RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
1 NAME OF THE Ms. SHILPA N. KUGALI.
CANDIDATE AND I YEAR M.SC. NURSING,
ADDRESS N.D.R.K. COLLEGE OF NURSING
B.M. ROAD HASSAN
2 NAME OF THE N.D.R.K. COLLEGE OF NURSING,
INSTITUTION HASSAN, KARNATAKA
3 COURSE OF STUDY MASTER OF SCIENCE IN NURSING
AND SUBJECT COMMUNITY HEALTH NURSING
4 DATE OF ADMISSION 11th MAY 2007
TO THE COURSE
5 TITLE OF THE TOPIC “COMPARATIVE STUDY TO ASSESS
THE KNOWLEDGE OF RURAL AND
URBAN PRIMARY SCHOOL
TEACHERS REGARDING SELECTED
COMMON HEALTH PROBLEMS”.
5.1 STATEMENT OF THE “A STUDY TO ASSESS THE
PROBLEM KNOWLEDGE OF RURAL AND
URBAN PRIMARY SCHOOL
TEACHERS REGARDING SELECTED
COMMON HEALTH PROBLEMS OF
SCHOOL CHILDREN AT HASSAN
6. BRIEF RESUME OF THE INTENDED STUDY:-
The health of children & youth is a fundamental value. Health services for
schoolchildren are a must for building a healthy young India. Over one fifth of our
population comprises of children aged 5-14years which is the age group covering primary
and secondary education. Among these only about 80% of children are enrolled and
about 65% are regularly attending school on an average for 200 days in a year.1
Children between 5-14 years of age spend most of their time in the school. The
school is an ideal place for learning and growing up. If schools are to become power
house of health education, we need to go for a change in the curriculum. The World
Health Organization considers school as a health promoting one when it is constantly
strengthening its capacity as a healthy setting for living , learning and working. Health
education, health services, and healthy school environment are components of such
schools. “Schools can do more than any other institution in society to help young people
live healthier, longer and more productive lives”.2
The teacher has maximum opportunity for close observation of children’s health
and to find out the deviation from normal health. As school heath nurses are not
appointed in the schools, this responsibility falls on the teachers. This rich resource and
influencing factor must be tapped in the wider context of the situation and teachers need
to be helped to cope with health and illness of children.3
Various studies have been conducted on selected common school health
problems like worm infestation, oral hygiene and nutritional problem.
A study conducted on Dominican school children aged 4-12 years revealed that
infestation with gastrointestinal parasites was very common with Trichuris affecting 92%
of children, Ascaris in 38%, Necator in 11%, Giardia in18% and E.Histolytica in 1%.This
study concluded that 18 of the 1000 children were found to have a hemoglobin level
below 10g/dl. 4
A study conducted on “oral hygiene in the control of dental caries”, with sample
size of 207 and 197 control school children with mean age 6 years. After 24 months of
professional tooth cleaning and dental health education programme, 179 test and 156
control children were examined and found to have good oral hygiene. The study
concluded that oral hygiene measures may be effective in the control of dental caries of
A study was conducted on impact of child health and nutrition on education in
developing countries. School performance was hampered in children with malnutrition.
This gives evidence that child health and nutrition has a significant impact on education
in developing countries.6
Health survey of Indian schools indicates that morbidity and mortality rates in
children were among the highest in World. Morbidity of school children’s has been
studied in small surveys in Tamilnadu, Kerala, Andhra Pradesh, Madhya Pradesh,
Punjab, Karnataka and Delhi. Most of the surveys yielded more or less similar findings
and the general prevalence of morbidity is as follows:
Dental Ailments (70-90%), Malnutrition (40-75%) Worm infestation (20-40%) Skin
diseases (10%), Eye diseases (4-8%) and Pulmonary Tuberculosis (4-5%). 5
The school health service comprises immunization, screening, surveillance,
counseling, early detection and treatment and referral services. Teacher will be trained
and equipped for recognition of sickness danger signals, giving first aid and referring the
children who need further care. For this purpose training programs have to be designed
jointly with health functionaries for present teachers and suitable changes made in the
training curricula for teachers. 7
The specific objectives of school health service are:
The promotion of positive health
The prevention of disease
Early diagnosis treatment and follow up of defects
Awakening health consciousness in children
The provision of healthful environment.
The aim of school service is to promote, protect and maintain health of school children
and reduce morbidity and mortality in them.8
Any discussion on school health services must be based on the local health
problems of the school child, the culture of the community and the available resources in
terms of money material and manpower. Another survey carried out in India indicates
that the main emphasis will fall on the following criteria:
2. Infectious disease
3. Intestinal parasites
4. Diseases of skin, eye and ear.
5. Dental caries.
School health is common community health. Health care which begins at
home should be continued in school. Today’s Children are Tomorrow’s Citizen and
Healthy Citizen are the Nation Pride. Keeping the above facts in mind and growing
realization of importance of health of a school child, this study is under taken amongst
the schools of urban and rural areas of Hassan district.
6.2 NEED FOR THE STUDY:-
Health problems of school children are very common, more over most of them
are preventable. Hence primary school teachers could play a significant role in
identifying these health problems among school children. This becomes the vital role of
primary school teachers because of inadequacy of health personnel in giving care to the
As per 2001 census India has 375million who are between 5-14 years of age (school
School children are vulnerable section of population by virtue of their physical,
mental, emotional and social growth during this period. It is in this age their personality
develops .Also they are exposed to various environmental factors which might cause
problems and require health, guidance and care.11
Children coming to school belong to different socio-economic and cultural
backgrounds which affect their health and nutritional status. They require help and
guidance in promoting, protecting and maintaining their health and nutritional status.
Children in school age are prone to get specific health problems. The various
acute and chronic conditions which can be encountered during school period anywhere in
the world include Dental caries, Diarrhea, Worm Infestations, Hepatitis, Anemia,
Scabies, Eczema ,Acne, Influenza , Pneumonia, Diphtheria , Pertusis , Asthma, Fracture,
Measles, Mumps, Chickenpox ,Urinary Tract Infection, Meningitis, Tuberculosis, Eye
and Ear Infections.12
The school teacher is the most important person in whom a child sees the
“Parent figure” away from home .The teacher has tremendous influence on the child
because of the “Emotional Bonding” that takes place between him and the pupil. Many
children accept their teachers as their “Role Model”.13
Teacher’s observation of school children is of particular importance in India because
of the limited number of trained personnel for school health work.
A study was conducted, on participation of primary school teacher in oral health
education Rungwe District, Tanzania. Primary school teachers from 15 rural and 4 urban
schools participated for the provision of oral health education. Result was, teachers
teaching in lower grades were significantly more active in providing oral health education
than those who taught in higher grades. The study concluded that oral health education
seems to be given mainly to primary school pupil in lower grades .There is a need for
influencing teachers in higher grades to be involved in oral health education
A study conducted on primary school teacher knowledge and practice of selected
common illness among the school children in Vellore revealed; illness-wise the teachers
knowledge was adequate in case of Vitamin-A deficiency (Causes, Etiology,
Management and Prevention), knowledge related to Vitamin-B deficiency was
moderately adequate and knowledge of teachers regarding prevention and management of
anemia was adequate but regarding causes of anemia knowledge was inadequate .15
A study conducted at Mayis University on 294 school sample (age group 7-13
years) of different social-status and environmental conditions was examined for Intestinal
Parasites. It revealed that parasitic incidence was high in village schools.16
The 9th conference of central council of health and central family welfare council
revealed that the teachers in primary classes should be trained for observing and
screening students for defects and deviations from normal health to maintain effective
surveillance and for providing supportive health education for the prevention of health
problems by developing desirable health habits.17
In the light of the above it is essential to assess the knowledge of primary school
teachers regarding the causes, identification, prevention and responsibilities towards
common health problems in this area .Keeping the above facts in mind and growing
realization of importance of the health of school child, the primary school teachers plays
an important role in providing appropriate school health. Hence, Investigator has
undertaken this study and titled as Comparative study to assess the knowledge of rural
and urban primary school teachers regarding selected common health problem of school
children at Hassan District.
6.3 STATEMENT OF THE PROBLEM:-
“A study to assess the knowledge of rural and urban primary school teachers
regarding selected common health problems of school children at Hassan district.”
1. To assess the knowledge of the rural and urban primary school teachers regarding
selected common health problem at Hassan district.
2. To compare the knowledge of the rural and urban primary school teachers regarding
selected common health problems of school children at, Hassan district.
3. To determine the relationship between selected demographic variables of the primary
school teachers and knowledge on selected common health problems of children at,
There will be significant difference in the knowledge regarding selected common health
problems between the rural and urban primary school teachers.
Urban teachers will be having adequate knowledge regarding selected common health
problems than the teachers working in rural area.
6.7. OPERATIONAL DEFINITIONS:-
1. ASSESS:-To make judgment about the understanding level of the primary school
teachers regarding common health problems.
2. KNOWLEDEGE:-It refers to the correct responses of primary school teacher on self
administration knowledge questionnaire regarding causes, identification, prevention
and their responsibilities towards selected health problems as evident from the test
3. PRIMARY SCHOOL TEACHER:-A person qualified with diploma in teacher
education or teacher training course or degree holder who has been teaching in a rural or
urban primary schools at Hassan district.
4. SCHOOL CHILDREN:- Referred to children those who are studying from I-V
standard at rural and urban primary schools of Hassan district.
5. SELECTED COMMON HEALTH PROBLEMS:- Referred to common health
problems occurring in school children from I-V Standards in the selected rural and urban
areas which includes nutritional problem, worm infestation and oral hygiene.
6. URBAN: It is an area in a town with better facility.
7. RURAL: It is an area where it does not have much facility and away from the city.
6.8 CRITERIA FOR SELECTION OF SAMPLES:-
1. Primary school teachers working in rural and urban areas of Hassan
2. Primary school teachers those who are present at time of study
3. Primary school teachers who are willing to participate in the study
1. Teachers those who are working in the secondary school.
2. Primary school teachers who are not present at the time of study.
6.9 DELIMITATION OF THE STUDY:-
1. Study duration limited to 4-6weeks.
2. Sample size limited to 60 teachers (rural 30 and urban 30).
6.10 SIGNIFICANCE OF THE STUDY:-
This study explores the knowledge of the primary school teachers on selected common
health problems of school children.
6.11 CONCEPTUAL FRAME WORK:-
“General System Theory”
6.12 REVIEW OF LITERATURE:-
Review of literature is a critical summary of research on a topic of interest
generally prepared to put a research problem in context to identify gaps and lacunae in
prior studies so as to justify new investigation.
Literature review was done for the present study and presented in following heading,
1. Studies related to worm infestations.
2. Studies related to Nutritional problem.
3. Studies related to oral hygiene.
4. Role of teachers in caring the children with health problems.
Studies related to worm infestations:-
A study was conducted to assess the relationship between Vitamin-A, Iron status
and Helminthiasis in Bangladeshi school children. The result of study revealed that 20%
had a low level of Vitamin-A, 31% were anemic, 30% had iron deficiency and 14%were
suffering from iron deficiency anemia. The study concludes that proportion of iron
deficiency anemia was significantly greater among children with Hook worm
A study was conducted to assess, whether the physical activity and growth of
Kenyan school children with Hook worm, Trichuris, Ascoris, lubricoids infections were
improved after treatment with Albendazole. For the study 55 Kenya primary school
children’s with Hook worm (93% prevalence) T.trichura (84%prevelence) and A
.lumbricoides (29%prevelence) before and 9 weeks after treatment with three 400mg
doses of Albendazole of placebo, was examined .The revealed that, activity, reported
appetite and most incidence of growth were significantly greater for the Albendazole,
treated group than for the placebo group.19
Studies related to Nutritional problem:-
A study was conducted to evaluate the clinical health and nutritional status of the
most vulnerable segment, i.e. Ashram school children in Kalahandi district of Orissa. Out
of 224 children 4.5% of them had protein energy mal-nutrition in the form of moon face ,
15.2% had Vitamin-A deficiency in the form of Bitots spots (6.7%) and Conjunctival
A study was conducted on awareness of teacher’s relationship between students
performance and nutrition at Egypt. Mal-nutrition disorder affects more than 30% of
school children in Egypt. School teachers perceive mal-nutrition only as low-body
weight. This lack of awareness, either about nutrition facts or the role of nutrition in
education, leads to miss diagnosis or delayed management of these children. This study
concludes that they suggested an integrated programme between teachers and parents to
over come mal-nutrition disorders through nutrition education and regular school feeding
programme to improve the health status and the education abilities of school children.21
Studies related to oral hygiene:-
A study was conducted to know the prevalence of Dental caries in 509 primary school
children in the age group of 3 to 7 years in Haryana. Prevalence of caries in age group
from 3 to 7 years was 33.8% while the prevalence among 6 years was 38.2%. Thus,
prevalence was significantly higher (p<0.05) at the age of 6 years as compared to 3
A study was conducted on prevalence of dental caries and risk assessment among
primary school children of 6 to 12 years, in the Varankala Municipal area of Kerala. This
study revealed that the prevalence of Dental caries was 68.5% with the highest decayed,
missed and filled teeth score found in 12 years age group .The study concluded that ,
statistically significant association was found with dental caries , oral hygiene , low –
socio- economic status and prevalence of caries .23
Role of teachers in caring the children with health problem:-
A study was conducted, to evaluate the effectiveness of teaching strategies for
primary school teachers on selected health problems in Anekal taluk, Karnataka state.
The problems selected for study includes Vitamin – A deficiency, Anemia, Dental
problem and Scabies. The major findings of the study were that the primary school
teachers had inadequate knowledge in the four selected health problems. Teaching
strategies increased the knowledge of primary school teachers in the areas of causes,
detection and prevention of selected health problem.24
A study conducted on Descriptive Elementary school teachers and skills in the
management of minor physical problems in Kaniambadi Block of North Arcot district
and Vellore town in TamilNadu, revealed that the urban and rural primary school
teachers were able to identify 32% of children suffering common cold, 47% from dental
caries, and 71% from Angular stomatitis. 48% of the teachers viewed the daily inspection
of students as necessary tool for health promotion and disease prevention. While 48% of
teachers considered themselves capable of carrying out this activity and only 44% viewed
the activity as part of their duty. 25
7. MATERIALS AND METHODS OF STUDY:-
7.1 SOURCES OF DATA COLLECTION: - Data will be collected from the
primary school teachers working in Rural and Urban primary schools of Hassan.
7.2 RESEARCH DESIGN:-Comparative design was chosen for the study to assess
the Knowledge of primary school teachers regarding selected common health problems
of school Children.
7.3 METHOD OF COLLECTING DATA:-Data collection is planned through
using a structured questionnaire on selected common health problems (Nutritional
problem, Worm Infestations and oral hygiene).
PART-A: - Demographic variables (Age, Sex, Educational qualification, Religion,
Marital status, Exposure to school health programme, Different types of
schools- private, government, aided, Years of experience, Exposure to in-
service education, Influence of Mass media).
PART-B: - Structured questionnaire regarding selected common health problems
among school children.
PART-B Divided into following sections
Section 1:- Nutritional problem.
Section 2:- Worm Infestations
Section 3:- Oral hygiene.
7.4 SAMPLING PROCEDURE:-
Target population:-All the school teachers at Hassan District.
Accessible population: - Primary school teachers working in Rural and Urban area
II Sample:-The primary school teachers those who are working in primary school at
Rural and Urban areas of Hassan District.
III Sample size: - 60samples divided in to two groups
30 sample from rural area.
30 sample from urban area.
IV SAMPLING TECHNIQUE: - Multistage Sampling Technique (Lottery Method),
so that by lottery method the schools will be selected for the study from Rural and
Urban areas. All the teachers from the selected schools will be taken for the study based
on the Inclusion and Exclusion criteria.
V SETTING:-The setting will be the schools coming under Shantigram primary health
Centre for rural area and selected schools in the urban area at Hassan,
Number of primary schools in Hassan districts-238
Number of primary schools in shantigram primary health centre-10
VI PILOT STUDY:-10% of the population is planned for the pilot study in the Month of
8.1 Independent variable: - Selected common health problems.
8.2 Dependent variable: - Knowledge of primary school teachers.
9. PLAN FOR DATA ANALYSIS: - It includes Descriptive and Inferential
Descriptive statistics: - To describe the demographic variables and level of Knowledge,
number, Frequency, Percentage, Mean and Standard Deviation.
1) To associate the demographic variable with knowledge (Chi-square X2).
2) To compare the knowledge of primary school teachers between rural and urban.
3) Student paired ‘t’ test.
4) ANOVA test.
10. ETHICAL CLEARANCE
1. Informed consent will be obtained from the chosen sample?
2. Has ethical clearance being obtained from the institution?
- Yes, it has been obtained.
11. LIST OF REFERENCES :- ( VANCOUVER STYLE)
1. K.Raghavan Prasad, Indian Journal of Community Medicine School Health, Vol
30, No, 4(2005-10-2005-12).
2. Sowaminathan, School of Good Health, Health Action, June 2001.
3. Antony, K.R, “Health Action Special issue”. 1990, 135-139.
4. Grell, A et al; Dominican School Children aged four to twelve years infestation
With gastrointestinal parasites was very common; 1981 September; 1(3):155-60.
5. Arrow, P, “Oral Hygiene in the control of dental caries”, Community dent oral
Epidemiology .1998, (26); 324-30.
6. Glewwe P; Impact of school health and nutrition an education in developing countries,
Theory, econometric issue, and recent empirical evidence; Food Nutr Bull; 2005 June;
26 (2 suppl 2); S 235-50.
7. Central Health Education Bureau. Report of seminar on School Health Services 1965
, New Delhi.
8. Ideal, Report of workshop for the development of criteria for Health Aspect of a
School Programme, 1965, New Delhi.
9. Park K, Park Text Book of Preventive and Social Medicine, 18th edition M/s
Banarisdas Bhanat Publisher .2005; 425-429.
10. Internet resource “http//www.censusindia.net”, accessed on 14 Oct 2007
11. TNAI, Community Health Nursing Manual, 3rd edition, 1998, Academy press noida.
12. K.K.Gulani, Community Health Nursing, Principles and practice, 1st edition, Kumar
Publishing house; 433-435.
13. Turner.C.E et al, School Health and Education on Health, 1957, C.V.Mosby.
14. Mwangosis IE, Nyandindi U,Matem; Participation of primary school teachers in oral
Health education in Rungwe district, Tanzania; East Afr Med J, 2001 Dec;
15. Showpackiam. “Assess primary school teacher knowledge and practice of
Selected common illness among the school children in CONCH area”, CMCH,
Vellore; unpublished master thesis, university of madras Vellor, 1997, India.
16. Guruses, N et al,”Microbial Bulletine”.Jan 1991; 25(1); 57.-62.
17. Manjul Jos, 9th conference of central council of health and family
Welfare council, 1983.
18. Persoon, V, et al; Assess the relationship between Vitamin –A, iron status and
Helminthiasis in Bangladesh school children; Public health Nutr 2000.
19. Adamas, E, J et al; Assess whether the physical activity and growth of Kenya School
Children with hook worm, trichuris, and infection were improved after treatment with
Albendazole; Journal of Nutrition, August 1994; 124(8); 1199-1206.
20. Balgir.R.S et al; Evaluate the clinical health and nutritional status of the most
Vulnerable segment, Ashram school children in Kalahandi district of orissa; Indian
Journal of Pediatrics, 2000, 57(1); 550-51.
21. Ismail Ibrahim; Awareness of the teachers of relationship between students
Performance and nutrition status at Egypt’s; National Institute of nutrition of Egypt
22. Twari S, Prevelance of dental caries in primary school children in the age Group of
3-7years in Haryana; Journal of the India Soc Pedol.preve Dent-June 2001; 19(2);
23. Ratna kumari; prevalence of dental caries and risk assessment among Primary school
Children of 6-12 years in the Varkala municipal area of kerala; Journal of Indian Soc.
pedodontics preventive dentistry (17). 1999; 135-42.
24. Esther Shirley S. “Effectiveness of the teaching strategies for primary school
teachers on selected health problems in Anekal Taluk, Karnataka staste”. unpublished
Master thesis, Bangalore University,1998, India.
25. Michel R M." Elementary school teacher’s knowledge and skill in the Management of
min or physical problems in Kaniambadi Block of North Arcot District and Vellore
town, in Tamilnadu”. Unpublished master thesis, University of Madras Vellore,
12 Signature of the candidate Ms.SHILPA .N. KUGALI
FORWARDED AND APPROVAL
13 Remarks of the guide
PROF.BERNICE MARGARET HOD
OF COMMUNITY HEALTH
14 Name and designation
PROF. BERNICE MARGARET
PROF. BERNICE MARGARET
14.3 Head of the department
FORWARDED AND APPROVAL
15 Remarks of the principal