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ROLE OF HEALTH AGENCIES IN THE PROMOTION OF HEALTH

CHAPTER ONE

INTRODUCTION

1.1   BACKGROUND OF THE STUDY

Inventories occupy the most strategic position in structure of working capital of most business enterprises. It constitutes the largest component of current asset in most business enterprises. In the sphere of working capital, the efficient control and management of inventory has paired the most serious problem to the health institutions. The turnover of working capital is largely governed by the turnover of inventory, that is the rate of working capital is largely governed by the amount of inventory which is largely provided by the government. It is therefore quite natural that inventory which helps to maximize profit occupies the most significant place among current and profit assets. The American usage of the word ‘inventory’ is synonymous with the British use of the word ‘stock’, this synonym is evident in the definitions of inventory and stock by the Oxford Dictionary. The Oxford English Dictionary defined inventory as follows:

 1. A list, catalogue, detailed account

2. A lot or stock of goods, etc which are or may be made the subject of an inventory.

3. The aggregate of goods and some specified kind of goods which a trader has on hand as provision for the possible future requirement of customers.

The American Institute of Certified Public Accountants (AICPA) defined inventory thus, the term inventory in used to designate the aggregate of those terms tangible personal property which are held for sale in the ordinary course of business, in the process of production for such sale or currently consumed in the production of goods and services to be available for sale. According to the Nigerian Accounting Standard Boards (NASB) stock includes those finished goods and livestock waiting sale, work-in-program, raw materials and supplies to be consumed in the production of goods and rendering of services. Many understand the word inventory as a stock of goods, but the generally accepted meaning of the word ‘goods’ in the accounting language is the stock of finished goods only. In a manufacturing organization, however, in addition to the stock of finished goods, there will be stock of partly finished goods; there will be stock of partly finished goods, raw materials and stores. The collective name of these entire items is ‘inventory’. Inventory management is aimed at maintaining a minimum investment in operations to maximize profitable operations. To maintain a large stock of investment to ensure a smooth and efficient operation of the firm. The effect of inventory management on government health institutions like UNTH Enugu cannot be over emphasized; this is because asset of many institutions represents considerable percentage of the total invested capital. The control, accounting and management of an efficient inventory management system is of a special interest to both management, suppliers and other users of accounting information. Therefore, poor inventory management leads to expiration of drugs, loss of quality sequel to poor storage system with resultant reduction in efficacy of the drug. This might even lead to death of some patients. There may be stock out and lot more effect of poor inventory control and management. Inventory control is concerned with the acquisition, control, handling and use of inventories so as to ensure the availability of inventory whenever needed, providing adequate provision for contingencies, deriving maximum economy and minimizing wastages and losses. Hence, inventory control refers to a system, which ensures the supply of required quantity and quality of inventory at the required time. Inventory control can make or break a company. This explains the usual saying that inventories are the grave yard of business. The aim of a sound inventory control system is to ensure the best balance between two much and too little. Too much inventory carries financial rises and too little reacts adversely on continuity of sequence. In health institutions such as UNTH Enugu, inventory control is more than just procurement and usage. The proper controls and processes can save millions in health care cost by enabling health institutions to efficiently order and store just the right amount of supplies needed for patient care while tackling cost, tier pricing and patient charges associated with supplies. Inventory management and control helps facilities identify, control and manage their inventories by keeping accurate records of all inflow, outflow and movement of inventory (drugs) in a user friendly environment. The proper tracking data allows for accuracy in patient charges and on audit trail to identify cist charges. The intention of this research work therefore aimed at studying the management and control of inventories (drugs) in government health institutions with special reference to University of Nigeria Teaching Hospital, Enugu.

1.2   THE ROLE OF THE SCHOOL

He classified that the school has been made to imbibe and inculcate into its students those learning experiences in health.  To teach the variety of experience for purpose of improving attitudes, knowledge and practices relating to health.  To teach the students the importance of health and to all intelligently in conformity with its awareness.

The school has been made to realize that the school age is the crucial and formative age of the child, an age when it is easier to cultivate habits than when older, realizing too the magnitude of the effect of poor health on the pupils learning output, and realizing more over that the child tends to spend more of his life in the school, it therefore becomes imperatives that both the school and the teacher must accept fully the responsibility for the health of the pupils placed under them.

Udoh (1991) contended that the health agency in institution of learning includes the school officer and his assigned main duties are:

1.          He is charge with the responsibility of developing and supervising the total school health programme.

2.          He co-ordinates the school healthy programme with other health agencies in the community including family doctors, and local medical society.

3.          Interprets to teachers the result of student’s, medical, dental, or psychological tests.

4.          He ensures that students needing medical attention in schools where there are no school doctors are refereed to doctors in general hospital.

5.          He ascertains that student recommended for special programmes, especially those placed on restricted activities  in physical education are given adequate attention and their programme implemented as prescribed by either a family or school doctor.

6.          He checks students returning to school after illness or injury and determines that students participating in extra-curricular activities can do so without damage to their health.

7.          He sources publicity for the school health programme and sees that all staff member are award of the services available to them.

8.          The checking of the sanitary environment of the school is his responsibility.

9.          He arrange in-service course, workshop and seminars for teacher especially the auxiliary health instructors.  He stated further that the composition of the school health team and their main duties are as follow.

The success of school health agencies depends upon the efficiency of the school health teams.  The school administration is responsibility for finding the programme and recruiting qualified personnel for the programmes.  The health committee gives guidance and leadership to the health education programme within the school and cooperates with the community health council through duly – appointed representative.

The school doctor function as the school’s medical adviser.  The physical educators, because of their strategic position, observe children health behaviour and offer counsels.

The physical educators also five health instructions to student on variety of topics.  The nurse in school provides essential school health care to the sick student in the absence of a medical doctor, and conveys the injured and sick students to the nearest hospital for treatment.  The nutritionist ensures balanced and nourishing diet for the students, where food is provided by the school, and well coordinated team work of those concerned with the implementation of school health programme is the key to the success of the programme.

He stated forward that a health agency is of paramount importance in our institution of learning.  With agencies, the school realizes the need for health inspection and examination, the need of training pupils in simple health skills and healthful school environment.

(1)    THE NEED FOR HEALTH RECORDS: 

Health record for pupils are very essential.  The use of charts, graphs, and histographs would be found very indispensable.  Regular recording of the pupils, age weight and height, is very essential as a useful way of observing their growth habits.  The teacher should endeavor to put in more effort to chart out the growth and or development pattern of each child, and put up such charts on a health display board.  Pupils themselves tend to derive pleasure and knowledge by themselves observing and interpreting their own growth curves or patterns.

A prompt report by the teacher to parents about any abnormal growth pattern of their children would quite of the meet with satisfying professional reward.  Besides this reward, such health records would form a useful basis for the accurate forecast of the pupils possible academic output, and thus facilitate the teachers, the teachers’ pedagogical and remedial approaches. Health records help to build up care history for the pupils which are very invaluable for diagnosis of latter health hazards.

(II)   THE NEED FOR REGULAR HEALTH INSPECTION AND EXAMINATION:-

The detective and diagnostic values of daily routine health inspections are so immense that the school timetable must be made to accommodate a few minutes for daily health inspections.  The routine is most valuable in guiding the pupils to cultivate good health habits.  It is importance that the pupils be inspected in a single file in the morning by the teachers before the day’s work or lesson commence.  With the aid of health agencies, pupils have been made to put up healthful look and to adhere to health habit and regulation.  They have helped to establish.

A sort of routine inspection like, routine medical check-up which must be organized by the school.

There is the routine medical dental examination for school children. Similarly, routine X-ray may be needed to eradicate or prevent some infection diseases.

(III)THE NEED FOR TEACHING PUPILS IN SIMPLE HEALTH SKILL:-

Taking advantage of the formative and creative potentials which usually dominate this stage of pupils’ developments, pupils would respond very favorable to training in carrying out simple health skills.  They may be exposed to simple first aid techniques by encouraging the formation of such organization as Red Cross,   scouting e.t.c health skills acquired through this process have a far reaching effect on the future citizen for the society.

(IV)HEALTHFUL SCHOOL ENVIRONMENT

Health school living or environment is defined as everything that is being done “to Provide at school, physical, emotional and social conditions which are of benefits to the health and safety of teachers are the school children. The school and the teacher are to recognize their crucial position amongst agencies that must being about an urgent and lasting change for better in our society.  Pupils must be encouraged to organize voluntary clear-up companies.  Pupils in top classes can organize the voluntary building of public incinerators.  By doing this, the teacher and the school are leading the pupils to acquire the vital spirit of public health. 

The teaching of physical education in school is very essential, in that it is a means of ensuring physical health of pupils, which is indisputable in educational practice, yet no educational practice is as the teaching of physical education (Udoh 1992).

1.3   THE ROLE OF THE TEACHER

It is a known fact that a teacher is a person who imparts moral value, academic teachings, both physically, mentally, socially, emotionally and spiritually into an individual for the proper development and systemic growth of an individual in any institution of learning.  There is power in examples and “examples, are better than precept” they say.

Quite often, it is said that “Those who preach the gospel must always live by the gospel” these two axioms must emphasize and point to the fact that the teacher must possess and practice good wealth attitudes and habits in order to show and demonstrate example to his pupils one of the very basic ability that is often exhibited by school pupils, in the power of imitation.  Pupils are easily damaged or ruined through imitation of every bad habits or bad practices, hence the teachers who fail to positively utilize the opportunity of such love for imitation by showing good health habits.  Teachers who display poor habits like dirty and shabby dressing, un kept hair and beards, bad table manners, poor toilet habit, un kept finger nails, spiting carelessly, before his pupils are negative and very damaging too, his personality and responsibility to the pupils, parents and the society at large.

He contended that, it is however the duty of the school through the headmaster via the teacher and the health agencies to :-

1.          Understand each child’s health need and interest for the development of high level health for each child.

2.          Prevent defects disorder and provide continues appraisal of each child’s health status.

3.          Provides special health services for the disabled and optional children.

4.          Develop in the child a positive health awareness and reduction in the incidence of communicable and non communicable diseases. 

5.          Develop and application of destintic factor as relate to health a huge level of self-esteem and social adjustment in each child.

6.          Develop healthful personal practices and whole some health attitudes.

7.          Provide emergency measure, mentally-hygienic school environment and maintain sanitary practice and surrounding.

He stated forward that the objectives of the school health programme cannot be achieved unless the various organs that constitute the health team function smoothly and effectively.

1.4   THE ROLE OF THE HOME AND COMMUNITY

Hosstrup (1989) stated that the roles played by the parents and health agencies and in the promotion of school health cannot be overemphasized. In the homes, the primary responsibility for the health of a child rests with the parent.  The mother is usually the first teacher and all the basic health habits are learn at home even before the child starts school.  The parents should be taught either through the Mass-media or adult education, the important of sound health of their children.  There are numerous desirable health practices which parents should know and inculcate into their children, such as:-

1.          Sanitation of home and its surrounding including access to water supplies, if the main source of H20 is well or spring, it is necessary that the water is boiled before drinking, people disposal of human waste refuses and garbage is essential and usually habit of throwing refuse around in the compound or street is undesirable.  Optional use should be made of existing environment sanitary conditions.

2.          To take appropriate steps for the prevention of home accident.

(a)         Do not put medicine within the reach of children

(b)        Keep children away from the kitchen

(c)         Do not use electrical appliances that are faulty

(d)        Do not improvise but repairs things that are repairable and keep sharp knives away from toddlers.

3.          To arrange for the best possible hygienic sleeping conditions and to avoid overcoming.

4.          To keep the immediate environment free-from rodents and insects.

5.          To wear clothing suitable for the prevailing climatic condition.

6.          To eat an adequate balanced diet in order to ensure full working capacity, correct Weight control and to fulfill dietary requirement which will enable the body to fight against diseases and to avoid disease due to malnutrition.

7.          To teach the children to wash hand after defecation and before handling food. 

8.          To bath regularly and brush teeth in the morning and before retiring to bed at night.

9.          To make appropriate use in the care fullness of the modern service available and to seek routine medical examination and supervision as indicated of age and development.

10.      To ensure that children obtain communization as recommended by health authority.

11.      Parents should know how budget and know what priority to be give to each items such as food, clothing, shoes. House etc.

12.      Parents must ensure that children wears shoes to school to avoid nail puncture.

He stated further that, it should be emphasized that parents at home should be able to learn more about their role in health promotion of children and hope that their effort will lead to improvement in health promotion of children and propagation of lives and that of the children to a degree greater than any previous ages have seen. Prevention is better and cheaper than cure and as such parents should work together to build a strong and healthy nation.

It is of contributory fact and know that must Nigeria lives in every thing from house – boast to free house and from poorly made huts or sheds to mansions-few like the isolation of the desert hut or the mountain sheds while other love to have their apartments in the city.  Whether rural suburbau, and urban living, all have their advocates within the community. Costly their house as they purpose (an buy” is an American saying which simply mean that a good home is worth what it costs.  What you can afford to spend you should spend, for the good home pays dividends far beyond its value in shelter.  The enjoyment of community living, the pleasure of gracious entertainment, and sheer physical comfort are but a few example, the benefits to be gained from life in a superior, clear and hygienic dwelling. Home and community as health agencies have to see to the proper health development of their environment so as to be conducive enough for habitation.

1.      For comfort: - a good home must go a step-further by providing comfort and protection.  Cross ventilation is a must for comfort during dry seasons and when the eat is great.  There must be prevention against unpleasant Odors. A highly personal cleanliness must be reach by the community.

2.      Proper lighting: - Every occupied room, bathroom, included should have at least one window providing the greatest possible illumination and this should be as much as possible without glare or shadow.

Direct sunlight is often advantageous particularly for the ill or invalid: Direct sunlight is physically and psychologically stimulating and a remarkable source of VITD in a house with children, space is as much a matter of comfort as of health. 

3.      For mental health: -Rooms should be shared only by persons of the same sex, for sleeping, young children should be separated from their parents early and certainly by the age of four.  Toilets, bathrooms and bedrooms should be   directly life provides those social contracts expected in the home and in the community people cannot be mentally healthy without them.  A suitable dwelling should have a living room or family room, one or more gathering places, place a kitchen, dining room or area and whatever bedroom and bathroom the family man need and can afford. The need for companionship as well as for privacy can thus be satisfied to keep the family happy.

4.      Cleanliness and Orderliness: - The mentally healthy well-adjusted person can abide with extremes of cleanliness and tidiness for short periods and can put up with disorders and disarray when necessary cleanliness demands water in plenty at the  right places, much of it under proper pressure.  What so supplied makes the home a different world from one where water must be carried.  Plenty of water inevitable means cleaner people in a cleaner home.  Where no harm can come from getting dirty con however bring health danger.

5.      Control of contagious diseases:- contagious and infections disease play major role in Nigeria life.  The kind of home, people live in, their size, designed and quality have a great deal to do with the amount of illness cause by communicable diseases.  It is of important that home be built in a way that gives bitter protection than just building a house with poor quality and with bad material.

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