Choice and cleanliness of clothing and foot wear.

This includes;

• Cleanliness.
• The bowel.
• Exercise.
• Rest and recreation.
• Fresh air and sun light.
• Good diet.
• Good habit.
• Clothing.

These include measures taken by the government, health authority, public workers, departments, Agriculture and veterinary departments which help to improve the health of people by the control and treatment of diseases adequate food production, water supply, etc.

• Free inoculation to prevent yellow fever, plague typhoid fever.
• Antenatal services for pregnant mothers.
• Post natal clinics of women after delivery.
• Infant well fare for children under school age.
• School clinics for school children.
• Care of water supply.
• Sanitation –disposal of refuse.
• Control of pest, prevention of breeding places of mosquitoes, flies, flea, rats’ mites, etc.
• Inspection of building, markets, shops and diary.
• Education of people on matter of health.
• Sick people to be treated in hospitals, dispensaries.
• Isolation infectious cases.
• Family planning clinics.
• Free vaccination.

• To keep the body healthy and give one confidence
• To prevent spread of germs to other people and prevent illness
• To promote a good standard of living

This must be kept clean and healthy in order to function well, daily bath is needed to remove dirt and give feeling of well-being.

• Regulates body temperature.
• Protection against sun rays and germs.
• Sensory organ of touch.
• Produces vitamin D through its ergosterols.
• Excretes sebum to nourish skin.
• Excretes sweats.
• Sebum, sweat, dead skin, cells and bacteria if not removed decomposes and produces an unpleasant smell and irritate the skin.
• The pores become blocked and the heat of the body can’t be regulated properly.
• Dirt favors growth and germs and parasites and may give rise to diseases.

• Should be washed frequently.
• Finger nails should be kept short cut to the shape of the fingers.
• After washing hands dry with clean materials and apply lotion to prevent roughness, cracking or soreness.

• Should be washed frequently to prevent smell from decomposing sweat.
• Dry in between toes thoroughly as wet surfaces promote the growth of spore fungal infection called Tania.
• Shoes or sandals should be worn to prevent picking hook worms and jiggers when walking bare footed.
• Shoes should be good fitting not to cramp the feet.
• Badly fitting shoes result in bore deformity, growth of corns or in growing toe nails.
• Too high heeled shoes should be avoided it throw the weight backward causing backache and bad posture.
• Toe nails should be cut short and straight across to prevent in growing toe nails.
• Corns: Thick painful round overgrowth and hardening of the skin. Usually occurs at the top of or in-between the toes. May need to be surgically removed.
• Callosity: A local hardening of the skin caused by friction or pressure.
• Bromidrosis: A profuse sweating of the feet/toes and can cause foul odors and sores.
• Athlete's Foot: caused by a fungal infection that occurs between the toes. Most common in communal living spaces, i.e., Showers.
• Jiggers: due to poor hygiene of the feet and not wearing shoes.

• Keeping the mouth and teeth clean is important to maintain good health.
• Teeth brushed each morning and before going to bed, nothing should again be eaten after cleaning before sleep.
• Brush teeth in up and down movement to remove food particles and prevent decay damage to enamel.
• Eat food containing adequate calcium such as dark green vegetables, beans, ground nuts and well water etc. and vitamin D like eggs, sun light, milk, cheese, butter, etc. These make teeth healthy.
• Mouth should be rinsed after every meal.
• Bad smelling breath.
• Indigestion.
• Tooth decay and dental carries and pain.
• Abscess formation on the gum.
• Toxins from infected teeth may enter blood stream causing illness.

The following complications may arise if mouth/teeth are neglected:

• Stomatitis: inflammation of the mucus lining of the mouth.
• Rhinitis: inflammation of the mucus lining of the nose.
• Halitosis: odor/smell from the nose.
• Gingivitis: inflammation of the gums.

This is part of the respiratory system.

• Warms air.
• Filter air entering respiratory tract.
• Moisten air.

For these reasons breathing should be done by nose not mouth. The nose should be blown at intervals using handkerchief to remove accumulated dirt and germs, handkerchief changed daily.

• Hair should be kept clean and tidy washed with shampoo or soap using warm water.
• In hot climate wash hair daily, it should be brushed.
• Well-kept hair gives a feeling of confidence and well-being.
• Dirty hair harbors lice this may cause ill health as result of some diseases.
• Dirty hair may allow spores of ring worms to develop.
• The brush and the comb must be kept clean in a good condition. They should never be shared.
• Pediculus Capitis (Hair Lice): Common with people whose hair is not kept regularly and/or sharing brushes/combs that are infected. Lice and mites infect the scalp and cause itchiness.
• Highly contagious.
• Treatment is available at your local pharmacy & you must clean all infected surfaces – i.e. beddings.
• Ringworm: A fungal parasite that attacks the hair follicle and destroys the hair – causes scar patches which are usually circular or ring shaped – can be found anywhere on the body that has hair. Highly infectious and it can be transmitted easily when coming in physical contact with the infection.
• Treatment: remove all diseased hair and apply anti-fungal cream to infected area and to all/any utensils used on the infected area.

The bowel should be opened regularly. The frequency may vary with the amount and the type of food taken but usually it is good to empty the bowels every day.

This is the condition of infrequent and difficulty in evacuation of feaces.

The longer the evacuation remains in the colon the water is absorbed and the feaces becomes harden and difficult to expel.

• Adequate roughage in the diet; this stimulates digestion.
• Adequate fluid intake which help keeping the feaces soft.
• Exercise to stimulate muscle tone and peristaltic movement in the intestine.
• Forming a regular habit of opening the bowels daily. Food entering the stomach stimulates peristaltic movement in the intestine which stimulate rectum to empty.
• This more noticeable after breakfast and is good time to form habit.
• Taking meals at regular ensures the stomach is not over loaded and food is properly digested.
• Abdominal discomfort and flatulence.
• Tiredness.
• Headache.
• Poor appetite.
• Later may result into hemorrhoids.

While the principles of hygiene are universal, specific considerations must be made for vulnerable populations. Nurses must adapt hygiene care for:

• Infants and Children: Who depend entirely on caregivers for their hygiene.
• The Elderly: Who may have mobility issues, thinner skin, or cognitive impairments that make self-care difficult.
• Ill or Bedridden Patients: Who require comprehensive assistance with all aspects of personal hygiene (bed baths, oral care, hair washing, etc.) to prevent infections and promote comfort.

• Is important in maintaining the health of the body.
• Helps all the muscles in the body to develop and improve muscle tone.
• Keeps the joints moveable.
• Stimulates the appetite and improve digestion.
• Stimulates respiration, breathing is deepened and more oxygen is taken into the lungs resulting in a more efficient purification of blood.
• It quickens the circulation of blood causing an increased flow of blood every part of the body and helps to clear a way waste product. It improves kidney function.
• It improves bowel action by stimulating peristalsis in the intestines and helps to prevent constipation.
• It gives a feeling of fitness and well-being.
• The mind is relaxed and refreshed.
• Exercise should be taken regularly and when possible in the open air. It should not be taken too soon after the meal or when tired and not for long. Clothing should be changed after exercise.

Some good types of exercise are;

• Walking.
• Swimming.
• Dancing.
• Gardening.
• Volleyball.
• Netball.
• Tennis.
• Running/Cardio.
• Biking.
• Yoga/Pilates.
• Non-recreational activities – i.e. digging.

The activities involved are:

• Diet
• Elimination of body waste
• Washing of Clothes
• Doing Exercise
• Sleep & Rest
• Fresh air & sunlight

Passive and active exercises help to stimulate the circulation and improve the muscle activity. Take deep breaths in through the nose and breathe out through the mouth.

When Standing: feet should be a little less than shoulder width apart, back straight, and chin up.

Negative Outcomes:

• Fatigue of the muscles and nerves and when not exercising properly, a person can cause harm to themselves.
• When water is not taken a person can become dehydrated.
• Glucose should NOT be substituted for water.

Positive Outcomes:

• Building/stimulating stronger muscles, stimulating the mind by increasing heart rate and blood flow.
• Will help the mental health of a person.

Sleep and rest are necessary to combat mental and physical fatigue that could lead to mental/physical breakdown if not received.

Hours of sleep that should be received by each age group:

• Infants: 12-14hrs
• Children/Teenagers: 9-10hrs
• Adults: 6-8hrs

Regular rest is necessary for the body to repair worn out muscles and organs. Sleep is the perfect form of rest. For good health; sleep must be sufficient and regular in a comfortable and relaxed position, the body should be kept warm during sleep, a warm bath before bed helps promote good sleep. The amount of sleep required varies with age:

• Infants sleep most of the day.
• Children sleep ranging from 12-16 hours a day.
• Adults need from 6-9 hours a day.

This is provided by an activity which is different from one's usual work, it is a time of relaxation and should be something that is enjoyable. It is important for individuals to have some form of recreation as doing the same thing over and over again leads to depression and nervous exhaustion. Outdoor games like walking, swimming, gardening, dancing etc. provides both exercise and recreation, reading, needle work and music are also other good forms of recreation.

• Fresh air provides oxygen and removes carbon dioxide.
• Good posture helps to provide adequate oxygen.
• Tight clothing around the chest and neck should be avoided.
• Fresh air gives a feeling of fitness, improves the appetite and helps in the elimination of waste products.

• Is important to maintain good health.
• Acts on ergo-sterol on the skin to produce vitamin D.
• The ultra violet rays kill many germs.
• It provides warmth.
• It encourages cleanliness as sun light shows up dirt and dust in our surroundings.

Food is necessary for growth, energy, strength, warmth and body repair. The amount required for health depends on size, sex, age, climate, degree of activity and basal metabolic rate. Our diet should be well balanced one containing all the essential food nutrients that the body requires to function normally and stay healthy.

These important nutrients or food factors are:

• Protein - responsible for body building, needed for growth and repair.
• Carbohydrates – Energy providing food.
• Fats - Heat and energy supply.
• Vitamins - Protective food which regulate normal tissue activities.
• Mineral salts - For body building.
• Water - Makes up 2/3 of body weight for normal body function.
• Roughages - Prevents constipation.

Habit is something we do without thinking about it. Good health can be maintained by forming regular habit, as we continue practicing doing particular activity, it becomes a habit e.g. going to bed at 10pm; the body will be ready to sleep at that time.

Some good habits are:

• Regular time for sleep.
• Daily bath.
• Daily bowel action.
• Regular meals.

Clothing is worn for:

• Provision of privacy.
• Promotion of warmth.
• Protection from sun heat.
• Protection from wind, injuries, germs, rain.
• Identification purposes.

Clothing's made of different materials:

• Suitable for hot climates.
• Absorbs moisture.
• Allow evaporation.
• Non- irritating to the skin.
• Can be boiled and washed well.
• Easy to iron.
• Long lasting material.

• Suitable for hot climate.
• Light cool material.
• Long lasting and pleasant to wear but they are expensive, not easy to iron and washing must be done carefully.

• This is made from the fur of animals and mainly sheep.
• It retains heat, preferably worn in cold weather.
• Can be irritating.
• Expensive.
• Needs careful washing.

E.g. Nylon, made from chemicals and used mainly for under wares and night clothes;

• They are light.
• Not irritating.
• Easy to wash.
• Do not need ironing.

Clothes should be changed frequently and washed thoroughly in clean soft water and soap. Stagnant water may contaminate it with bacteria and spores of fungi and lead to infection and itching.

After washing, they should be rinsed well and hanged to dry in a wire line in the fresh air and not put on the ground. When dry they should be ironed with hot iron to kill any source of infection. In damp climate, clothes should be dried to avoid/prevent moulds from growing.

Clothes cupboard should be dry and clean; clothes should be loose and with normal fitting to allow movement and not constrict the blood vessels/circulation or breathing. In hot climate clothes should be light and of bright color as the dark colors absorbs heat, in cold weather, heavier, warmer clothing should be worn.

• What are the three main aims of practicing good personal hygiene ?
• Describe two common scalp infections and how they can be prevented.
• List three conditions that can result from wearing badly fitting shoes.
• Explain four ways to prevent constipation .
• Compare the properties of cotton and wool clothing and state which climate each is best suited for.
• Why is it important to never share personal items like combs or towels?

The following reference materials are recommended for this module unit.

• Rahim, A. (2017). Principles and practices of community medicine. 2nd Edition. JAYPEE Brothers Medical Publishers Ltd. New Delhi
• Cherie Rector, (2017), Community & Public Health Nursing: Promoting The Public's Health 9e Lippincott Williams and Wilkins
• Gail A. Harkness, Rosanna Demarco (2016) Community and Public Health Nursing 2nd edition, Lippincott Williams and Wilkins
• Basavanthapp, B.T and Vasundhra, M.K (2008), Community Health Nursing, 2nd edition. JAYPEE Brothers Medical Publishers Ltd. New Delhi
• Kamalam, S. (2017), Essentails in Community Health Nursing Practice 3rd edition. JAYPEE Brothers Publishers Ltd. New Delhi
• James F. McKenzie, PhD, et al. (2018) An Introduction to Community & Public Health, 9th edition, Jones and Bartlett Publishers.
• Maurer, F.A, Smith, C.M (2005), Community /Public health Nursing Practice, 3rd edition ELSEVIER SAUNDERS, USA
• МОН, (2013) Occupational Safety and Health Training Manual, 1st Edition