Introduction to Basic Concepts and Definitions in Family Health PDF

Basic concepts and definitions in Family Health By Dr. O.O. Sekoni Department of Community Medicine College of Medicine, University of Ibadan  The Family The most basic unit of human social organization Consist...

Basic concepts and definitions in Family Health By Dr. O.O. Sekoni Department of Community Medicine College of Medicine, University of Ibadan  The Family The most basic unit of human social organization Consists primarily of the father, mother and children by birth or adoption (nuclear family) Members of the family relate with each other within a social and cultural context. Integral part of every community- the family plays a central psychological, social and economic role within the community 2  Functions of the Family Propagation of the family line Nurturing, growth and development of members of the family Giving members of the family a sense of history and social identification Reproductive role Socialization role: the family provides both formal and informal education for the children. The home is the ‘first school’ Economic role 3  Identifiable culture in every family which is shared and handed over to the next generation Health-a state of complete physical, social and mental well being and not merely the absence of disease/ infirmity. The study of Family Health helps us to develop a family-oriented approach to health care delivery. Any programme aimed at improving the health status of a family aims at improving the role of individuals in the family which by extension affects the community and nation as a whole 4  Family Composition Nuclear – Father, mother Children (biological or adopted) Extended – Father, mother Children Relations – Vertically to include grandparents – Horizontally to include uncles, aunties, nephews and nieces 5  Advantages of the extended family – Uncles, aunts etc contribute to the raising of the children and in some cases to the upkeep of the family – Elders can offer good counsel or advice Disadvantages of the extended family – Lack of privacy – Economic burden 6  Families could be identified with respect to: Type of marriage – Monogamous – Polygamous Polygynous (one man and several women) Polyandrous (one woman and several men) 7  Implications of polygamy with respect to Family Health – Competition and rivalry amongst wives prevents women from practicing family planning – In localities where polygamy is predominant, family planning is not effective despite the large amounts of money spent on it by government – Where the man is the bread winner he has to spread limited resources amongst wives and many more children 8  Locality Patrilocal – Family assumes residence of father for social and political identification Matrilocal – Mothers residence is assumed Neolocal – Family resides in a neutral place that does not belong to the man or wife 9  System of heredity Patrilineal – Inheritance is on the basis of fathers lineage – Fathers name is assumed for the family Matrilineal – Inheritance is according to mothers lineage e.g. in Ghana 10  Decision making Patriarchal – Father is the decision maker. Nothing can be done until he endorses it Matriarchal – Mother is the decision maker 11  Choice of marriage Endogenous – Within the same ethnic group Exogenous – From different ethnic group – Has associated challenges e.g. language barriers, acceptability problems due to cultural differences 12  Concept of Family Health Family health is a broad term that is all encompassing and all embracing The essence of the concept of family health is to be able to use an individual as an index case to gain access into the family. This is important because members of the family inter relate and affect each other. This has implications on their health The concept of family health will enhance program planning by helping to determine high risk families and take measures to address needs of all the family members A united healthy, happy family will be more productive and this will enhance the health and wealth of a nation 13  Objectives of Family Health Reduction of morbidity and mortality Control /elimination of communicable and non communicable diseases Enhance longevity Improve the quality of life The ultimate objective of FH is to improve national, social and economic development 14  There is a very close relationship between the health status of one member of the family and others. Since the family is recognized as the basic unit of health and living it is also the basic unit of illness 15  Inter relationship between family members and its effect on health Direct effect  Mucus membranes  Droplet infection  Gastric system  Direct skin contact Indirect effect  Psychological e.g an accident resulting in a handicap to the breadwinner of the home would affect other members of the family 16  Problems that could also be encountered among families include: Genetic problems e.g. sickle cell anaemia Environmental problems – physical, biological, chemical, sociocultural, economic and political environments A combination of both genetic and environmental problems 17  Physical environment – Climate – Land – Water – Sewage/refuse – Housing 18  The state of any of the components of the physical environment ultimately affects family health e.g. drought famine malnutrition children pregnant women lactating mothers resulting in anaemia high infant, under 5 and maternal mortality 19  Biological environment – Inadequate supply of water, Water borne diseases eg guinea worm, typhoid, shigella Water impounding diseases eg schistosomiasis Water related diseases eg malaria, onchocersiasis 20  Poor sewage and refuse disposal as well as poor housing allow the biological environment to thrive. Vectors and pests thrive under these conditions and propagate illness and disease 21  Chemical environment – Effluents from factories/industries can create a toxic environment (via air, water, soil) – Short term effects of this include gastroenteritis, skin diseases and cancers – Long term effects of this are various types of congenital malformations 22  Sociocultural environment – Childhood marriage and teenage pregnancy – Female genital mutilation – Nutritional taboos – Tribal marks and scarifications – Uvulectomy – Son’s preference – Bad widowhood practices 23  Political environment – Political instability could lead to dispersal of the family e.g. during wars – Resultant refugee situations – Suffering of women and children – Health programs like immunization are affected 24  Economic environment – The economic situation in a country affects the standard of living of the family – The standard of living of the family influences all facets of family health and life e.g. poverty in the family would affect: – nutrition of family members – education of the children – could cause anaemia in pregnancy for the wife which could ultimately result in maternal death. 25  Determinants of FH status Age of the couple Marital status and family stability Educational status Pregnancy interval and family size Health status of parents Beliefs, attitudes and behavioural practises e.g FGM Income Utilization of health services  Availability  Accessibility (physical, social)  Affordability 26  Quality of service rendered Priority given by government to health care delivery  Political will  Level of commitment of funds Level of environmental health (housing, water supply, sewage & refuse disposal) Extent of intersectoral collaboration and multidisciplinary cooperation with government ministries and parastatals (ministry of education, agriculture, women affairs, youth and social development) 27  Family Health involves…. Vital statistics Maternal health Child health Family planning Environmental health Occupational health Care of the elderly Care of the handicapped 28 Thank you 29