Rajiv Gandhi University of Health Sciences s20

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA. PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION 01. NAME OF THE Mr. GEORGE THOMAS. CANDIDATE AND 1ST YEAR M.Sc. NURSING STUDENT, ADDRESS N.D.R.K. COLLEGE OF NURSING B.M. ROAD, HASSAN, KARNATAKA. 02. NAME OF THE N.D.R.K. COLLEGE OF NURSING INSTITUTION B.M. ROAD, HASSAN, KARNATAKA. 03. COURSE OF THE STUDY MASTER OF SCIENCE IN NURSING AND SUBJECT (COMMUNITY HEALTH NURSING)

04. DATE OF ADMISSION TO 29.06.2012 THE COURSE “ASSESS THE EFFECTIVENESS OF 05. TITLE OF THE STUDY STRUCTURED TEACHING PROGRAMME ON HOUSEHOLD PURIFICATION OF WATER AMONG THE RURAL PEOPLE IN SELECTED VILLAGES AT HASSAN.’’

“A STUDY TO ASSESS THE EFFECTIVENESS 5.1. STATEMENT OF THE OF STRUCTURED TEACHING PROGRAMME PROBLEM ON HOUSEHOLD PURIFICATION OF WATER AMONG THE RURAL PEOPLE IN SELECTED VILLAGES AT HASSAN.”

6. BRIEF RESUME OF INTENDED WORK 6.1. INTRODUCTION Rivers, ponds, lakes and streams - they all have different names, but they all contain water. Just as religions do - they all contain truths.  Muhammad Ali The water on the surface of earth has its own journey. The water from the ocean gets evaporated by the sun’s heat. Evaporated water rises up into the air and forms clouds and later fall onto the earth in the form of rain and snow and flows on the earth as streams, lakes, rivers which ultimately fall in the oceans like air, water is also very essential for man to survive. But unlike air, man can live without water for about a week or so. The water which is required for human consumption should be palatable and free from any kind of impurities so that it is safe and suitable for daily activities1. Water is one of the very crucial natural resources. It is available abundantly on the surface of earth .There is about 1.4 billion cubic kilometer of water on the earth which comes about 71% of the earth’s surface. About 97% of the water on the earth is in the oceans. The ocean water is salty and is not suitable for human consumption. The remaining 3% of the total water is available in the form of ice sheets, cloud, river, lakes, ponds, well and springs. Only 1-1.6% of the 3% of water is useful for human consumption.1 Water is a prime necessity of life, without which, terrestrial animals and vegetables life must cease to exist. Water helps the man in many ways, i.e., it replaces loss of fluids from tissues; maintains fluidity of blood and lymph; helps in excretion of waste products; acts as a vehicle of dissolving food; helps in digestion and regulates body temperature. The purification water by treatment is to produce water that is safe and wholesome. The method of treatment to be employed depends upon the nature of raw water, and the desired standards of water quality. For ex: ground water (wells and springs) may need no treatment, other than disinfection. Surface water (river water) which trends to be turbid and polluted requires extensive treatment. Water purification system comprise of storage, filtration and disinfection.11 In India, water pollution is becoming a serious problem. To protect water from being contaminated, Parliament in 1974 passed the water (prevention and control of pollution) Act. The Act seeks to provide legal deterrent against the spread of water pollution. The Act is a comprehensive piece of legislation. It provides for the constitution of Central and State Water Boards and Joint Water Boards endowed with wide powers for controlling pollution.2 Much of the ill-health which affects humidity, especially in the developing countries can be traced to lack of safe and wholesome water supply. Water that is easily accessible, adequate in quantity, free from contamination, safe and readily available throughout the year .There can be no state and positive health and wellbeing without safe water. Water is not only the vital environmental factor to all forms of life, but it has also a great role to play in socio-economic development of human population. Each country should develop its own water resources, exploitation and hydrogeology. In 1980, the United nations general assembly launched the International drinking water supply and sanitation decade, 1981-1990 the aim being to provide all people with adequate supplies of safe water and sanitation by 1990.In 1981, the 34th World Health Assembly in a resolution emphasized that safe drinking water is a basic element of “primary health care” which is the key to the attainment of Health for All by the yr 2000 AD. Water is also integrated with other PHC components because it is an essential part of health education, food and nutrition and also MCH.2 Water purification is the process of removing undesirable chemicals, biological contaminants, suspended solids and gases from contaminated water. The goal is to produce water fit for a specific purpose. Most water is purified for human consumption (drinking water), but water purification may also be designed for a variety of other purposes, including meeting the requirements of medical, pharmacological, chemical and industrial applications. In general the methods used include physical processes such as filtration, sedimentation, and distillation, biological processes such as slow sand filters or biologically active carbon, chemical processes such as flocculation and chlorination and the use of electromagnetic radiation such as ultraviolet light. The purification process of water may reduce the concentration of particulate matter including suspended particles, parasites, bacteria, algae, viruses, fungi; and a range of dissolved and particulate material derived from the surfaces that water may have made contact with after falling as rain.3

The standards for drinking water quality are typically set by governments or by international standards. These standards will typically set minimum and maximum concentrations of contaminants for the use that is to be made of the water. It is not possible to tell whether water is of an appropriate quality by visual examination. Simple procedures such as boiling or the use of a household activated carbon filter are not sufficient for treating all the possible contaminants that may be present in water from an unknown source. Even natural spring water – considered safe for all practical purposes in the 19th century – must now be tested before determining what kind of treatment, if any, is needed. Chemical and microbiological analysis, while expensive, are the only way to obtain the information necessary for deciding on the appropriate method of purification.3

It is very important to purify the water before it is used for domestic purposes. Purification is done at large scale before water is supplied to the people at large through underground pipes. Purification is also done at small scale especially in the villages. To prevent contamination of water, the Act (Prevention and control of pollution) was passed by the parliament in 1974. This Act provides powers to central and state water boards for controlling water pollution. The guidelines are recommended by WHO in 1993 to determine by various countries. These guidelines are related to under mentioned aspects: -Acceptability of water -Microbiological content of water -Chemical substances -Radiological aspects.12

6.2. NEED FOR THE STUDY

Water is the driving force of all nature.  Leonardo da Vinci Increasing sustainable access to clean drinking water is an essential step in promoting health in developing countries. The World Bank’s Millennium Development Goals call for a 50% reduction in the proportion of people without sustainable access to safe drinking water by 2015 (MDG7, Target 10). Drinking water can be contaminated with disease-causing bacteria, parasites, and viruses at the source, within the delivery system, or during transport to homes for use. Each year, over 1.8 million people around the world die from diarrheal diseases and this burden of disease falls very highly on children under five years of age: over 90% of deaths from diarrhea are among children under five years old (Nath et al., 2006). The World Health Organization (WHO) estimates that up to 94% of diarrheal illness is preventable with interventions to increase availability of clean water and through improved sanitation and hygiene.4 Unsafe water supplies and inadequate sanitation and hygiene increased the transmission of diarrheal diseases, trachoma, hepatitis and cholera. Although more people have access to safe water and improved sanitation globally compared with these in 2000, rapid population growth has hampered improvements in many countries. Close to a billion people are still without access to improved water supplies. Over 2 billion people are without improved sanitation.5 Access to clean water is a key aspect in the overall health of any population. Purified drinking water has been found to not only reduce mortality and illness of children under five, but it also decreases diseases like viral hepatitis, typhoid fever, cholera, dysentery and other causes of diarrhea. Previous intervention studies in Liberia, Kenya, and Guatemala resulted in significant reduction diarrhea incidence and improved water handling practices when using P&G Purifier of Water and similar products and trained in safe water handling.6 A study was conducted in Australia, facing serious challenge in the management of water in various regions two popular responses to these challenges are increasing so recycled and desalinated water significant gaps exist in our knowledge of community attitudes to these alternative sources of water. This paper reports 66 qualitative interviews were held at 8 location health distinctly different water situation key result indicate that people hold both positive and negative belief about water from alternative sources. People also feel they lack knowledge and state that information from scientist would influence their decision to drink.7 The WHO estimates 21% of communicable diseases in India are water borne. Of these diseases, diarrhea alone killed over 7, 00,000 Indians in 1999 (estimated) – over 1,600 deaths each day. The highest mortality from diarrhea is in children under the age of five, highlighting an urgent need for focused interventions to prevent diarrheal disease in this age group.8 In India More than 50% domestic water supply is obtained from groundwater in India and, therefore, it is very important to check the purity of groundwater before it is supplied to the public. DDT, BHC, carbonate, Endosulfan, etc. are the very common pesticides used in India both in agricultural and public health sectors. Very little monitoring of water pesticides has been done in India. However, some reports have been published on the presence of organochlorine pesticides in some urban water resources near Calcutta.9 Purifying water can be defined as transforming water that is undrinkable to a drinkable state. There are several ways to purify water so it is clean and healthy for people. If the water is indeed polluted, a very dangerous, possibly deadly illness can be caught and will do the body much harm. Nearly 20% of the world's people lack safe drinking water, which is why it is imperative to have all drinking water cleansed and purified. Water shortage is also an ongoing issue in America, specifically in California and Florida. These states are experiencing massive water shortages and it is very important to help prevent this by taking steps to preserve any extra water.10 In order to safely drink water, it is important to be able to tell if the water is polluted, and if it is, then steps need to be taken in order to purify it. To confirm polluted water, check the smell and the taste. If they both are different from what is normally expected, a water test should take place followed by the purification of the water, if the test concluded that the water was dirty. The same process should also be made if the water different in appearance, such as the color or cloudiness of it. Water can also be detected as polluted if stains are being set on laundry and residue is consistently spotted.10

From the above facts and the observation of the people during my community posting, all are drinking water without purification and have noticed many water borne diseases, it clear that rural people have less knowledge regarding water purification method and water borne disease. Hence the researcher is interested in studying the house hold method of water purification at rural areas.

6.3. STATEMENT OF PROBLEM

“ A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON HOUSEHOLD PURIFICATION OF WATER AMONG THE RURAL PEOPLE IN SELECTED VILLAGES AT HASSAN.’’

6.4. OBJECTIVES OF THE STUDY

1. To assess the knowledge of rural people regarding household Purification of water before the administration of Structured Teaching Programme.

2. To Prepare and administer Structured Teaching Programme to improve the knowledge of rural people regarding household Purification of water.

3. To assess the knowledge of rural people regarding household Purification of water after the administration of Structured Teaching Programme.

4. To evaluate the effectiveness of Structured Teaching Programme by comparing pre and post test knowledge scores regarding household purification of water.

5. To determine the association between the demographical variables(age, sex, type of family, educational status, source of water, method of water purification, previous knowledge) and pre and post test knowledge score.

6.5. HYPOTHESIS - H1: There will be a significant difference between the pre and post test knowledge scores on household Purification of water among the people of rural area at Hassan.

- H2: There will be a significant association between the knowledge scores on household Purification of water and demographic variables of rural people.

6.6. ASSUMPTION

1. The rural people will not be having knowledge or less knowledge regarding to household Purification of water.

2. Demographic variable will be having more influence on the knowledge.

3. Structured Teaching Programme will increase the knowledge on household Purification of water.

6.7. OPERATIONAL DEFINITION

- Assess: To make the judgment about the understanding knowledge level of the people living in the rural areas regarding House hold water purification.

- Effectiveness: In this study effectiveness refers to the extent to which the structured teaching programme on identification of household purification of water will achieve the desired effect in terms of gain knowledge level.

- Knowledge: It refers to the response of rural area people to the questions stated in the questionnaire regarding meaning, sources of water, treatment of water, purification techniques in the house.

- Structured Teaching Programme: Structured Teaching Programme refers to systematically developed instructions for rural people regarding household purification of water (Boiling, chemicals, Domestic filters, UV irradiation).

- Household purification of water: The methods employed for purification of water on a small scale such as for domestic purpose are as follows:

-Boiling

-Chemicals (a) Bleaching powder

(b) Alum

(c) Potassium permanganate

(d) Chlorine tablets

-Domestic filters

-Ultraviolet irradiation

- Rural People: It is an area covers a population of 20,000 at Dodagenigere, which fulfill the criteria of rural area, where it does not have much facility and away from the city.

- Selected Villages: Among the rural area, selected villages are dodagenigere and chikagenigere, which have the criteria of rural area.

6.8. CRITERIA FOR SELECTION OF SAMPLE Inclusive criteria: - Rural people those who are present at the time of study.

- Rural people those who are willing to participate.

Exclusive criteria: - Rural people those who are not available at the time of study.

6.9. LIMITATIONS OF THE STUDY

- Study is limited only to rural area people.

- Study is limited to 4 to 6 weeks of duration.

- Sample size is limited to 100 rural area people.

6.10. SIGNIFICANCE OF THE STUDY This study explores the knowledge on household Purification of water and Structured Teaching Programme will give the awareness regarding household Purification of water. 1. This study will give more information regarding household Purification of water to rural peoples as there is very little information available from the previous studies. 2. This study will be promoting the extent of knowledge level on household Purification of water and prevention of water borne diseases at rural peoples.

6.11. CONCEPTUAL FRAMEWORK

STUFFLE BEAM’S- CIPP Model (Context, Input, Process, Product Model)

6.12. REVIEW OF LITERATURE

A review of literature on the research topic makes the researcher familiar with the existing studies and provides information which helps to focus on studies & provides information which helps to focus on a particular problem laid a foundation upon which to base new Knowledge. The review of literature is to obtain comprehensive knowledge and in depth information through systematic and cultural review of scholarly publications, unpublished scholarly print materials, audio visual materials & personal communications. It helps to gain an insight into the research problem, and provides information of what has been done previously.

The review of Literature will be organized under following headings: - Literature related to general information regarding household purification of water.

- Literature related to knowledge regarding Water borne diseases.

6.12.1. Literature related to general information regarding household purification of water. A study was conducted on the disinfection of raw water plays an important role in environmental engineering. In this document we overview several feedback controllers proposed by different authors to purify the water contained in water distribution systems. Several techniques to purify the water and the sensors needed as part of the whole system are presented to provide an overview of the components and processes encountered in water treatment plants. Literature Review Purification of drinking water is a very important problem in environmental engineering. Purification of drinking water is typically achieved via adding a disinfectant. Chlorine is the most common disinfectant used in drinking water purification systems because it is inexpensive and destroys a large number of pathogens. The purification of drinking water involves several stages of treatment of the raw water for the removal of suspended solids, color, and bacteria before entering the distribution network.13

High-quality water is defined as water that contains no pathogenic organisms and is free from biological forms that may be aesthetically objectionable. It is clear and colorless, and has no objectionable taste or odor. It does not contain concentrations of chemicals that may be physiologically harmful, aesthetically objectionable, or economically damaging. It also is not corrosive, nor does it leave excessive or undesirable deposits on water-conveying structures, including pipes, tanks, and plumbing fixtures. Criteria used to evaluate the safety of drinking water are continually reassessed as new constituents are identified and health effects research advances. Regulatory agencies are developing standards and recommendations for contaminant levels in drinking water. Concurrently, the water supply industry is developing new and improved operation and treatment techniques to respond to the changing criteria. Drinking water quality criteria must consider all factors that affect the quality of water, the public health significance of the constituents, and the available technology to treat water.14

Water quality operating guidelines must be comprehensive and balanced. They must be responsive to regulatory requirements and suitable for implementation. They must account for selection, protection, and management of the highest-quality source of supply. They must consider proper operation of the facilities that treat and distribute water to the consumers.14

Water programs should include a comprehensive water quality control plan with at least the following aspects:

- Resource development and management.

- Adequate quantities of high-quality water should be reserved for future needs.

- Watershed protection. Surface water and groundwater should be protected through control of waste disposal and restricted land use. - Water quality operating levels. Criteria should define appropriate, acceptable constituent levels that are reasonably

- Achievable under most conditions.

- End-product standards. Development should include regulatory standards for health- related constituents

- Recommended standards for constituents not related to health.14

The local water utility program should include a water quality control response plan for all appropriate constituents of concern. In some cases, no regulatory standard has been set for these constituents. In other cases, a reasonable time would be required to modify system design and operational procedures to comply with changes in regulatory requirements that may occur. The local utility program should include establishment of system baseline data for future use by the utility. This information about source of supply, facilities, and operations can assist in the identification of conditions that prevent the utility from achieving compliance with water quality criteria. Health-based regulatory criteria, water quality goals, and a current assessment of appropriate operating levels are necessary to identify good- quality water. The goals and recommended operating levels encompass the regulatory standards that are based on evaluation of health effects research, risk assessments, and risk management approaches. Because there are regional resource and size differences that affect the ability of water utilities to provide an adequate quality and quantity of water supply, the achievement of recommended operating levels must be reasonably evaluated.14

A study was conducted on water purification using magnetic assistance: Water is a major source for survival on this planet. Its conservation is therefore a priority. With the increase in demand, the supply needs to meet specific standards. Several purification techniques have been adopted to meet the standards. Magnetic separation is one purification technique that has been adapted from ore mining industries to anti-scale treatment of pipe lines to seeding magnetic flocculent. No reviews have come up in recent years on the water purification technique using magnetic assistance. The present article brings out a series of information on this water purification technique and explains different aspects of magnetism and magnetic materials for water purification.15

A study was conducted on Noble metal nanoparticles for water purification: A critical review: Water is one of the essential enablers of life on earth. Beginning with the origin of the earliest form of life in seawater, it has been central to the evolution of human civilizations. Noble metals have been similarly associated with the prosperity of human civilizations through their prominent use in jewelers and medical applications. The most important reason for the use of noble metals is the minimal reactivity at the bulk scale, which can be explained by a number of concepts such as electrochemical potential, relativistic contraction, molecular orbital theory, etc. Recently, water quality has been associated with the development index of society. A number of chemical and biological contaminants have endangered the quality of drinking water. An overview of important events during last 200 years in the area of drinking water purification is presented. Realizing the molecular nature of contamination in drinking water, significant progress has been made to utilize the chemistry of nonmaterials for water purification. This article summarizes recent efforts in the area of noble metal nanoparticle synthesis and the origin of their reactivity at the nanoscale. The application of noble metal nanoparticle based chemistry for drinking water purification is summarized for three major types of contaminants: halogenated organics including pesticides, heavy metals and microorganisms. Recent efforts for the removal, as well as ultralow concentration detection of such species, using noble metal nanoparticles are summarized. Important challenges during the commercialization of nano-based products are highlighted through a case study of pesticide removal using noble metal nanoparticles. Recent efforts in drinking water purification using other forms of nanomaterials are also summarized. The article concludes with recent investigations on the issue of nanotoxicity and its implications for the future.16

A study was conducted on current status of the application of ionizing radiation to environmental protection: I. Ionizing radiation sources, natural and drinking water purification: Present-day applications of ionizing radiation to environmental protection are surveyed. This part of the review summarizes new data on the ionizing radiation sources used in this area, on the radiation-chemical purification of polluted natural and drinking water, and on the mechanisms of processes occurring in these systems under exposure to ionizing radiation. A particular emphasis is placed on large-scale processes.17

6.12.2. Literature related to knowledge regarding Water borne diseases.

A study was conducted on Viruses in recreational water-borne disease outbreaks. Viruses are believed to be a significant cause of recreationally associated water-borne disease. However, they have been difficult to document because of the wide variety of illnesses that they cause and the limitations in previous detection methods. Nor viruses are believed to be the single largest cause of outbreaks, which have been documented in the published literature 45% (n = 25), followed by adenovirus (24%), echovirus (18%), hepatitis A virus (7%) and coxsackieviruses (5%). Just under half of the outbreaks occurred in swimming pools (49%), while the second largest outbreak occurred in lakes or ponds (40%). The number of reported outbreaks associated with nor viruses has increased significantly in recent years probably because of better methods for virus detection. Inadequate disinfection was related to 69% (n = 18) of swimming pool outbreaks. A lack of required reporting and no uniform water quality and chlorination/disinfection standards continues to contribute to water-borne recreational disease outbreaks.18 Non-uniform water quality and chlorination/disinfection standards may contribute to waterborne recreational disease outbreaks, because regulations are determined by localities and may not be sufficient to control the spread of disease. The lack of required reporting for recreational water-borne disease outbreaks makes surveillance efforts more difficult, and may bias or obscure observations made from those outbreaks that are reported. Training of pool maintenance personnel may also play an important role in reducing outbreaks; because it may reduce inadequate disinfection because of operator error and equipment malfunction.18

A study was conducted on waterborne transmission of protozoan parasites: A worldwide review of outbreaks and lessons learnt. At least 325 water-associated outbreaks of parasitic protozoan disease have been reported. North American and European outbreaks accounted for 93% of all reports and nearly two-thirds of outbreaks occurred in North America. Over 30% of all outbreaks were documented from Europe, with the UK accounting for 24% of outbreaks, worldwide. Giardia duodenalis and Cryptosporidium parvum account for the majority of outbreaks (132; 40.6% and 165; 50.8%, respectively), Entamoeba histolytic and Cyclosporine cayetanensis have been the etiological agents in nine (2.8%) and six (1.8%) outbreaks, respectively, while Toxoplasma gondii and Isospora belli have been responsible for three outbreaks each (0.9%) and Blastocystis hominis for two outbreaks (0.6%). Balantidium coli, the microsporidia, Acanthamoeba and Nigeria fowleri were responsible for one outbreak, each (0.3%). Their presence in aquatic ecosystems makes it imperative to develop prevention strategies for water and food safety. Human incidence and prevalence-based studies provide baseline data against which risk factors associated with waterborne and food borne transmission can be identified. Standardized methods are required to maximize public health surveillance, while reporting lessons learned from outbreaks will provide better insight into the public health impact of waterborne pathogenic protozoa.19

A study was conducted on costs of Illness in the 1993 Waterborne Cryptosporidium Outbreak, Milwaukee, Wisconsin. To assess the total medical costs and productivity losses associated with the 1993 waterborne outbreak of cryptosporidiosis in Milwaukee, Wisconsin, including the average cost per person with mild, moderate, and severe illness, we conducted a retrospective cost-of-illness analysis using data from 11 hospitals in the greater Milwaukee area and epidemiologic data collected during the outbreak. The total cost of outbreak- associated illness was $96.2 million: $31.7 million in medical costs and $64.6 million in productivity losses. The average total costs for persons with mild, moderate, and severe illness were $116, $475, and $7,808, respectively. The potentially high cost of waterborne disease outbreaks should be considered in economic decisions regarding the safety of public drinking water supplies.20

A study was conducted on Waterborne Disease-A Status Report Emphasizing Outbreaks in Ground-Water Systems. A total of 192 outbreaks of waterborne disease affecting 36,757 persons were reported in the United States during the period 1971-1977. More outbreaks occurred in no municipal-water systems (70%) than municipal-water systems; however, more illness (67%) resulted from outbreaks in municipal systems. Almost half of the outbreaks (49%) and illness (42%) were caused by either the use of untreated or inadequately treated ground water. An unusually large number of waterborne outbreaks affected travelers, campers, visitors to recreational areas, and restaurant patrons during the months of May-August and involved no municipal-water systems which primarily depend on ground-water sources. The major causes of outbreaks in municipal systems were contamination of the distribution system and treatment deficiencies which accounted for 68% of the outbreaks and 75% of the illness that occurred in municipal systems. Use of untreated ground water was responsible for only 10% of the municipal system outbreaks and 1% of the illness. The major cause of outbreaks in nonmunicipal systems was use of untreated ground water which accounted for 44% of the outbreaks and 44% of the illness in these systems. Treatment deficiencies, primarily inadequate and interrupted chlorination of ground-water sources, were responsible for 34% of the outbreaks and 50% of the illness in nonmunicipal- water systems.21 7. MATERIALS AND METHODS OF THE STUDY

7.1. Source of Data:

Rural People in selected villages at Hassan.

7.2. Method of Data Collection

1. Research Design: Pre Experimental One group Pretest and Post test design

Group Pre-test Intervention Post-test

Experimental Group 01 X 02 n = 100

2. Setting: Rural area: is at Dodagenigere which the data covering nearly 20,000 population. Research area is Dodagenigere village 800 populations.

3. Population:

a. Accessible population: All the people those who are residing under Dodagenigere rural area Hassan.

b. Target population: all the people living in Rural area at Dodagenigere and chikagenigere village(PHC), Hassan district.

4. Sample: who fulfill the inclusion criteria.

5. Sample size: a total of 100 samples of rural area.

6. Sampling technique: Non Probability Convenient Sampling Technique.

Collection of data: Data will be collected from samples using a structured questionnaire and then 7.

Interview schedule.

8. Selection of tool: The following steps are followed by the investigator to construct the tool:

a. Literature is review in preparation of the tool.

b. Guidance and suggestion will take from experts.

c. Consultation will obtain from statistician.

9. Data collection method: Data collection is the gathering of information need to address a research problem. Written permission will be obtained from PHC Medical Officers higher authorities for the study, with co-operation of nursing personnel of PHC. The investigator maintained good interpersonal relationship with the public, to get co-operation for the study. The investigator collected the data from rural people.

8. VARIABLES

Independent Variable: Structured Teaching Programme on Household Purification of Water.

Dependent Variable: Knowledge of Rural People Regarding Household Purification of Water.

9. PLAN FOR THE DATA ANALYSIS Descriptive statistics: It includes percentage, frequency, mean, and standard deviation for peoples regarding domestic land Water purification. Inferential statistics: It includes paired ‘t’ test and chi square test and ANOVA ‘ f ’ test for the assessment of knowledge and to associate the socio-demographic variables planned.

10. PILOT STUDY 10% Population is planned for the pilot study

11. ETHICAL CONSIDERATION 1. Has ethical clearance being obtained from the village?

…………Yes. Ethical clearance being obtained from the village 2. Has the consent been taken from the respondent?

…………Yes. Informed consent will be obtained from the respondents.

12. LIST OF REFERENCES (VANCOUVER STYLE)

1. Gulani k.k. Principles and Practice Community Health Nursing. 1st ed. Delhi: kumar publishing house; 2007; 244-245. 2. Park K. Textbook of Preventive and social medicine. 19th ed. Jabalpur; M/s Bhanarsidas Bhanot publishers; 2007; 376,377, 567,587. 3. http://en.wikipedia.org/wiki/Water_purification. 4. http://medmissionaries.org/id49.html. 5. World Health Statistics (WHO) 2009. WHO Library Cataloging Data.WHO-2009: 83-84. 6. http://globalreach.med.umich.edu/articles/umms-students-propose-water-purification- pilot-study. 7. Dolnicar S, Hurlimann A drinking water from alternative water sources: A journal of international associations of water pollution research publisher press Water science technology 2009. 8. http://www.who.int/mediacentre/multimedia/2002/ind_sanitation/en/index.html 9. www.ias.ac.in/currsci/nov251998/articles17.htm 10. http://voices.yahoo.com/ways-reasons-purify-water-2203386.html 11. The text book of community health nursing, B.T Basavanthappa, 2nd edition, Jaypee Publishers, pg no: 289 to 294. 12. The text book of community health nursing, K.K Gulani, Kumar publishing, pg no: 251- 253. 13. http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.134.9478 14. Board of Directors. Drinking Water Quality. http://wwwmawwa.org/driwapol.htm. Jan. 29, 1989, 15. Ritu D. Ambashta, Journal of Hazardous Materials, Volume 180, Issues 1–3, 15 August 2010, Pages 38–49. 16. T. Pradeep, Thin Solid Films, Volume 517, Issue 24, 30 October 2009, Pages 6441–6478. 17. A. K. Pikaev, Current status of the application of ionizing radiation to environmental protection: I. Ionizing radiation sources, natural and drinking water purification (A Review), January–February 2000, Volume 34, Issue 1, pp 1-12. 18. Sinclair RG, Jones EL, Gerba CP, Viruses in recreational water-borne disease outbreaks: a review. J Appl Microbiol. 2009 Dec 1; 107(6):1769-80. 2009 May 5. 19. Panagiotis Karanis, Christina Kourenti and Huw Smith, Waterborne transmission of protozoan parasites: A worldwide review of outbreaks and lessons learnt, Journal of Water and Health Vol 5 No 1 pp 1–38 © IWA Publishing 2007. 20. Phaedra S. Corso, Michael H. Kramer, Costs of Illness in the 1993 Waterborne Cryptosporidium Outbreak, Milwaukee, Wisconsin, Emerg Infect Dis. 2003 April; 9(4): 426–431. 21. Gunther F. Craun, Waterborne Disease — A Status Report Emphasizing Outbreaks in Ground-Water Systems, Ground Water, Volume 17, Issue 2, pages 183–191, March 1979 SIGNATURE OF THE 13 CANDIDATE Water Borne Diseases are more in rural area, due to the impure water usage, and less or no knowledge regarding 14 REMARKS OF THE GUIDE household purification of water. Hence, this study will enhance the knowledge on household purification of water, thus prevents water borne diseases. NAME AND DESIGNATION 15 OF

15.1 GUIDE Prof. BERNICE MARGARET

15.2 SIGNATURE

15.3 CO – GUIDE

15.4 SIGNATURE

HEAD OF THE 15.5 Prof. BERNICE MARGARET DEPARTMENT

15.6 SIGNATURE Water Borne Diseases are more in rural area, due to the impure water usage, and less or no knowledge regarding REMARKS OF THE 16 household purification of water. Hence, this study will PRINCIPAL enhance the knowledge on household purification of water, thus prevents water borne diseases.

16.1 SIGNATURE