat

consumption.
 RECOMMENDATION

Mother was advised to avail the facility of ICDS for her child.

Importance of using LPG for cooking purpose instead of kerosene

were discussed.

Advised to drain the dirty water logged outside their house.

Advised to use mosquito net daily.

Provision of adequate ventilation should be maintained .

The elder son of head of family was advised to quit smoking and
drinking.

The younger son of head of family was advised to quit chewing

khaini.
 ACKNOWLEDGEMENT
We are sincerely grateful to:
-Our respected Head of the Department
Prof. Dr. R.N .Mishra.
- We are thankful to all our respected
teachers of Community Medicine
Department.
- We are also thankful to the family
members of the study family.