ComMed-Logbook tcs.docx

7/25/2019 ComMed-Logbook tcs.docx

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AIMST UNIVERSITY

Faculty of Medicine

MBBS PROGRAMMEYear 3 & 4

Batch (19)

Log Book

COMMUNITY MEDICINECOMMUNITY MEDICINE

NAME : TEELAN A/L CHANTHIRA SEEKARANREG NUMBER : 1!!""#

BATCH : 1$ % &R'U() *

POSTING FROM : 1$THA(RIL +!1# T' 1THMAY +!1#


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YEAR III

CERTIFICATE

T,i- i- to ce.tify t,at

TEELAN CHANTHIRA SEEKARAN

I* N' 1300886

Has attended the clinical postings in Community Medicinefrom 1th!pril to 1"thMay and conducted community sur#ey

as sho$n in this log %oo&'

________________

_________________

Course Coordinator Head of Department


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(D)' INN *YNN *H!IN+, (!--OC' .)O/ D)' *YI *YI -EIN,

TA0LE 'F C'NTENT

N

'

TITTLE (A&E N'

1 The Objectives Of Comm!it" #e$ici!e %osti!&' 3 ( 6

) Comm!it" S*ve" +Comm!it" ,i-&!osis.

Re/o*t o! Comm!it" S*ve"

Re/o*t o! He-th C-m/

Re/o*t o! ocs 2*o/ ,iscssio!

( 10)

( 84

86 ( 8885 10)

3 Ci!icoSoci- C-se St$"

C-se 1

C-se )

C-se 3

C-se 7

C-se 4

10)1))

10)104

106108

105111

11)116

111)1

7 A//e!$i

A//e!$i 1

A//e!$i )

A//e!$i 3

100 1"0

1"" 2 1"31" 145

4 Refe*e!ce17117)


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I. THE OBJECTIVES OF COMMUNITY MEDICINE POSTING:

At the end of the pot!n"# the t$dent h%&& 'e %'&e to:

Descri%e the concept of .u%lic Health and its rele#ance to the National Health +oals and the 6ision of

the Ministry of Health

Descri%e the Health Care Deli#ery -ystem

Descri%e Malaysia7s National Health .rograms $ith emphasis on /amily Health De#elopment

(including Maternal and Child Health8 Nutrition8 -chool Health8 !dolescent Health8 HI69!ID-8 Mental

Health8 Care of Children $ith -pecial Needs8 Care of the Elderly Disease Control8 En#ironmental

Health8 Occupational Health and /ood :uality Control

Descri%e the National -ur#eillance -ystem and the Health Management Information -ystem

Descri%e the .rinciples and .ractice of /ood :uality Control in relation to the /ood !ct 13" and /ood

)egulations'13;

Identify the En#ironmental and Occupational Ha


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-ur#ey for Community Diagnosis

Clinicosocial case studies

6isits to places of pu%lic health importance

.osting to *lini& *esihatan

.osting to Office of the District Health Officer'

(The details are gi#en in the -chedule,'

O'-et!,e of Co))$n!t/ D!%"no! S$*,e/

Descri%e the concepts8 principles and methods of a Community Diagnosis in a field setting'

+ather8 understand and present secondary data'

De#elop and use data collection tools li&e >uestionnaires and other forms of field o%ser#ation tools in

community settings'

E?plore issues of culture8 religion8 ethnicity and their impact on health of the community'

!ppreciate ethical issues in#ol#ed in Community Diagnosis'

.lan and implement appropriate community inter#ention strategies for community education8 health

promotion and health screening

The pe!f! o)peten!e to 'e "%!ned d$*!n" the pot!n" %*e:

Selected competency Selected CD experience

1' O%tain health related data a%out

social and cultural en#ironments8gro$th and de#elopment factors8

needs and interests

Teams gather >ualitati#e and >uantitati#e data from

secondary sources and inter#ie$s

0' !naly


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organiuantitati#e and

>ualitati#e research in a real community setting

A' !ssess the merits and limitations of

>ualitati#e and >uantitati#e researchmethods

-tudents must discern the merits and limitations of each

type of data'

O'-et!,e of the C&!n!o0So!%& C%e St$d/

!%le to elicit history of a gi#en pro%lem8 $ith reference to the agent8 the host and the en#ironmental

factors'

In the gi#en case e?plain the interaction of the factors leading to the present status of the indi#idual'

Dra$ a plan for managing the indi#idual descri%ing the actions under #arious le#els of pre#ention'

Descri%e the remedial actions to %e ta&en at the family and community le#el'

At!,!t/:

You $ill %e gi#en a case of pu%lic health importance'

Ta&e a detailed clinicsocial history'

Especially pay attention to ho$ the condition started8 de#eloped and progressed to the present state'

Elicit history on the treatment see&ing %eha#iour8 the decision ma&ing process and the e?penditure

in#ol#ed'

.repare a plan of action for impro#ing the health condition'


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II. COMMUNITY SURVEY 1COMMUNITY DIAGNOSIS2

A. REPORT ON COMMUNITY SURVEY

Approach

Our community sur#ey site $as selected %y !ssoc' .rof Dr' Beela !nthony oe' efore conducting the sur#ey8 a fe$ of

our group mates lead %y our group leader met the #illage head8 En' !


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3o%t!on of the 4%)p$n" B%*$ Th/e En"# Bedon"# S$n"%! Pet%n!# 4ed%h.

-ourceG +oogle Earth


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-&etch diagram of *ampung aru Thye Eng'

O$* $*,e/ o)p*!ed the fo&&o+!n" %te"o*!e:


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(a) Demographic data

Demographic information on the household num%er8 occupants of the house8 %asic information of the#illagers such as name8 age8 gender8 ethnicity8 religion8 marital status8 occupation8 education8 householdincome per month and type of family are assessed'

(b) Environment sanitation and housing variable

-anitation refers to the condition related to pu%lic health8 especially the pro#ision of clean drin&ing $aterand ade>uate se$age disposal' Housing #aria%le is a%out the physical space8 en#ironment including theelectricity supply8 num%er of rooms and type of house that a family li#es in'

In this section8 fi#e su%titles are made to categoriuired' Essential inter#entions in!NC include identification and management of o%stetric complications such as preeclampsia8 tetanus to?oidimmuniual to " years8 e?cept the >uestions ofage during first pregnancy8 num%er of pregnancies8 the year of last pregnancy and practice of familyplanning $hich are directed to all maternal $omen'

/amily planning is assessed through the use of contracepti#e methods' :uestions regarding family planningin the sur#ey are directed to$ards all maternal $omen'

Child immuni


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reproducti#e age (1;4 years old, $ho ha#e children of 0 years old or %elo$' The co#erage and completeimmuniuantity offood and its relation to health' Nutrition in general consists of the %asic nutrients such as car%ohydratesproteins8 fats8 and the micronutrients li&e #itamins and minerals'

Nutritional assessment of the #illagers $as aimed at the respondent8 $ith en>uiries regarding any foodallergy present8 meals s&ipped and many more' The meals eaten %y respondent and their family mem%ers theday %efore $ere also recorded' -alty food and oily food inta&e $as also noted'

1e2 Morbidity and health seeing behaviour

!cute ($ithin the last " months, diseases are ta&en into account for the assessment of physical $ell%eingand to assess out%rea& in the #illage'

Health see&ing %eha#iour is one of the important components in getting good medical care and treatment ina community' E?amples of healthcare ser#ices a#aila%le in Malaysia are modern medication(hospitals9clinics,8 traditional healers8 and others' Type of medical practitioner and medical institutions ofchoice of the #illagers are assessed'

Unhealthy ha%its such as smo&ing8 alcohol consumption and drug a%use are e#aluated as these ha%its can

significantly affect mor%idity'

(!) Chronic diseases

Chronic diseases (more than @ $ee&s consecuti#ely, such as dia%etes mellitus8 hypertensionhyperlipidemia8 asthma8 chronic &idney disease8 stro&e8 cardio#ascular disease and other chronic diseasesare assessed'

O'-et!,e of the o))$n!t/ $*,e/

To study the method of conducting a sur#ey'


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To learn the %enefits and restrictions of >ualitati#e and >uantitati#e research methods'

To analyse social8 cultural8 economic and political factors that influence health'

To learn the method of using -.-- soft$are to %uild the >uestionnaire8 to record the data as $ell as to

analyse the data'

To formulate a >uestionnaire on the %asis of assessing the health status of the people in *ampung aru

Thye Eng'

To identify health related issues $hich are common in *ampung aru Thye Eng'

To e?plore issues of culture8 religion8 ethnicity and their impact on health of the community'

Methodo&o"/

P*ep%*%t!on 'efo*e the $*,e/:

efore conducting the sur#ey in 4".B%*$ Th/e En"8 $e $ere to prepare a set of >uestionnaire $hichcomprises of the follo$ingG

a, Demographic #aria%les

%, En#ironmental sanitation and housing #aria%les

c, Batrines

d, -olid $aste disposal

e, House conditions

f, Nutritional assessment

g, Mor%idity and health see&ing %eha#iours

h, Mortality


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i, Chronic disease

, Maternal care

&, Child immuni


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MOGRAPHIC DATA# ENVIRONMENTA3 SANITATION 5 HOUSING

NUMBER OF PEOP3E IN THE HOUSEHO3DS INTERVIE6ED

Table (1): Number of family members in studied household in Kampung Baru Thye Eng

The results a%o#e do not represent the $hole population of the #illage'

This is %ecause some of the houses $ere a%andoned some refused to ta&e part in the sur#ey thus theinformation o%tained cannot represent the total num%er of family mem%ers in *ampung aru Thye Eng'

N$)'e* of f%)!&/ )e)'e* !n

the ho$eho&d

F*e7$en/ Pe*ent%"e

One f%)!&/ )e)'e* 1 0'3T+o f%)!&/ )e)'e* 3 00'0Th*ee f%)!&/ )e)'e* " 3'"Fo$* f%)!&/ )e)'e* 3 00'0F!,e f%)!&/ )e)'e* ; 1"'S!8 f%)!&/ )e)'e* 4 11'1Mo*e th%n !8 f%)!&/

)e)'e*

A

Tot%& "@ 155'5


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AGE OF VI33AGERS

Figure (1): Histogram showing the age of illagers

The graph sho$s that the study population in *ampung aru Thye Eng has a mean age of "4'41 years old and astandard de#iation of 00';' Median age is "1' The age distri%ution seems to %e of normal distri%ution'

!dults (1; to @4 years,

? 155F

=

Deendenc ratio =105

41 + 19

Children (0-14 years) + Elderly (65 years and above)


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In this sur#ey8 total dependency ratio is ;A'1F'

The dependency ratio is an indicator that can %e used to estimate the economic %urden of a family' The a#eragedependency ratio of household in *ampung aru Thye Eng is in an unhealthy state %ecause the num%er ofindi#iduals $ho are economically inacti#e outnum%ers the acti#e ones'

!ccording to the =orld an&8 the age dependency ratio in Malaysia in year 0514 $as 44 to 155 people' Incomparison $ith the dependency ratio from this sur#ey8 there is around 1"F difference from the national le#el'The difference may %e due to small sample si


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Figure (%): "ie #hart showing ra#e of family members

The highest racial percentage of respondent are Indians at ;@'"@F8 follo$ %y Malays at 45'55F and the least isChinese at "'@4F

RE3IGION OF VI33AGERS

Figure (&): "ie #hart showing religion of family members

The highest religion percentage is Hinduism ;@'AF8 follo$ %y Islam at "'"F and the least is uddhist at

"'@4F'


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MARITA3 STATUS OF RESPONDENTS

Figure ('): "ie #hart showing marital status of respondent

The percentage of married person is the highest at ;5'"5F8 follo$ %y singles at 4;'4;F8 and $ido$ed ones at"'@4F'

OCCUPATION OF RESPONDENTS

Figure (): "ie #hart showing o##upation of family members

The percentage of respondents $or&ing in nongo#ernment %odies8 unemployed and are students are almoste>ual at 0"'@F8 04'0F8 and 04'0F respecti#ely' )espondents $ho are selfemployed amount at 'AF' Thepercentage of the retired and those $or&ing other occupations are the same at A'"F each' )espondents $or&ingin go#ernment sectors are the least8 only at "'@F'


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EDUCATION OF RESPONDENTS

Figure (): "ie #hart showing edu#ation leel of family members

The percentage of respondents $ho completed their education up to secondary le#el is "'"F8 $hilecompleted up to only primary le#el $as at ";'A@F' .ercentage of respondents $ho completed education up toother le#el is 05'@1F' The least amount of respondents completed up to tertiary education8 only at 4'04F'

TYPE OF FAMI3Y STRUCTURE

Figure (*): "ie #hart showing type of family

The main type of family in *ampung Thye Eng is nuclear family $hich constitutes A0'00F although


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t$oparent families are %ecoming less common in many parts of $orld' In 05148 there $ere A millionhousehold in Malaysia and the percentage of nuclear family $as A5'"F (resource from Malaysia.opulation and /amily -ur#ey 05148 B..*N Economic .lanning unit,' Malaysians prefer nuclear family%ecause it is an autonomous unit8 free from control of elders' Children are more close to parents and thereis less chance of inla$s conflict' E?tended family is also common in *ampung aru Thye Eng $hichconstitutes 0;'55F'They share the household responsi%ilities such as coo&ing8 cleaning and organi


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1'44F8follo$ %y 4 family(11'11F, $ith income less than )M;55 and lastly 0 family $ith income e?ceeding)M0;55'This small portion only accounts for ;';@F'

TYPE OF HOUSE

Figure (1,): "ie #hart showing type of house

In summary8 there are 0; (@'44F, #illage houses and 11 ("5';@F, singlestorey houses in *ampung aru ThyeEng'

TYPE OF HOUSE MATERIA3


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Figure (11): "ie #hart showing type of materials house is built up by

There are 1@ (44'44F, houses that are made up of %ric& and $ood8 10 (""'""F, houses are made up of %ric&and the remaining 3 (00'00F, houses are made up of $ood'

NUMBER OF ROOMS

Figure (1!): Bar #hart showing number of rooms in a house

The houses in *ampung aru Thye Eng ha#e num%er of rooms ranging from 1 to A' The most num%er of rooms

are " $hich is found in 1A houses (4A'00F,8 follo$ed %y 0 rooms $hich is in 15 houses (0A'A3F, and 4 rooms

in @ houses (1@'@AF,'The least one is 5 rooms81 room8 and A rooms and all " of them share e>ual num%er of

house $hich is 1 house (0'A3F, each'


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PRESENCE OF 4ITCHEN IN HOUSES

!lthough there are some houses in this $orld that don7t ha#e &itchen8 fortunately all the "@ houses in *ampung

aru Thye Eng ha#e &itchens inthe house'

C3EANING OF HOUSE

Figure (1%): "ie #hart showing fre-uen#y of house #leaning

The #illagers in *ampung aru Thye Eng also care for their house cleaning status' Most of the households$hich are "0 of them $ill clean their houses daily 'This contri%utes to a%out 33'3F" #illagers clean their houses $ee&ly $hich accounts for 3'""F' Only 1 #illager (0'A3F, cleans the house e#eryfortnightly'


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NUMBER OF 3ATRINES

Figure (1&): Bar #hart showing numbers of latrines in the house

Normally all the houses are e>uipped $ith latrines' 0A out of "@ houses in *ampung aru Thye Eng ha#e only

one latrine in their house $hich accounts for A;F' @ houses (1@'@AF, ha#e 0 latrines inside the house and there

are also " houses (3'""F, $hich ha#e no latrine'

TYPE OF 3ATRINES


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Figure (1'): "ie #hart showing types of latrine in houses

The most used type of latrine in this #illage is septic tan& in $hich it is at 33'3F' This is %ecause Malaysian

go#ernment rules are that to ha#e -eptic tan&s in each household' Ho$e#er there $ill %e a fe$ that is missed

$hich led to ;'@F of households to %e still using %uc&et latrine and another ;'@F to use other methods for

e?ample disposing their $aste disposals into soil or ust onto the ground and then %urying it'

FRE9UENCY OF C3EANING 3ATRINE

Figure (1): Bar #hart showing fre-uen#y of #leaning the latrine

;3'"F of the #illagers clean their latrines daily $hereas the second highest fre>uency of cleaning the latrine isonce a $ee& at 1@'AF8 follo$ed %y t$ice a $ee& at 1"'F and lastly8 three times a $ee& at 3'"F' The

household $hich cleans their latrine e#ery day is %ecause their spouses are house$i#es' Ho$e#er for those $ho

cleans only once a $ee&8 it is %ecause %oth hus%and and $ife are $or&ing adults'


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GARBAGE DISPOSA3

Figure (1): "ie #hart showing method of disposing the garbage

The most fre>uented method to dispose the gar%age is #ia open %urning8 $hich accounts for a%out AA'3F' This

is %ecause it is the most con#enient8 easy8 and cheapest method for the #illagers to dispose their gar%age'

-econd most common $ay is %y dumping $hether it is into the ri#er or %y the roadside' This is due to their lac&

of consideration due to lac& of education and for their con#enience' Bastly8 only 0'3F thro$ %y others method

for e?ample8 into $aste %ins in the neigh%ouring garden or %y %urying them'

6ATER SOURCE

!ll of the households ha#e a constant $ater supply from running pipe $ater'

METHOD OF 6ATER TREATMENT


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Figure (1*): "ie #hart showing method of water treated for drin.ing purpose

The $ater for drin&ing purposes are most often %oiled %efore drin&ing %y $hich the pie chart sho$s us that1'4"F of the total household of "@ chose %oiling of the $ater' Ho$e#er there are ;'A1F $hich chose other

methods $hich encompasses chemical treatment and other traditional $ays' Bastly8 only 0'3@F of household

uses filtration method for treating the drin&ing $ater'

9UA3ITY OF 6ATER

ate. 2uality F*e7$en/ Pe*ent%"e

Co&o$* "0 1'4F

C&%*!t/ 14 45'5F

S)e&& "@ 155'5F

T%te "0 1'4F

Table (!): /uality of water in households

The a%o#e ta%le sho$s that the #illagers in *ampung aru Thye Eng recei#e $ater $ith good >uality $here1'4F has no change in $ater colour8 155F has odourless $ater8 1'4F $ater is tasteless and only 45F of thetotal num%er of "@ households do not recei#e clear $ater in $hich some may %e only slightly cloudy %ut notdirty'


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6ATER SUPP3Y INTERRUPTION

Figure (1+): "ie #hart showing interruption of water supply

ased on the charts a%o#e8 not more than half of houses in *ampung aru Thye Eng (appro?imately 41'@AF,

complained of interrupted $ater supply' The remaining ;3'""F of houses are satisfied $ith the $ater supply'

FRE9UENCY OF INTERRUPTION

Figure (!,): "ie #hart showing fre-uen#y of water supply interruption


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/ortunately8 1 out of 05 houses (;F, claimed that the $ater interruption rarely occurred' O#erall8 #illagers in

the &ampong are satisfied $ith the current $ater supply'

MONTH3Y 6ATER BI33

Figure (!1): Bar #hart showing monthly water bill

1 households out of "@ in *ampung aru Thye Eng ha#e monthly $ater %ill e?ceeding )M"5 $hich accounts

for ;0'A3F of total houses' Only 4 houses ha#e monthly $ater %ill less than )M15' Despite of the lo$

socioeconomic status of #illagers8 the e?penditures spent on $ater utility is >uite high' Ho$e#er8 most

respondents claimed that the $ater are only for domestic uses and deny any $asting of $ater' This might

attri%ute to the num%er of family mem%ers in the houses'

TYPE OF E3ECTRICITY SUPP3Y


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Figure (!!): "ie #hart showing ele#tri# supply to households

ased on the pie chart a%o#e8 1'@AF of houses in *ampung aru Thye Eng are e>uipped $ith continuous

electrical supply' Only ;';@F ha#e cut off electric supply'

FRE9UENCY OF E3ECTRICA3 SUPP3Y DISRUPTION


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Figure (!%): Bar #hart showing fre-uen#y of ele#tri#al interruption

/rom the %ar chart a%o#e8 three houses or 3'""F of all total households $ere e?periencing electrical cut off'

T$o out of three houses descri%ed the electrical cut off only occurred rarely $hereas only one house

e?perienced the electrical cut off fre>uently' In conclusion8 the electrical supply to *ampung aru Thye Eng is

consistent'

MONTH3Y E3ECTRICA3 BI33


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Figure (!&): Bar #hart showing monthly ele#tri# bill

ased on the %ar chart a%o#e8 ;3'30F of houses from *ampung aru Thye Eng are ha#ing electrical %ill

ranging %et$een )M01@5' This is follo$ed %y "0'";F of houses and 3'30F of houses $ith electrical %ill range

from )M@1155 and more than )M155 respecti#ely' Most houses ha#e moderate electrical consumption as

their houses are not e>uipped $ith hea#y energy usage appliances such as airconditioner or $ater heaters'

VARIAB3E RE3ATIONSHIPS


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a, -e? and education

Sex of respondent * Education Crosstabulation

Education Total

Primary Scondary Trtiary Ot!r"

S# o$ r"%ondnt Mal Count &' &( & )* ++

, -it!in S# o$ r"%ondnt &(./, /0.1, &./, )1.&, )00.0,

Fmal Count '* '1 / )* **

, -it!in S# o$ r"%ondnt &2.), &*.*, 2.', ''.), )00.0,

Total Count 21 (2 * &/ )(2

, -it!in S# o$ r"%ondnt &2.+, &1./, /.', '0.(, )00.0,

3 HoG There is no relationship %et$een se? and education le#el3 H!G There is relationship %et$een se? and education le#el3 Chis>uare #alue G 5';53 p #alue 5'3 (J5'5;,8 it is not significant3 -ince p #alue is J 5'5;8 null hypothesis is accepted' There is no relationship %et$een se? and education

le#el

Chi-Square Tests

4alu d$ A"ym%totic Si5ni$icanc 6'7

"idd8

Par"on C!i7S9uar .210a & .+11

i;li!ood Ratio .2+1 & .+11

inar7


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%, -e? and occupation

3 HoG There is no relationship %et$een se? and occupation3 H!G There is relationship %et$een se? and occupation3 Chis>uare #alue G 14'3""3 p #alue 5'500 (K5'5;,8 it is significant

3 -ince p #alue is K 5'5;8 null hypothesis is reected' There is relationship %et$een se? and occupation

2 )eligion and Education

Sex of respondent * Occupation Crosstabulation

Occu%ation Total

Go=rn

mnt

Non7

5o=rnm

nt

Sl$7

m%loy

d

Unm%l

oyd

Rtir

d

Stud

nt

Ot!

r"

S# o$

r"%ondnt

Mal Count & '( )' )' * ') * ++

, -it!in S# o$

r"%ondnt

&./, '1.2, )&.(, )&.(, +.0

,

'&.1

,

+.0

,

)00.

0,

Fm

al

Count & )& / '+ 2 )1 2 **

, -it!in S# o$

r"%ondnt

&.1, )(.1, 2.', &(./, (.2

,

'/.*

,

(.2

,

)00.

0,

Total Count ( &1 )( /0 )' /0 )' )(2

, -it!in S# o$

r"%ondnt

&.(, '&.(, 1.*, '/.', *.&

,

'/.'

,

*.&

,

)00.

0,

Chi-Square Tests


"idd8

Par"on C!i7S9uar )/.+&&a ( .0''

i;li!ood Ratio )2.''' ( .0)1

inar7


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Religion of respondent * Education Crosstabulation

Education Total

Primary Scondar

y

Trtiary Ot!r"

Rli5ion o$ r"%ondnt I"lam Count '' '* & )& (2

, -it!in Rli5ion o$

r"%ondnt

&&.+, /).2, /.(, '0.0, )00.0,

Budd!

a

Count / ' 0 0 (

, -it!in Rli5ion o$

r"%ondnt

((.*, &&.&, 0.0, 0.0, )00.0,

Hindu Count && &( / ') 1/

, -it!in Rli5ion o$

r"%ondnt

&2.), &+.&, /.&, ''.&, )00.0,

Total Count 21 (2 * &/ )(2

, -it!in Rli5ion o$

r"%ondnt

&2.+, &1./, /.', '0.(, )00.0,

Chi-Square Tests


"idd8

Par"on C!i7S9uar &.20'a ( .*//

i;li!ood Ratio /.((/ ( .2++

inar7uare #alue G "';503 p #alue 5'A44 (J5'5;,8 it is not significant3 -ince p #alue is J 5'5;8 null hypothesis is accepted' There is no relationship %et$een religion and

education le#el'

2 MATERNA3 CARE 5 CHI3D IMMUNISATION

AGE DURING FIRST PREGNANCY


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=hat is your age during first pregnancyL

-ample si


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Figure (!): "ie #hart showing period of time (in years) between last pregnan#y and now

ased on the pie chart a%o#e8 1"'"F of mothers had their last pregnancy $ithin one to three years $hile theremaining 3@'AF of mothers had their last pregnancy more than three years ago'

NUMBER OF CHI3DREN

Figure (!): Bar graph showing number of #hildren in ea#h family

ased on the %ar graph a%o#e8 maority families had a total of 4 children in their families8 follo$ed %y t$o8three and fi#e children'

PREVIOUS MISCARRIAGE HISTORY


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Figure (!*): "ie #hart showing o##urren#e of mis#arriages during preious pregnan#ies

03'@F of mother had miscarriages during the pre#ious pregnancies8 $hile the remaining A1'4F of mothers hadno reported miscarriages during pre#ious pregnancies'

NATURE OF MISCARRIAGE

ased on the data collected8 all miscarriages that occurred among the mothers of *ampung aru Thye Eng $erenatural'

FAMI3Y P3ANNING

Figure (!+): "ie #hart showing pra#ti#e of family planning

A"'"F of families practice family planning $hile the remaining 0@'AF do not practice family planning'


39/143

FAMI3Y P3ANNING METHOD

Figure (%,): "ie #hart showing methods of family planning

13'0F of #illagers use oral contracepti#es8 inections and a%stinence each as a method of family planning' '1Fof #illagers use physical %arrier $hile the remaining "@'4F of #illagers use other methods of family planning'

ANTENATA3 CARE VISITS

Figure (%1): Bar graph showing antenatal #are proider during re#ent pregnan#y

""'"F of the mothers had their antenatal care from the go#ernment hospital $hile the remaining @@'AF of themothers had their antenatal care from the go#ernment health clinics'


40/143

REGU3AR ANC VISITS

ased on the data collected8 all mothers of *ampung aru Thye Eng $ent for regular antenatal follo$ ups'

COMP3ICATIONS DURING 3AST PREGNANCY

Figure (%!): "ie #hart showing #ompli#ations fa#ed during last pregnan#y

The pie chart a%o#e sho$s that 35F of the respondents did not face any complications during their last

pregnancy $hile 05F of them had complications during their last pregnancy'

TYPE OF COMP3ICATIONS FACED# IF ANY


41/143

Figure (%%): Bar graph showing types of #ompli#ations fa#ed during last pregnan#y

The a%o#e %ar chart sho$s that highest fre>uency of 0 mothers of this #illage had other pro%lems $hereas oneof them had hypertension and another had anemia during her last pregnancy'

IMMUNISATION DURING PREGNANCY

Figure (%&): "ie #hart showing immuni2ation ta.en during last pregnan#y

The a%o#e pie chart sho$s that A"'"" F of the respondents had immuni


42/143

Figure (%'): "ie #harts showing pla#e of deliery of last #hild

The a%o#e pie chart sho$s that "'""F of them deli#ered their last child at the go#ernment hospital $hereas@'@AF of them deli#ered their last child at an alternati#e %irth center'

FU33 TERM OR PRETERM DE3IVERY

Figure (%): "ie #hart showing preterm or full term #hild deliery

The chart a%o#e sho$s that "'"" F of %a%ies deli#ered %y mothers of this #illage $ere full term %a%ies$hereas @'@A F of them $ere preterm %a%ies'


43/143

METHOD OF CHI3D DE3IVERY

Figure (%): "ie #hart showing method of deliery of the #hild

The a%o#e chart sho$s that A"'""F of the mothers deli#ered their child #ia spontaneous #aginal deli#ery' 05 F

of them $ent through caesarean section and @'@A F deli#ered their child %y assisted deli#ery'

COMP3ICATIONS DURING;AFTER DE3IVERY


44/143

Figure (%*) Bar graph showing #ompli#ations fa#ed during or after deliery

The a%o#e chart sho$s that 15 of them did not face any complications' One of them had prolonged la%or $hile

" of the mothers had other complications during or after the deli#ery'

NUMBER OF IN HOUSE CARE BY STAFF NURSE

Figure (%+): Bar graph showing number of times of in3house #are by the staff nurse

The %ar chart sho$s that the highest num%er of in house care pro#ided $as A times $hereas there $ere alsosome mothers $ho did not recei#e inhouse care %y the staff nurse

BREASTFEEDING STATUS OF MOTHER


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!ll the mothers %reastfed their child'

PROB3EMS FACED DURING BREASTFEEDING# IF ANY

There $ere no pro%lems faced %y the mothers during %reastfeeding'

E


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Figure (&1): "ie #hart showing #ompletion of immuni2ation a##ording to s#hedule

Maority of children (0'3@F, had their immuni


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13month D.T 0 "'"F 03'@F

13month I.6 0 "'"F 03'@F

13month HI 0 "'"F 03'@FTotal @5 155'5F 3;A'1F

Table (&): 4mmuni2ation status for #hildren less than or e-ual to ! years of age

ased on the ta%le a%o#e8 all four children are #accinated from C+ at %irth until " month HI " are#accinated from ;th month D.T until 10th month MM) $hereas only 0 out of the four children are immuni


48/143

3 HoG There is no relationship %et$een age of first pregnancy and education le#el3 H!G There is relationship %et$een age of first pregnancy and education le#el3 Chis>uare #alue G 5';113 p #alue 5'4A; (J5'5;,8 it is not significant3 -ince p #alue is J 5'5;8 null hypothesis is accepted' There is no relationship %et$een age of first

pregnancy and education le#el'

%, Num%er of pregnancies and miscarriages during pre#ious pregnancy

u!ber of pregnancies you had * "id you ha#e any !iscarriages during your pre#ious pregnancies? Crosstabulation

id you !a= any mi"carria5" durin5

your %r=iou" %r5nanci"?

TotalY" No

Num


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3 Chis>uare #alue G 5'0353 p #alue 5';A (J5'5;,8 it is not significant3 -ince p #alue is J 5'5;8 null hypothesis is accepted' There is no relationship %et$een num%er of

pregnancies and miscarriages'

c, Num%er of children and practice of family planning

u!ber of children * "o you practice any fa!ily planning? Crosstabulation

o you %ractic any $amily %lannin5?

TotalY" No

Numuare #alue G 5'5043 p #alue 5'3A@ (J5'5;,8 it is not significant3 -ince p #alue is J 5'5;8 null hypothesis is accepted' There is no relationship %et$een num%er of children

and family planning

Chi-Square Tests

4alu d$

A"ym%totic

Si5ni$icanc 6'7

"idd8 E#act Si5. 6'7"idd8 E#act Si5. 6)7"idd8

Par"on C!i7S9uar .0'/a

) .+*(

Continuity Corrction< .000 ) ).000

i;li!ood Ratio .0'/ ) .+*(

Fi"!r" E#act T"t ).000 .(('

inar7


50/143

=2 NUTRITIONA3 ASSESSMENT

HISTORY OF FOOD A33ERGY AMONG RESPONDENTS

Figure (&!): Bar #hart showing en-uiry about history of food allergy in respondents (n 5%)

ased on the "@ households7 respondents9 head of family that $e inter#ie$ed in *ampung aru Thye Eng8 only4 of them $ere allergic to food or any su%stance8 $hich is 11'1F of the total respondents' "08 or 33'F of therespondents do not suffer from any &ind of allergy'

TYPE OF FOOD A33ERGY# IF PRESENT# AMONG RESPONDENTS

Type of food allergy /re>uency

Chic&en 1


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Medicine 1-eafood 0

Total 4

Table ('): Type of food allergy in respondents (n5%)

Out of the 4 people suffering from allergy8 0 of them8 or ;5'5F of the total8 are allergic to seafood' 1 person(0;'5F, is allergic to medicine8 $hile the other (0;'5F, is allergic to chic&en'

NUMBER OF MEA3S TA4EN BY RESPONDENTS IN A DAY

Nmbe* of me-s t-9e! /e* $-" *e:e!c" %e*ce!t-&e

Less th-! th*ee me-s 6 16;

Th*ee me-s )1 48;3

#o*e th-! th*ee me-s 5 )4;0

Tot- 36 100;0

Table (): Number of meals ta.en per day (n5%)

Out of the "@ respondents8 @ of them (1@'AF, ta&e less than " meals per day8 01 of them (;3'"F, ta&e " mealsper day8 and of them (0;'5F, ta&e more than " meals per day'

MEA3 OFTEN S4IPPED


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Figure (&%): Bar #hart showing the meals often s.ipped6 if any6 among respondents (n5%)

Out of the "@ respondents8 0;'5F8 or of them usually s&ip %rea&fast' 1"'F8 or ; of them8 usually s&ip lunch'Ho$e#er8 @1'1F8 or 00 of them usually don7t s&ip any meals' None of the "@ people do s&ip dinner'

POU3TRY;FISH CONSUMPTION IN A 6EE4

Figure (&&): "ie #hart showing the number of times respondents eat poultry7fish in a wee. (n5%)


53/143

Out of the "@ respondents8 0'3F or 1 of them usually $on7t eat poultry or fish at all' 11'1F or 4 of them usuallyeat once in a $ee&' 1@'AF or @ of them eat t$ice a $ee&' 0;F8 or of them8 usually thrice in a $ee&' 1"'F or; of them eat 4 times a $ee&8 and "5'@F or 11 of them eat e#ery day in a $ee&'

VEGETAB3E CONSUMPTION IN A 6EE4

Figure (&'): Bar #hart showing the number of times respondents eat egetables in a wee. (n5%)

Out of the "@ respondents8 0'3F or 1 of them eat #egeta%les once a $ee&' 1@'AF or @ of them eat #egeta%lest$ice a $ee&' 3'"F or " of them eat #egeta%les thrice a $ee&' 11'1F or 4 of them eat #egeta%les 4 times a $ee&;'@F or 0 of them eat #egeta%les ; times a $ee&' ;;'@F or 05 of them eat #egeta%les e#ery day in a $ee&'

DESSERT;SNAC4S;FAST FOOD CONSUMPTION IN A 6EE4

Num%er of desserts9fast food in a $ee& /re>uency .ercentage

None 14 "3')arely 13 ;5'5

Often 4 11'1Total "@ 155'5

Table (): Number of times respondents eat desserts7sna#.s7fast foods in a wee. (n5%)

Out of the "@ respondents8 "3' F of them do not eat dessert or snac&s or fast food at all';5'5F of them rarelyeat dessert or snac&s or fast food' 11'1F of them often eat dessert or snac&s or fast food in a $ee&'


54/143

BREA4FAST FOR YESTERDAY

Type of food /re>uency .ercent

read $ith mil& or porridge 0;'5

Nasi lema& ($ith or $ithout coffee, @ 1@'A)oti canai $ith other types of food or drin&s ; 1"'Noodles $ith milo or tea 4 11'1iscuit $ith tea or coffee " 3'"Thosai " 3'"/ried rice8 rice and egg8 rice and sardine " 3'"Drin&s such as tea8 milo 0 ;'@None 1 0'3

Total "@ 155'5

Table (*): Types of food for brea.fast yesterday (n5%)

Out of the "@ respondents8 0;F of them had %read $ith mil& or porridge for %rea&fast yesterday' 1@'AF of themhad nasi lema& $ith or $ithout coffee8 1"'F of them had roti canai $ith other types of food or drin&s8 11'1Fof them has noodles $ith milo or tea8 3'"F of them had %iscuit $ith tea or coffee8 3'"F of them had thosai83'"F of them had fried rice8 rice and egg8 rice and sardine8 ;'@F of them had drin&s only such as tea and milo$hile 0'3F of them do not ha#e their %rea&fast at all'

3UNCH FOR YESTERDAY


)ice $ith meat (fish or chic&en, or egg 1 ;0'3)ice $ith meat and #egeta%les 14 "3')ice 0 ;'@)ice $ith #egeta%les 1 0'3

Total "@ 155'5

Table (+): Types of food ta.en for lun#h yesterday (n5%)


55/143

4);838;5

4;6 );8

)ice $ith meat (fish or chic&en, or egg )ice $ith meat and #egeta%les )ice )ice $ith #egeta%les

Figure (&): "ie #hart showing types of food ta.en for lun#h yesterday (n5%)

Out of the "@ respondents8 ;0'3F of them had rice $ith meat or egg for lunch yesterday' "3'F of them had rice$ith meat and #egeta%les8 ;'@F of them had rice only $hile 0'3F of them had rice $ith #egeta%les'

DINNER FOR YESTERDAY


)ice $ith meat (fish or chic&en, or egg 1@ 44'4)ice $ith meat and #egeta%les 1" "@'1read or urger 4 11'1Noodles 0 ;'@Thosai 1 0'3

Total "@ 155'5

Table (1,): Types of food ta.en for dinner yesterday (n5%)


56/143

Rice *e-$ o* >*&e* Thos-i

1@

1"

4

01

Figure (&): %8 Bar #hart showing the types of food ta.en for dinner yesterday (n5%)

Out of the "@ respondents8 44'4F of them had rice $ith meat or egg for dinner yesterday' "@'1F of them had

rice $ith meat and #egeta%les' 11'1F of them had %read or %urger' ;'@F of them had noodles $hile 0'3F of

them had thosai'

TYPE OF COO4ING OI3 USED

Figure (&*): Bar #hart showing the type of #oo.ing oil used by the respondents (n5%)


57/143

Out of the "@ respondents8 "0 of them or 33'F use #egeta%le %ased oil for coo&ing $hile remaining 4 of themor 11'1F use animal %ased oil for coo&ing'

CONSUMPTION OF ANY NUTRITIONA3 SUPP3EMENTS

Nmbe* of /eo/e t-9i!&!t*itio!- s//eme!ts

*e:e!c" %e*ce!t-&e

?es 3 8;3

No 33 51;

Tot- 36 100;0

Table (11): Number of times respondents ta.ing any nutritional supplements (n5%)

Out of "@ respondents8 "" of them or 1'AF do not ta&e any nutritional supplements $hile remaining 4 of themor 3'"F ta&e nutritional supplements'

TYPE OF SUPP3EMENTS TA4EN

Figure (&+): "ie #hart showing the type of supplements ta.en by the respondents (n5%)


58/143

Out of " respondents $ho are ta&ing nutritional supplements8 1 of them or ""'"F ta&es fish oil' 1 of them or""'"F ta&es .harmaton #itamin ta%lets and remaining 1 or ""'"F ta&es her%al yeast food supplement andchic&en essence'

NUMBER OF TEASPOONS OF SUGAR INC3UDED IN BEVERAGES;FOOD IN A DAY

Num%er of teaspoons of sugar in%e#erages9food in a day

/re>uency .ercentage

Bess than four 0 35'@/our 4 11'1More than four " 3'"

Total "@ 155'5

Table (1!): Number of teaspoons of sugar in beerages7food in a day by respondents (n5%)

Out of "@ respondents8 0 of them or 35'@ F use less than 4 teaspoons of sugar in %e#erages in a day' 4 of themor 11'1F use e?actly 4 teaspoons of sugar in %e#erages in a day' " of them or 3'"F use more than 4 teaspoons in%e#erages in a day'

RESPONDENTS> INTEREST IN EATING SA3TY FOODS

Interest in eating salty foods /re>uency .ercentage

Yes 10 ""'"No 04 @@'A

Total "@ 155'5

Table (1%): 4nterest of respondents in eating salty foods (n5%)

Out of "@ respondents8 10 of them or ""'"F li&e to eat salty foods $hile remaining 04 of them or @@'AF do notli&e to eat salty foods'

IF YES# HO6 MANY TIMES PER 6EE4


59/143

Figure (',): Bar #hart showing the number of times salty food inta.e in a wee. (n5%)

Out of "@ respondents8 10 of them li&e salty food' ; of them or 41'AF li&e to eat salty foods once a $ee&'!nother ; of them li&e to eat salty foods t$ice a $ee&' )emaining 0 of them or 1@'AF li&e to eat salty foodsthrice a $ee&'

RESPONDENTS> INTEREST IN EATING OI3Y FOODS

Interest in eating oily foods /re>uency .ercentage

Yes 13 ;5'5No 03 ;5'5

Total "@ 155'5

Table (1&): 4nterest of respondents in eating oily foods (n5%)

Out of "@ respondents8 13 of them or ;5F li&e to eat oily foods' )emaining 13 of them or ;5F do not li&e to eatoily foods'

IF YES# STATE HO6 MANY TIMES PER 6EE4


60/143

Figure ('1): Bar #hart showing the number of times oily food inta.e in a wee. (n5%)

Out of "@ respondents8 13 of them li&e to eat oily foods' 4 of them or 00'0F li&es to eat oily foods once a $ee&'!nother 4 of them or 00'0F li&es to eat oily food t$ice a $ee&' ; of them or 0A'3F li&es to eat oily food thrice

a $ee&' )emaining ; of them or 0A'3F li&es to eat oily foods e#ery day'

VARIAB3E RE3ATIONSHIP


61/143

a, -e? of respondent and meal often s&ipped

$eal often s%ipped * Sex of respondent Crosstabulation

S# o$ r"%ondnt Total

Mal FmalMal o$tn ";i%%d BREADFAST Count / 2 1

, -it!in Mal o$tn ";i%%d //./, 22.(, )00.0,

UNCH Count ' & 2

, -it!in Mal o$tn ";i%%d /0.0, (0.0, )00.0,

NONE Count 2 )* ''

, -it!in Mal o$tn ";i%%d ''.*, **.&, )00.0,

Total Count )) '2 &(

, -it!in Mal o$tn ";i%%d &0.(, (1./, )00.0,

Chi-Square Tests


"idd8

Par"on C!i7S9uar ).((/a ' ./&2

i;li!ood Ratio ).(&+ ' .//)

inar7


62/143

Mor%idity in last "months /re>uency .ercentageYes 3 01'1No 03 A3'

Total "@ 155'5Table (1'): En-uiry on morbidity in last % months

Eight respondents $hich are 01'1F of the community ha#e reported that they ha#e suffered from acute diseasesin last " months' Ho$e#er8 A3'F of them ha#e denied that they ha#e suffered from any disease in last "months'

TYPE OF MORBIDITY

Types of mor%idity in last "months


Communica%le Disease " ;5'5

Non Communica%leDisease

" ;5'5

Total @ 155'5

Table (1): En-uiry on types of morbidity in last % months

;5F of them reported that they ha#e suffered from communica%le disease and other ;5F suffered from non

communica%le disease'

EN9UIRY ON SEE4ING MEDICA3 CARE FOR MORBIDITY


63/143

Figure ('!): Bar graph showing response on see.ing medi#al #are for morbidity

The figure sho$ed that A;F $ho ha#e suffered from acute disease in last " months had sought for health care

%y ans$ering YE- and other 0;F did not' Those respondents $ho did not see& health care had other reasons

li&e lac& of money8 no transport facilities and lac& of time'

EN9UIRY ON HEA3TH CARE SERVICES ATTENDED

Figure ('%): Bar graph showing type of health #are seri#es utili2ed for illness


64/143

ased on the %ar chart a%o#e8 three respondents $ho suffered from any acute illness consecuti#ely for si? $ee&s

preferred to go to *lini& *esihatan8 $hile t$o of them $ent to pri#ate hospital or clinic' The residents prefer to

go to *lini& *esihatan %ecause it is near the #illage and also cheaper compared to tra#elling to the +o#ernment

Hospital $hich is located at the to$n' Traditional medical healers are least #isited pro%a%ly due to higher trust

on certified doctors and understanding of their symptoms prompt them to choose $isely'

DIAGNOSIS OF I33NESS

Figure ('&): "ie #hart showing the types of diagnosis of illness

ased on the pie chart a%o#e8 the most common illness among the residents here are respiratory tract infections'

E#ery other diagnosis %ased on their symptoms sho$s e>ual distri%ution among the residents $ith one person

affected $ith a certain illness' The other illnesses accounts for 14F each'

COMP3IANCE 6ITH TREATMENT RECEIVED


65/143

Table (1): En-uiry on the #omplian#e on treatment re#eied

!mong all residents $ho are affected %y acute illnesses8 only one opened up on not ta&ing regular treatment forhis illness' The rest claims to %e compliant in ta&ing their treatment' The reason gi#en %y the one person for notta&ing regular treatment is %ecause of ignorance' He does not thin& medications are needed to treat his illnessand continues to $or& $ithout them'

MORBIDITY FOR @ 6EE4S OR MORE

Table (1*): En-uiry on the morbidity for wee.s #onse#utiely or more

ased on the ta%le8 it is clear that the num%er of residents suffered $ith any disease consecuti#ely for @ $ee&s

or more is only "AF $hen compared to the maority of the residents $ho is healthy from any illnesses'

TYPE OF MORBIDITY FOR @ 6EE4S OR MORE

Compliance $ith treatmentrecei#ed /re>uency .ercentage

Yes A 3A';No 1 10';

Total "@ 155'5

Mor%idity for @ $ee&sconsecuti#ely or more


Yes 14 "A'1No 00 @0'

Total "@ 155'5


66/143

Table (1+): En-uiry on types of morbidity for #onse#utiely wee.s or more

Out of 14 people $ho are suffering $ith chronic illnesses8 only 1 is suffering $ith communica%le disease $hile

10 of them are suffering $ith noncommunica%le disease $hich is a%out 3;F of total residents $ith chronic

illnesses'

SEE4ING MEDICA3 CARE FOR I33NESS

Figure (''): Bar graph showing en-uiry on see.ing medi#al #are for illness

Of all of those suffering $ith a disease8 only 0 residents claim to not see& health care for their illnesses $hile all

the other 10 ha#e attended medical care to treat themsel#es $hich accounts to 3;'AF of those affected' The

reason gi#en %y one out of 0 residents to not see& medical attention is due to lac& of money for follo$ up

treatments' The other reason gi#en %y the remaining resident is other than that of lac& of money8 lac& of time or

transport'

3OCATION OF HEA3TH CARE SEE4ED

Types of mor%idity @ $ee&sconsecuti#ely or more


Communica%le Disease 1 A'1Non Communica%le Disease 10 3;'AOthers 1 A'1Total 14 155'5


67/143

Figure ('): Bar graph showing en-uiry on the pla#e to attain health #are for the illness

ased on the %ar chart a%o#e8 maority of the residents $ho suffered from any illness consecuti#ely for si?

$ee&s prefers to go to +o#ernment hospital for treatments $hich is 4@'1;F' *lini& *esihatan attri%utes to

"3'4@F' =hile the rest go to pri#ate hospital9clinic $here the percentages of it is 1;'"3F' The residents prefer

to go to the +o#ernment hospital %ecause it is near the #illage and also cheaper compared to pri#ate clinics'

DIAGNOSIS OF I33NESS

Figure ('): "ie #hart showing en-uiry on the diagnosis of the illness


68/143

The diagnosis of the illness among those $ho suffered from any illness consecuti#ely for @ $ee&s or more is assho$n a%o#e' The highest num%er of illness affecting the population is hypertension $hich accounts for @person8 attri%uting to 40'3@F follo$ed %y people suffering $ith dia%etes mellitus alone8 or dia%etes mellitus$ith hypertension' This accounts for 0 people for each diagnosis8 each at 14'0F respecti#ely' The restconsisting of angina8 slipped disc8 asthma8 %lurring of #ision and loss of hearing attri%ute to A'14F that is 1person for each disease respecti#ely'

REGU3AR TREATMENT FOR I33NESS

Figure ('*): Bar graph showing the regularity of the treatment ta.en for the illness

Out of 14 of them $ho are suffering from illnesses8 15 of them do ta&e regular treatment $hich attri%utes to

A1'4"F of the total population8 and 4 of them do not ta&e regular treatment $hich attri%utes to the remaining

03';AF' There are four people $ho do not ta&e treatment regularly' The person $ho is suffering from dia%etes

mellitus and hypertension stated her reason of not ta&ing medication regularly is due to the reason that she

forgets to consume it sometimes' Ne?t8 the person $ho is ha#ing asthma gi#es the reason that she feels that

MDI is trou%lesome' Then the person $ho is ha#ing %lurring of #ision and loss of hearing decided to ignore her

illness' The last one is $ho is suffering from hypertension said they ta&e the medication only $hen symptoms

arises'

MEDICA3 CHEC40UP FOR I33NESS


69/143

Figure ('+): Bar graph showing en-uiry on medi#al3#he#. up for this illness

Out of 14 respondents $ho suffer from chronic diseases8 there are 10 of them $ho do go for medical chec&upfor their illness' There are 0 of them $ho did not go for medical chec&up'

FAMI3Y MEMBERS 6ITH DISEASE IN 3AST = MONTHS

Table (1+): No of family members suffering from any disease in last % months

ased on the ta%le a%o#e8 it sho$s that 1'4 F of the #illagers had family mem%er(s, $ho had fallen sic& in thepast " months' There is 35'@ F of the family mem%er(s, $ho did not fall sic& during the past " months'

TYPE OF I33NESS SUFFERED

/amily mem%ers suffering fromany disease in last " months


Yes A 1'4

No 0 35'@

Total "@ 155'5


70/143

Figure (,): "ie #hart showing type of illness they suffered

ased on the pie chart a%o#e8 among the family mem%ers $ho $ere sic& during the past " months8 non

communica%le disease sho$s a higher rate of incidence $hich is A1'4F8 $hile communica%le disease has an

incidence rate of 03'@F' Of all the family mem%er of the respondents $ho fell sic& in the last " months8 each of

them see& medical healthcare for their illness'

HEA3TH CARE CENTER VISITED


71/143

)5@

43@

17@

En2ui.y on Healt, Ca.e Cente. Vi-ited

K0i!i9 Kesih-t-! 2ove*!me!t Hos/it-0

%*iv-te Hos/it-0

Figure (1): "ie #hart showing en-uiry on health#are #enter isited

ased on the pie chart a%o#e8 1 #illager $hich is 14'" F of the total is see&ing health care in the pri#ate

hospital8 0 of them $hich is 03'@F are see&ing health care in &lini& &esihatan and 4 of them $hich is ;A'1 F are

see&ing health care from the go#ernment hospital' It is o%#ious from here that the most preferred choice is to the

go#ernment hospital'

DISEASES DIAGNOSIS


72/143

Figure (!): Bar graph showing the diagnosis of illness

/rom the %ar chart a%o#e8 0 #illagers has suffered from hypertension and 0 #illagers from Dia%etes Mellitus'

The rest of respondents suffered from fe#er8 trauma8 hypercholesterolemia8 heart diseases and respiratory tract

diseases8 each disease affecting one person each' Thus8 $e can say that the most common illnesses suffered

among the residents here are hypertension and dia%etes mellitus'

REGU3AR TREATMENT FOR I33NESS


73/143

Figure (%): Bar graph showing regular treatment ta.en for illness

Out of A respondents $ho suffered from chronic diseases8 @ of them ta&e regular treatment for their illness' -o

$e can say maority of them are compliant to medications gi#en' The one person $ho did not ta&e regular

treatment for their illness is %ecause the doctor had stopped the medications'

FAMI3Y MEMBERS PASSED A6AY


74/143

Figure (&): Bar graph showing en-uiry on family member passed away last year

ased on the chart a%o#e8 it sho$s that 11'1F of #illagers ha#e had one of their family mem%ers passing a$ay

last year $hile 33'F of them ha#e none of their family mem%ers $ho passed a$ay last year'

AGE OF DEATHS FOR THE PAST ONE YEAR IN 4AMPUNG THYE ENG

Out of four households $ho ga#e mortality conditions in last year8 it $as found that the death occurred in theage group of 5 to @ year in one household and the three households had mortality in the age group of more than

@5 year'

CAUSE OF DEATHS FOR THE PAST ONE YEAR IN 4AMPUNG BARU THYE ENG


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Figure ('): "ie #hart showing #ause of death of illagers for the past one year

The pie chart depicts the cause of death of the #illagers $ho had died in the past one year' It is a continuation

and ela%oration of the pre#ious pie charts depicted a%o#e and ser#es as an e?planation as to the reason for the

#illagers7 untimely passing' !ccording to the data8 1 #illager had died of cardio#ascular disease9heart attac&8

accumulating a total of 5'@1F of the total #illagers' !lso8 only 0 #illagers had died of old age8 accumulating a

total of 1'01F of the total #illagers' !nother 1 #illager had died due to a road traffic accident8 accumulating atotal of 5'@1F of the total #illagers'

SECTION 1F2 BP AND BMI

MI C!TE+O)Y


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Figure (): "ie #hart showing B94 #ategory of respondents

The pie chart sho$s the ody Mass Inde? of the residents of *ampung aru Thye Eng' !lthough it clearlydepicts half of the population in that are of normal %ody $eight8 it is important to note than almost the other halfof the population are o#er$eight $hich is appro?imately 4A'44F' This can easily relate to the incidence ofcardio#ascular related diseases among the population' !mong the population also lies 0';@F $hich is

e>ui#alent to 0 mem%ers of the population $ho are under the category of under$eight'

. C!TE+O)Y


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Figure (): "ie #hart showing blood pressure #ategory of respondents

The pie chart clearly descri%es the o#er#ie$ of the %lood pressure status among the residents of *ampung aru

Thye Eng' =hat is important to gather from here is the amount of residents suffering from hypertension $hich

is "5';"F of the $hole population' This means that the maority of the population $hich is a%out @'4AF are of

$ithin the normal %lood pressure le#el' Though it may seem li&e a small percentage of them suffering $ith

hypertension8 it is important to &no$ that the ris& factors to increase this percentage is a%undant in the area

especially since half of the population are o#er$eight' Thus this condition can easily %e the catalyst for more

cardio#ascular related pro%lem that this #illage already suffers from'

VARIAB3E RE3ATIONSHIPS

a, !ge and MI


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&ge* '$( Category Crosstabulation

A5 Total

@/0 yar" /0 yar"

BMI cat5ory Undr-i5!t Count ) ) '

, -it!in BMI cat5ory 20.0, 20.0, )00.0,

Normal -i5!t Count )* '' &1

, -it!in BMI cat5ory /&.(, 2(./, )00.0,

O=r-i5!t Count )) '( &*

, -it!in BMI cat5ory '1.*, *0.&, )00.0,

Total Count '1 /1 *+

, -it!in BMI cat5ory &*.', ('.+, )00.0,

Chi-Square Tests


"idd8

Par"on C!i7S9uar ).*0(a ' ./'(

i;li!ood Ratio ).*)* ' ./'/

inar7


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Mal Fmal

BPcat5ory Hy%rtn"ion Count 1 '0 '1

, -it!in BPcat5ory &).0, (1.0, )00.0,

Normotn"i= Count &' &/ ((

, -it!in BPcat5ory /+.2, 2).2, )00.0,

Total Count /) 2/ 12, -it!in BPcat5ory /&.', 2(.+, )00.0,

Chi-Square Tests

4alu d$ A"ym%totic

Si5ni$icanc 6'7

"idd8

E#act Si5. 6'7

"idd8

E#act Si5. 6)7

"idd8

Par"on C!i7S9uar '.20)a ) .))/

Continuity Corrctionuented method to dispose the gar%age $as #ia gar%age dumping $hich accounted for a%outAA'3F' This is %ecause it $as the most con#enient8 easy8 and cheapest method for the #illagers to dispose thegar%age'

M%te*n%& %nd Ch!&d C%*e

!ll $omen are gi#en complete immuniuired age to recei#e the #accination dose' O#erall sho$s that most of the children $ere#accinated and they ha#e a satisfying immuni


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ased on Ta%le @8 most of the respondents ta&e at least " meals per day8 $hile some of them ( of them90;'5F,ta&e more than " meals per day' 00 out of the "@ respondents usually don7t s&ip any meals8 $hile of themusually s&ip %rea&fast8 and the remaining8 lunch' Maority of the respondents do eat fish or poultry e#ery day6egeta%le consumption is also high among the respondents8 $ith many of them eating #egeta%les e#ery day inthe $ee&'

"0 out of the "@ respondents use #egeta%le oil for their coo&ing purposes' ! #ast maority of them do notconsume any type of nutritional supplements' Most of the respondents also do not consume much salty or oilyfood'

Mo*'!d!t/ %nd He%&th Beh%,!o$*

ased on Ta%le (1;,8 01'1F or 3 of the respondents had suffered from an acute disease in the last " months' Outof these 3 people8 only @ of them did see& medical care for their disease'

ased on /igure (;4,8 the most common type of disease that affects the residents of *ampung aru Thye Eng isrespiratory tract infections' This accounts for 40'3@F of the total type of illness that %efalls these #illagers'

ased on Ta%le (13,8 14 of the residents ha#e suffered from disease that lasted for @ $ee&s consecuti#ely8 $hichis "AF of the total population of respondents'

The pie chart in /igure (@;, sho$s that the most common cause of death in *ampung aru Thye Eng in the past1 year $as due to old age' 0 #illagers had passed a$ay due to this8 accounting for 1'01F of the total populationof *ampung aru Thye Eng'

The pie chart in /igure (@@, sho$s the ody Mass Inde? of the residents of *ampung aru Thye Eng' !lthoughit clearly depicts half of the population in that are of normal %ody $eight8 it is important to note than almost theother half of the population are o#er$eight $hich is appro?imately 4A'44F' This can easily relate to the

incidence of cardio#ascular related diseases among the population' !mong the population also lies 0';@F $hichis e>ui#alent to 0 mem%ers of the population $ho are under the category of under$eight'

!s for the %lood pressure category8 the amount of residents suffering from hypertension is "5';"F of the $hole

population' This means that the maority of the population $hich is a%out @'4AF are of $ithin the normal

%lood pressure le#el' Though it may seem li&e a small percentage of them suffering $ith hypertension8 it is

important to &no$ that the ris& factors to increase this percentage is a%undant in the area especially since half of

the population are o#er$eight' Thus this condition can easily %e the catalyst for more cardio#ascular related

pro%lem that this #illage already suffers from'

ased on the cross ta%ulations8 there $ere no correlations %et$een se? of respondents and . le#el' Ho$e#er8

there is a relationship %et$een the occupation and . le#el8 sho$ing that employed people had higher . le#els

than unemployed people8 relating to possi%le stress at $or&'

Con&$!on


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In 4%)p$n" B%*$ Th/e En"8 the highest proportion of race is Indian follo$ed %y Muslim and Chinese' Thedependency ratio is an indicator that can %e used to estimate the economic %urden of a family' The a#eragedependency ratio of household in *ampung aru Thye Eng is in an unhealthy state %ecause the num%er ofindi#iduals $ho are economically inacti#e outnum%ers the acti#e ones' The education le#el of the residents is inthe %orderline (secondary le#el, and this corresponds to the occupation and the income status' Those $ith thehigher educational le#el ha#e the chances to ha#e a %etter o% $ith high income' The residents should ha#e

a$areness to$ards importance of education' This accounts for the income status of residents at the po#erty line'Most of the households do not face any pro%lems $ith electricity supply8 $ater supply8 $astage disposal andsanitary latrine' The cleanliness le#el is at the satisfactory le#el' Maternal and child healthcare is at thesatisfactory le#el in *ampung aru Thye Eng' Most of the children are #accinated' In conclusion8 the healthstatus in this community is satisfying'

Reo))end%t!on

In order to impro#e the education le#el of the indi#idual and family8 parents should ta&e theirresponsi%ilities in their children7s education and to ensure that they ha#e proper education including primary8secondary and tertiary too' The residents should %e educated a%out the method of proper $aste disposal' Theresidents still practice gar%age %urning and this should %e ta&en seriously %ecause it can cause pollution to theland and air' M.-.* should pro#ide gar%age %in in each and e#ery house in *ampung aru Thye Eng8 toreduce the %urden of residents to dispose their gar%age' !ll the septic tan&s must %e impro#ed to pre#entinsanitation' /or e?ample8 the siuires the use of a lid to co#er the hole in the floor $hen not in use' There is a need to create a$arenessregarding the significance of family planning' This is to pre#ent un$anted pregnancies or increase %urden to the

family' .rograms should %e done to create a$areness among the pregnant $omen a%out ho$ to ta&e care ofthemsel#es8 foods to consume during pregnancy and e?ercises that can %e done during pregnancy' Community%ased antenatal care ser#ices should %e introduced in this #illage so that it is more con#enient for the $omen torecei#e antenatal care' Health campaigns should %e organi


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Community Medicine posting in M- Year "8 !IM-T Uni#ersity8 re>uires the students to conduct a sur#eyin a community and to deri#e a community diagnosis %ased on the community sur#ey conducted' !t the end ofthe sur#ey8 a health camp is to %e conducted %y the students to educate a$areness among the residents of thecommunity' oth the sur#ey and health campaign $as conducted %y mem%ers of +roup D8 atch 18 M-

Year "8 !IM-T Uni#ersity' This group consists of 0; medical students8 super#ised %y course coordinator Dr' Inn*ynn *haing and ad#ised %y Head of Community Medicine Unit8 !ssociate .rofessor Dr' *yi *yi -ein8!ssociate .rofessor Dr' Beela !nthony oe8 and !ssociate .rofessor Dr' Tracy -ein'

The area that $as assigned to us $as *ampung aru Thye Eng8 edong8 -ungai .etani8 a moderatesocioeconomic #illage mainly accommodated %y Indian ethnicity' !t the end of the sur#ey8 $e decided toconduct the medical camp on the 1"thMay 051@' .lanning and election of organi


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! total of four doctors $ere %rought in for medical consultation namely Dr' Tin -oe (Medicine,8 Dr' Christina+ell&night (Opthalmologist,8 Dr' Narayanan (Opthalmologist,8 Dr' *anchan !li (.aediatrician, and .rofessorT'.andurangan (-urgery,8 and $ho also the Dean of /aculty of Medicine8 !IM-T Uni#ersity' They contri%utedto this health campaign %y e?amining the patients8 offering necessary counselling and prescri%ing medication tothe patients' !t the same time8 they also taught the medical students on ho$ to perform a physical e?aminationand elicit the signs and symptoms in the patient' =e $ere also aided %y a Year 4 student8 *ent .ee8 $ho $as

helping out the lecturers in the ophthalmology section8 and $as also tutoring the students' Dr' Beela !nthonyoe8 from the Community Medicine Unit played an important role in guiding and assisting the medical studentsin the proper $ay of history ta&ing and #ital signs assessment such as MI8 %lood pressure and %lood glucosele#el measurements' =e $ere also oined %y .rofessor Dr' .* )aesh in his capacity as .resident of )otaryClu% andar -ungai .etani' He $as accompanied %y a fe$ mem%ers of the )otary Clu%'

esides the medical chec&up8 there $ere se#eral %ooths set up to educate and create a$areness regarding#arious lifestyle issues affecting the health' These include posters and %rochure distri%ution a%out healthy diet8

effects of smo&ing8 o%esity and dia%etes' Dr' Beela $as at hand to demonstrate proper %reast selfe?aminationto the $omen present there' esides that8 the )otarians ga#e a tal& on the #ision and mission of the )otaryClu%' .rofessor Dr' .'*' )aesh8 Head of Department of Micro%iology unit of !IM-T Uni#ersity and also thecurrent .resident of )otary Clu% -ungai .etani8 ga#e a tal& regarding the current emerging diseases includingtyphoid and polio' This tal& $as #ery %eneficial not only for the medical students %ut also the residents presentat the e#ent' During the closing ceremony8 sou#enirs $ere distri%uted to the lecturers8 medical consultants8mem%ers of )otary Clu% -ungai .etani and the Head of the #illage'

! part of this health camp also includes interacti#e acti#ities and health education for children' This acti#ity$as done on the same day at the .erpusta&aan *ampung aru Thye Eng8 around 155 meters from theCommunity Hall' It $as conducted %y ; medical students from the same group' The acti#ity $as held from "'"5pm to ;'55 pm' There $ere a total of "5 children $ho participated in the acti#ities' The first acti#ity that $ascarried out $as a colouring competition' The paper pro#ided $as that of #egeta%les8 so it $as also to educate thechildren regarding the many different types of #egeta%les around us and its importance for health' The children$ere gi#en 4; minutes to colour the picture' Crayons and colour pencils $ere pro#ided to them'

!fter the colouring e#ent8 the children $ere then in#ited to participate in a tooth%rushing and hand$ashing

acti#ity' /irst8 the medical students demonstrated the proper methods of hand$ashing' !fter that8 all thechildren $ere gi#en the opportunity to perform it step %y step' Ne?t8 0 dental students from the dental faculty of!IM-T Uni#ersity $ere at hand to e?plain and demonstrate to the children on the proper tooth%rushingtechni>ues' Toothpaste and tooth%rushes $ere pro#ided for them' Bast %ut not least8 $e ended the session $ithpri


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%eneficial e#ent should %e held often in their #illage' !s for the children8 they $ere #ery e?cited and %u


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INTRODUCTION

Bi#ing a healthy lifestyle is certainly not easy' ! healthy lifestyle is defined %y three different categories

physical8 mental8 emotional and spiritual' In order to li#e a truly healthy lifestyle8 you must %alance all three

categories and they must all function together simultaneously'

In order to li#e a physically healthy lifestyle8 you must learn ho$ to %alance your e#eryday life' Doing a

minimum of thirty minutes of cardio#ascular acti#ity for ust three days a $ee&8 can do a myriad num%er of

positi#e things for your %ody' Not only can physical acti#ity e?tend your years of life8 %ut it can also reduce the

li&elihood of getting many health related pro%lems' E?ercising is not the only important feature of %eing

physically healthy8 though' ! healthy diet is the &ey' The food pyramid is there for a reason !long $ith e?ercise

and a healthy diet8 sleep is also #ery importantP ! healthy range of hours of sleep is %et$een A hours' Once

you7#e reached a state of %alance8 you $ill already feel that much %etter physically8 and e#en8 mentally'

The term Qfood hygieneQ is used to descri%e the preser#ation and preparation of foods in a manner that ensures

the food is safe for human consumption' This term typically refers to these practices at an indi#idual or family

le#el8 $hereas the term Qfood sanitationQ usually refers to these types of procedures at the commercial le#el

$ithin the food industry8 such as during production and pac&aging or at stores or restaurants' /ood hygiene in

the home &itchen includes things such as the proper storage of food %efore use8 $ashing oneRs hands %efore

handling food8 maintaining a clean en#ironment $hen preparing food and ma&ing sure that all ser#ing dishes

are clean and free of contaminations' Meats must %e stored and coo&ed properly as part of proper food hygiene'

Many people use containers that are especially designed for use in a free


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(@5S to A4S Celsius,8 depending on the specific type of meat %efore %eing eaten' /ood hygiene also includes

&eeping preparation areas clean and germfree' Mi?ing %o$ls8 spoons8 paring &ni#es and any other tools used in

the &itchen should %e $ashed thoroughly %efore they are used8 as $ell as after' *itchen countertops and cutting

%oards also should %e cleaned and steriliuite a $hile8 such as those

reser#ed for special occasions'

OBJECTIVES OF SURVEY

(. To assess the $ays of healthy life style and food hygiene practised among #illagers'


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. To assess the a$areness to$ards hygiene in the community'=. To assess opinion on healthy life style and food hygiene among #illager'?. To assess opinion on $ays to impro#e the life style and food hygiene among #illagers'. To assess the interest of #illagers in ta&ing initiati#e to impro#e lifestyle and food hygiene'

JUSTIFICATION

The result from focus group discussion is used to help the #illagers to impro#e healthy life style and food

hygiene'

METHODO3OGYG

/ocus group discussion is focus group is a data collection procedure in the form of a carefully planned

group discussion among a%out ten people plus a moderator and o%ser#er8 in order to o%tain di#erse ideas

and perceptions on a topic of interest in a rela?ed8 permissi#e en#ironment that fosters the e?pression of

different points of #ie$8 $ith no pressure for consensus .urposi#e sampling (Heterogeneity sampling,

=e #er%ally in#ited 15 different participants from the #illage on the day /+D $as carried out' On the day of /+D8 only A out of 15 #illagers turned up for the discussion session' /ocus +roup BocationG ! small hall %eside the mos>ue in the #illage' CadreG !#enesh +opal (moderator,8 )a#ines -el#arau (noteta&er 1,8 .riyadashini (noteta&er 0,8

(taperecorder,8 ryan oseph (photographer 1,8 Bogindrah(photographer 0, DurationG "5 minutes Transcri%erG )a#ines -el#arau and .riyadashini Indi#iduals agreed to participate in the research of their o$n free $ill' =ritten consent is preferred8 %ut #er%al consent $as done instead'

)esearchers agreed to &eep personal information that is re#ealed to them confidential'

C*!te*!% of t%*"eted "*o$pG

=or&ing adults aged 13 years and a%o#e


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Male and female !dolescents aged 1" and a%o#e

FINDINGS

Details of participantsG

not real name if participants

RESU3TS:

!ccording to the discussion8 the participants are all a$are that they are not practicing a healthy lifestyle and

food hygiene' This actually sho$s that their poor life style and food hygiene that has %een practicing %y the

#illagers actually lead to some health pro%lems and also causes gastrointestinal infection among the #illagers

-ome of them are not a$are a%out poor food hygiene and food sanitation '/rom the discussion $e had 8 they

agreed to change their lifestyle if they ha#e proper guidance or &no$ledge on that'

CONC3USION

%-*tici/-!ts A&e Se Occ/-tio!

I!$ivi$- 1 35 em-e Hose


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/rom the discussions8 $e can conclude that the #illagers are not practicing a healthy lifestyle and food

hygiene '-ome of them are a$are a%out these pro%lems and yet no further initiati#e $ere ta&en %y them due to

poor &no$ledge on the healthy lifestyle and also food hygiene '/rom this $e came to a conclusion that only

some uses the correct hand $ash steps to $ash hands %efore and after meals and some of them not %other to

$ash hands also 'esides that 8 poor food hygiene -ome of them fail to prepare 8 store and reheat the food

$ell 'Many of them don7t clean their &itchens ' Only of the house &itchen is near%y the gar%age areas $hich

allo$s more flies to enter in the &itchen and yet the #illagers didn7t sho$ any initiati#e to store the food

properly Ho$e#er8 they ha#e agreed to impro#e their lifestyle and also food hygiene if there is a guidance on

ho$ to $ays to impro#e'

RECOMMENDATIONS

The #illagers need to %e educated further regarding healthy lifestyle and food hygiene' Health educations and

health programmes are #ery much important to create a$areness among /or e?ample health ministry can send

some #olunteers to the #illage to teach them on steps to $ash hands 8effecti#e $ays to store food and many

more 'the #illagers on ho$ to practice good lifestyle and also food hygiene' Other than that8 the go#ernment

must ta&e action on the num%er of street dogs and cats in the #illage $hich actually distur%s the #illager7s

daily life and also hygiene' ! petition can %e signed %y all the #illagers and su%mitted to the go#ernment so

that they can do their part' The #illagers need to %e more cooperati#e and get in#ol#ed in acti#ities li&e

gotong 2 royong7 more often to &eep their #illage clean especially if their houses are near%y the gar%age

dumping areas'


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Anne8 (G

:uestion +uidelinesG

1' Do you $ash hands regularly %efore and after mealL

0' Do you soa& your utensils in hot $ater %efore using themL

"' Ho$ far your &itchen from toilet or gar%age dumping areaL

4' Do you place the coo&ed food on the same area $here there is ra$ meat8 poultry or seafoodL

;' Is your &itchen #entilated properly for coo&ingL

@' Do you ha#e pets at homeL If yes ho$ often it comes to &itchenL

A' Ho$ often you reheat your foodL

3' Do you co#er your food on ta%le after eatL

' Do you %oil your $ater %efore drin&L

15' Ho$ often do you eat fruits in a $ee&L

11' Ho$ often do you e?ercise or go for a $al& in a $ee&L

10' Ho$ often you eat oily8 salty8 sugary or fast foods per $ee& L

1"' Ho$ many of you ha#e dia%etes mellitus and hypertensionL

14' Do you $ash the #egeta%les and meat properly %efore you coo&L

1;' Ho$ often you clean your &itchenL

Anne8 G


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ModeratorG

(. Do /o$ +%h h%nd *e"$&%*&/ 'efo*e %nd %fte* )e%&

INDI6IDU!B 1G I $ill $ash my hands regularly %efore and after meal'

INDI6IDU!B 0G I $ill $ash my hands regularly %efore and after meal'

INDI6IDU!B "G I $ill $ash my hands regularly %efore and after meal'

INDI6IDU!B 4G I $ill not my $ash hands regularly %efore meal'

INDI6IDU!B ;G I $ill not my $ash hands regularly %efore meal'

INDI6IDU!B @G I $ill $ash my hands regularly after meal'

INDI6IDU!B AG I $ill $ash my hands regularly %efore and after meal'

. Do /o$ o% /o$* $ten!& !n hot +%te* 'efo*e $!n" the)

INDI6IDU!B 1G I $ill soa& my utensils in hot $ater %efore using them'

INDI6IDU!B 0G I $ill not soa& my utensils in hot $ater %efore using them'

INDI6IDU!B "G I $ill $ash soa& my utensils in cold $ater %efore usingthem'

INDI6IDU!B 4G I $ill soa& my utensils in cold $ater %efore using them'

INDI6IDU!B ;G I $ill not soa& my utensils in hot $ater %efore using them'

INDI6IDU!B @G I $ill soa& my utensils in hot $ater %efore using them'

INDI6IDU!B AG I $ill not soa& my utensils in hot $ater %efore using them'

=. Ho+ f%* /o$* !then f*o) to!&et o* "%*'%"e d$)p!n" %*e%


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INDI6IDU!B 1G 6ery near

INDI6IDU!B 0G 6ery far

INDI6IDU!B "G :uiet near

INDI6IDU!B 4G 6ery far

INDI6IDU!B ;G 6ery far

INDI6IDU!B @G 6ery near

INDI6IDU!B AG 6ery near

?. Do /o$ p&%e the ooed food on the %)e %*e% +he*e the*e ! *%+ )e%t# po$&t*/ o*

e%food

INDI6IDU!B 1G No

INDI6IDU!B 0G No

INDI6IDU!B "G No

INDI6IDU!B 4G No

INDI6IDU!B ;G No

INDI6IDU!B @G No

INDI6IDU!B AG No

;. I /o$* !then ,ent!&%ted p*ope*&/ fo* oo!n"

INDI6IDU!B 1G No

INDI6IDU!B 0G Yes


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INDI6IDU!B "G Yes

INDI6IDU!B 4G Yes

INDI6IDU!B ;G No

INDI6IDU!B @G No

INDI6IDU!B AG No

@. Do /o$ h%,e pet %t ho)e If /e ho+ often !t o)e to !then

INDI6IDU!B 1G No

INDI6IDU!B 0G Yes8 I ha#e a cat and it $ill %e in &itchen most of the time

INDI6IDU!B "G Yes %ut it $on7t enter the &itchen

INDI6IDU!B 4G Yes i ha#e a dog and it $ill %e &itchen $hene#er I7m in &itchen'

INDI6IDU!B ;G No

INDI6IDU!B @G No

INDI6IDU!B AG No

. Ho+ often /o$ *ehe%t /o$* food

INDI6IDU!B 1G efore the meal


INDI6IDU!B "G Once in a$hile



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INDI6IDU!B ;G efore the meal

INDI6IDU!B @G efore the meal

INDI6IDU!B AG efore the meal

. Do /o$ o,e* /o$* food on t%'&e %fte* e%t

INDI6IDU!B 1G No

INDI6IDU!B 0G Yes

INDI6IDU!B "G Yes

INDI6IDU!B 4G Yes

INDI6IDU!B ;G No

INDI6IDU!B @G Yes

INDI6IDU!B AG Yes

. Do /o$ 'o!& /o$* +%te* 'efo*e d*!n

INDI6IDU!B 1G No

INDI6IDU!B 0G Yes

INDI6IDU!B "G Yes

INDI6IDU!B 4G Yes

INDI6IDU!B ;G No

INDI6IDU!B @G No

INDI6IDU!B AG Yes


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(. Ho+ often do /o$ e%t f*$!t !n % +ee

INDI6IDU!B 1G E#eryday

INDI6IDU!B 0G 0 times in a $ee&

INDI6IDU!B "G E#eryday


INDI6IDU!B ;G I don7t eat fruits'

INDI6IDU!B @G I don7t eat fruits'

INDI6IDU!B AG I don7t eat fruits'

((. Ho+ often do /o$ e8e*!e o* "o fo* % +%& !n % +ee


INDI6IDU!B 0G " times in a $ee&

INDI6IDU!B "G I don7t ha#e time to e?ercise or $al&


INDI6IDU!B ;G Once in a month

INDI6IDU!B @G Once in a month

INDI6IDU!B AG E#ery $ee&end

(. Ho+ often /o$ e%t o!&/# %&t/# $"%*/ o* f%t food pe* +ee



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INDI6IDU!B "G I don7t eat fast foods


INDI6IDU!B ;G Once in a month

INDI6IDU!B @G E#ery $ee&end

INDI6IDU!B AG E#ery $ee&end

(=. Ho+ )%n/ of /o$ h%,e d!%'ete )e&&!t$ %nd h/pe*ten!on

INDI6IDU!B 1G No

INDI6IDU!B 0G Yes

INDI6IDU!B "G Yes

INDI6IDU!B 4G Yes

INDI6IDU!B ;G Yes

INDI6IDU!B @G No

INDI6IDU!B AG Yes

(?. Do /o$ +%h the ,e"et%'&e %nd )e%t p*ope*&/ 'efo*e /o$ oo

INDI6IDU!B 1G Yes

INDI6IDU!B 0G Yes

INDI6IDU!B "G Yes


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INDI6IDU!B 4G Yes

INDI6IDU!B ;G Yes

INDI6IDU!B @G Yes

INDI6IDU!B AG Yes

(. Ho+ often /o$ &e%n /o$* !then

INDI6IDU!B 1G Yes (E#ery $ee&end,

INDI6IDU!B 0G Yes (" times in a $ee&,

INDI6IDU!B "G Yes (0 $ee&s once,

INDI6IDU!B 4G Yes (E#ery $ee&end,

INDI6IDU!B ;G Yes (" times a $ee&,

INDI6IDU!B @G Yes (0 $ee&s once,

INDI6IDU!B AG Yes (0 $ee&s once,


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III. C3INICO0SOCIA3 CASE STUDY

CASE NO. (

COMMUNITY MEDICINE

PROFORMA FOR INTERGRATED APPROACH TO A CLINICAL CASE

N!ME O/ THE .!TIENT G !rumugam !9B Narayanasamy

!+E G "3 years old -EV G Male

!DD)E-- G*ampung Thye Eng8 53155 edong8 *edah8 Malaysia

.)E-ENTIN+ COM.B!INT- GThe patient is a &no$n hypertension and DM patient since 15 years ago'

.)E-ENT HI-TO)Y GIn 055@8 patient suddenly de#eloped 0 s$ellings on left shin and 1 s$elling on the %ac& of nec& $ith presenceof discharge' He denied any trauma history' !t first $ee&8 he applied traditional remedy %ut the s$elling didn7tresol#e' Then8 he see& medical treatment in ** edong and daily $ound cleaning and ointment $ereprescri%ed' He $as diagnosed $ith HTN8 DM and hypercholesterolemia at that time' "months later8 he did a full%ody chec& up and the diagnosis $as confirmed' .atient claimed to compliance to medications and follo$ up at


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** edong'

.!-T HI-TO)Y GNo history of hospitali


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R-j e!

INCOMEG

/amily income is fluctuating $ith a#erage )MA55 per month' The family income is %arely sustaina%le $ith the

e?penditure' He is currently applying for financial aid from +o#ernment'

EN6I)ONMENT!B HI-TO)YG

1' Type of HouseG The house is a $ood house $ith ade>uate lighting and #entilation'

0' Type of /amilyG Nuclear

"' +ar%age DisposalG Open %urning

4' -ource of =aterG Treated pipe $ater

;' BatrineG 1 latrine located inside the house'

Gene*%& E8%)!n%t!on GO#er$eight.atient is conscious and alert'No signs of respiratory distress or dehydration '=arm8 pin&ish and moist palm8 no palmar erythema8 no tendon ?anthomaNail colour pin&ish8 no digital clu%%ing 'No flaming tremorNo needle puncture mar&s on forearm

His pulse rate is A@ %pm $ith normal #olume8 tone and rhythm'His %lood pressure is 1;5935 mmHg' No ?anthelesma on the eyelids -clera is $hite8 no sign of aundice oth pupils are round8 regular and reacti#eOral hygiene is a#erage8 no dehydration8 no anemia and no central cyanosis' No cer#ical lymphadenopathy No %ilateral pitting edema

Mental state e?aminationG+ood rapport

+ood eye contactHis speech $as coherent and rele#ant $ith normal tone8 amount8 speed and #olume'!ppropriate affect

S/te)! E8%)!n%t!onW )-9 C6- X

Inspection G Chest $all has no gross deformitiesThere is no scar or masses can %e seen' There is no sign of respiratory distress'


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.alpation G No tracheal de#iation !pe? %eat can %e felt at left ;thIC- at midcla#icular line'

.ercussion G Bung percussion normal!uscultation G Normal %reath sound'

-1 and -0 heard $ith no murmurs at 4 areas'

OTHE) -Y-TEM EV!MIN!TION G!%domen e?amination G

Inspection G a%domen is round %ut not distended um%ilicus is in#erted all >uadrants mo#esynchronously $ith respiration no #isi%le peristalsis no other s&in lesions on the a%dominal $all

.alpation G soft and nontender no mass can %e felt' Bi#er and spleen is not palpa%le' .ercussion G Bi#er span is normal (Acm, !uscultation G presence of normal %o$el sounds'

PROVISIONA3 DIAGNOSIS ; DIFFERENTIA3 DIAGNOSIS

.ro#isional diagnosisG HTN8 DM 8 Hypercholesterolemia

Differential diagnosisG

IN6E-TI+!TION-G lood9 Urine9 /undoscopyOthers

1, lood pressure le#el

Ba% in#estigationG1, )outine test (chec& %lood glucose le#el8 chec& cholesterol le#el,0, iochemical screen such as renal profile test and lipid profile test (chec& for the association $ith meta%olicsyndrome,

M!N!+EMENT O/ THI- .!TIENTG.harmacological managementG1, -im#astatin 2 05mg ON0, !mlodipine 2 15 mg ON", +li%enda


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.)E6ENTI6E ME!-U)E- IN-TITUTEDG1, Diet modification0, )egular e?ercise0, +eneral &no$ledge on complications that might de#elop from DM and HTN

DISCUSSION0 (

!ging process'

DISCUSSION0 II

Medical .ro%lems in the /amily G /amily history of Dia%etes mellitus and hypertensionEconomic .ro%lems G Bo$ household income-ocial .ro%lems G Not significant

DISCUSSION0 III

=hat are the le#els of pre#ention that ha#e failed and $hyL.rimary pre#ention Bac& of health promotion during health campaign leads to lac& of a$areness of pu%licto$ards health issues-econdary pre#ention .atient lac& of attention to$ards her conditionTertiary pre#entionG Bac& of a$areness of healthy diet

CASE NO.

COMMUNITY MEDICINE

PROFORMA FOR INTERGRATED APPROACH TO A CLINICAL CASE

N!ME O/ THE .!TIENTG -almah %inti !yu%

!+EG ;5 years old OCCU.!TIONG House$ife -EVG /emale

!DD)E--G *ampung aru Thye Eng

COM.B!INT-G Difficulty in %reathing

.)E-ENT HI-TO)YG .atient e?perienced sudden onset of %reathlessness and difficulty in %reathing duringha


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*esihatan' .atient also has seretide accuhaler $hich is prescri%ed %y specialist' .atient claims that accuhaler isher last option to relie#e her %reathlessness'

.!-T HI-TO)YG .atient is a &no$n asthma patient for "@ years' -he started to ha#e asthma $hen she $as 14years old' -he has a family history of asthma (her mother,' There is no other &no$n medical illness' Nosignificant past surgical history'

.E)-ON!B HI-TO)YG .atient studied until -.M and is married and currently staying $ith her hus%and8children8 in a single storey #illage house' -he

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