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![RECOMMENDATIONS FOR THE FAMILY
• Strengthen preventive practices [Hand wash,Safe water]
• Since the Head of the family is having
HTN ,recommended for DASH
• Lifestyle modifications
• Regular BP checkup](https://image.slidesharecdn.com/vidhyafapfinal-250902071813-cb35b68e/75/Vidhya-FAP-FINAbdbdbdbdbdbdbdbdbhvsggwL-pptx-33-2048.jpg)
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Vidhya FAP FINAbdbdbdbdbdbdbdbdbhvsggwL.pptx
- 1. FAMILY ADOPTION PROGRAMME 2022 BATCH Name:vidhyasarngan Roll No:186
- 2. HOUSEHOLD RECORD • HouseNo:224 • Ward Number: 35 • Village:Quilandi • Address:Seetha Thekkethalaparambil, Cheriyamangadu,Quilandi PO 673305 Insert photo of your adopted house
- 3. ROUTE MAP TOTHE HOUSE
- 4. FAMILY • Name ofthe Head of the family:Seetha TP • Type of family: Nuclear / Joint / Extended :Nuclear • Total number of family members:3 • Religion: Hindu / Christian / Muslim: Hindu
- 5. FAMILY COMPOSITION SI. No. Name Relationshipto the HoF Age (in yrs) Sex Educational Status Occupation Marital Status 01 Seetha TP Head of the family 59 Female 5th std.passed Part time housemaid Widow 02 Ajith TP Son 37 Male 8th std.passed Fisherman Married 03 Suma A daughter in law 35 female 10th std.passed Housewife Married 04 05 06 07 08 09 10 11 12
- 6. SOCIO-ECONOMIC STATUS • AbovePoverty Line / Below Poverty Line: APL • Total Monthly Income:Rs.2000 • Per Capita Income:Rs.666 • Socio-economic status:(as per Updated Modified BG Prasad Scale):Lower class family
- 7. HEALTH RELATED HISTORY Sl.No Name Present Complaints Chronic diseases Disability Treatment history Health care utilization 1 Seetha TP Nil Hypertension Nil Treatment under Dr.sandhya kurup. Surgery done for inguinal hernia Beach hospital Calicut IQRAA HOSPITAL 2 Ajith TP Nil No Nil Treatment taken for infertility (Low sperm count) Quilandi hospital 3 Suma A Nil Hypothyroidism Nil Under medication for hypothyroidism. Treatment taken for infertility Quilandi hospital
- 8. HABITS & ADDICTIONS Sl.No Name Smoking Chewing Tobacco Alcohol Drugs/Others 1 Seetha TP Nil Nil Nil Nil 2 Ajith TP Nil Nil Yes Nil 3 Suma A Nil Nil Nil Nil
- 9. HEALTH PREVENTION Sl. NoName Immunization status 1. seetha TP covid dose I& Covid dose II 2 Ajith TP Covid dose I COVID DOSE II 3 Suma A COVID DOSE I COVID DOSE II
- 10. VITAL EVENTS • Duringthe past 12 months any birth occurred:NO • During the past 12 months any death occurred:NO SI. No. Mother’s Name Month & year of birth Sex M/F Delivered at home / hospital * Ante natal care Yes / No Post-natal care Yes / No Registered Yes / No Surviving or Dead SI. No. Name Age at Death Sex M/F Month & year of death Place of death Home/ Hospital * Cause or symptom during death Registered Yes/No
- 11. VITAL EVENTS •During thepast 12 months any still birth/abortion has occurred: NO Name of mother Stillbirth/Abortion Month & Year of event Gestational period at termination Place Home/ Hospital Antenatal care Yes/No Who attended the delivery Cause if any
- 12. PREGNANCY RECORD Name of mother Ageat Marriage Age at first Pregnancy Now Pregnant Yes / No Gestational Period Total No. of Pregnancy No. of live births No. of still births or abortions No. of children surviving
- 13. FAMILY PLANNING (eligiblecouples only) SI. No. Name of eligible couple FP methods adopted Yes/No. Method used How long If not reasons Willing to accept Yes/No Method preferred Husband 1. __________ Wife Ajith TP Suma A Nil nil not concieved yet no nil Husband 2. __________ Wife Husband 3. __________ Wife
- 14. AVAILABILITY AND UTILISATIONOF HEALTH SERVICES • Distance to nearest Hospital....1.........kms – P. H. C. ...........4.9.................................................kms – Private consultation facility .....8.........................kms • Health Institution attended:IQRAA HOSPITAL,BEACH HOSPITAL • Do pregnant mothers attend antenatal clinic? Yes/No If ‘No’ – reason • Place of delivery HOSPITAL Home / Hospital • If delivering at home, who conducts? Trained PHC midwife/Relative/Mother/Untrained midwife/others(specify) • Did any of the members in the house attend hospital or consult doctor during the past one month? Yes/No If ‘Yes’ (Specify): • Iron & Folic acid tablet given (pregnant mother & < 5 children) Yes • Are preschool children (3-5 years) attending Anganwadi? Yes
- 15. HEALTH INSURANCE • RashtriyaSwasthya Bima Yojana (RSBY)
- 16. IMMUNISATION HISTORY: • Nameof the child: Age: • Immunizatio status
- 17. GENERAL EXAMINATION Sl. NoName Height (cms) Weight (kgs) BMI Midarm Circumference (cms) 1 suma A 147cm 54 kg 24kg/m2 25cms
- 18. GENERAL EXAMINATION Sl. NoName Pallor Icterus Cyanosis Clubbing Lymph-adenopathy 1. Suma A no pallaor no icterus no cyanosis No clubbing No lympadenopathy
- 19. GENERAL EXAMINATION S.No NameTemperature Pulse Blood pressure Respiratory rate 1 Suma A normal 76 beats /min 138/84 mm of Hg 16 breaths/min
- 20. Skin, Eyes, Earsand Mouth Sl. No Name Skin Eyes Ears Mouth 1 Suma A Normal Normal Normal Normal
- 21. SYSTEMIC EXAMINATION Sl. NoName Respiratory System Cardiovascular System Gastrointestinal System Central Nervous System 1. SUMA Normal vesicular breath sounds heard S1 and S2 heard normal bowel sounds no neurological deficit
- 22. ENVIRONMENT SURVEY Housing: Rented/ownedScore Roof: Terraced Tiled or asbestos Thatched 5 Walls: Brick with plaster Brick without plaster Mud & Others 5 Floor: Cement Tiled Mud 7 Kitchen: In separate room Inside living room 10 Latrine: Septic Tank Pit latrine Absent 10 Drinking water Tube well Protected well Unprotected well & others 10 Solid Wastes disposal Composting Burning Open dumping 7 Sullage disposal Soakage pit Open pit None 7 Crowding: No crowding Mild Moderate Severe 10 Fly Mosquito breeding No Yes 10 Ventilation Adequate Inadequate 10 TOTAL 91
- 23. Domestic animals: Absent Cowshed - Absent Distance from the house:
- 24. ENVIRONMENT MACROENVIRONMENT Location:CHERIYAMANGADU Road to thehouse :present Vector Breeding sites:No vector breeding sites Pets/stray animals :Nil MICROENVIRONMENT Type of house:Pucca house No of rooms:5 Total floor space:1000 sq ft Doors and Windows:4 doors and 8 window Lighting: Good Ventilation :Well ventilated
- 25. LAYOUT OF THEHOUSE Bedroom Bathroom Bedroom Living room Dining room Kitchen
- 26. KITCHEN • Separate kitchen:Yes •Cooking fuel:LPG • Food storage:refrigerator • Windows or exhaust in kitchen:Yes • Sullage disposal : Yes
- 27. WATER AND SANITATION WATER •Source of drinking water:Underwater Borewell • Purification of water:boiling and chlorination • Source of water for domestic use:Tubewell • Water storage:Tank • Rainwater harvesting:No SANITATION • Toilet attached/not : No Attached Toilet • Continuous Water supply:Yes • Water seal:Yes • Soap:Yes • Hand washing practices:Yes
- 28. WASTE DISPOSAL • Segregationof waste:Present • Paper & plastic waste:Paper is burnt.plastic collected by municipality • Sewage disposal:septic tank • Sullage disposal:Compost pit
- 29. Follow-up details ofthe family • include growth chart for under-5 children
- 31. 1. Identify socialproblems in the family allotted to you? 2. How far they have utilized the medical facilities available in the health centre to solve them? 3. Who are vulnerable groups? What are the health problems you have identified in the family relating to the vulnerable groups? Suggest corrective measures 4. Comment on the nutritional status of the family members . Suggest modifications if needed. 5. Comment on the environmental sanitation in the family
- 32. 1.No any relevantsocial problems identified 2.All the medical facilities from the health services are well utilised 3.No any vulnerable groups are present. 4.Adequate diet intake is observed 5.Proper sanitation is maintained.
- 33. RECOMMENDATIONS FOR THEFAMILY • Strengthen preventive practices [Hand wash,Safe water] • Since the Head of the family is having HTN ,recommended for DASH • Lifestyle modifications • Regular BP checkup
Editor's Notes
- #5 Instructions for filling 2.2, 2.3, 2.5, 2.6, 2.7 2.2 -Relationship to the Head: Write as wife, son, daughter, grandson, daughter - in - law, etc. 2.3 -Age of children below I month write the age in days for children below 1 year write the age in month for children above 1 year write the age in year & months. 2.5 -Educational status: Primary / Secondary / High School / Pre degree / College / Professional 2.6 -Occupation: Professional / Clerk / Teacher / Housewife / skilled worker / unskilled worker / student / unemployed 2.7 -Marital Status: unmarried / married / widow / widower / divorced / separated.
- #12 Live birth: All the live births and deaths one year prior to the date of study. Death: If the cause of the death is not ascertained, write the symptoms, noticed before death like fever, convulsion, coma, oedema, dyspnoea etc. Abortion: Early foetal death less than 28 weeks of gestation. Write the cause in the mother (e.g.) anaemia, systemic diseases, etc. Still birth: Late foetal death more than 28 week of gestation.
- #13 Instruction for filling 11: Eligible couples: Couples living together where wife’s age is 15-44 years. Methods: Male - Vasectomy, Condom. Female - P. P. S; Laparoscopic sterilization, oral pill, IUD, others (specify) Reasons: Just write the reasons the husband or wife tells you. Methods preferred: If they do not know the method, write “don’t know”
- #20 Skin – Ulcers/Scabies/ Tinea/ Pyoderma/ Anaesthetic patches/ Pediculosis/ Injuries/ Burns/ Pimples on face/ Varicose vein/Eczema/Others (Specify) Eyes – Pale conjunctiva/ Conjunctivitis/ Corneal opacities/ Cataract / squint/ Blindness/ Defective vision/ Congenital anomalies/ Others (Specify) Ears – Wax/ Perforations/ Otitis media/ Deafness/Others (Specify) Mouth – Angular stomatitis/ Glossitis/ Gingivitis/ Dental caries/ Tonsillitis/ Pharyngitis/ Missing teeth/ Leukoplakia/ Others (Specify).