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Place de l’Albertine 2

1000 Bruxelles

Title of the project

GERIATRIC AND PALLIATIVE NURSING CARE TRAINING

FOR SCHOOL DROPOUT GIRLS – HONAVAR

2013 – 2014

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Table of contents Brief Description ..................................................................................................................................................... 2 1. Applicant/Organisation (local partner) .................................................................................................. 3 2. Project Location .............................................................................................................................................. 3 3. Beneficiaries ........................................................................................................................................................ 3 4. Socio-economic conditions ......................................................................................................................... 3

4.1. Social Situation ...................................................................................................................................... 3 4.2. Economic Situation ............................................................................................................................... 4 4.3. Situation of Women ............................................................................................................................. 4

5. Criteria used in the selection of the beneficiaries ............................................................................. 5 7. Logical Framework ............................................................................................................................................ 8 8. Duration and activity schedule ................................................................................................................. 9 9. Material and human resources ................................................................................................................. 9 10. Budget ......................................................................................................................................................... 10 11. Viability ....................................................................................................................................................... 12

11.1. Socio-cultural Viability (programme viability) ........................................................................... 12 11.2. Economic Viability ................................................................................................................................ 12 11.3. Technical Viability ................................................................................................................................. 12

12. Monitoring & evaluation ........................................................................................................................ 12 ATTACHMENTS ...................................................................................................................................................... 13

1. Plan of the building ground floor and first floor ........................................................................... 13 2. SYLLABUS FOR NURSING AIDE COURSE ....................................................................................... 14

Brief Description

The purpose of the project is to provide nursing care skills for the school dropout rural girls

to deal with geriatric patients as well as palliative patients, where there is high demand for

this profession in the locality as well as abroad. So that, to enable the rural girls to seek job

and to empower them with improved socio economic life.

The projects will address following 5 main problems Girls those are drop outs that face economic constraints to study further.

Inadequate awareness among the families about the capacities of the teenagers

Social stigma attached to girls being sent for higher studies

Poverty of parents and their dependents

Lack of skill development courses that are conducive for the girls to study

The planned key strategies are:

1. Capacity building of Parents on the education of Girl child;

2. Awareness programmes for the Women, SHG leaders, Teenagers, Teachers and the

Community in general;

3. Building linkages and Networking with GOs and NGOs;

4. Providing skill development trainings (Nursing AID/Palliative/Geriatric care);

5. Counseling on Job facilities to all age groups;

6. Initiate Income Generating through placement services.

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1. Applicant/Organisation (local partner)

Person In charge for the Project: Sr Maria Goretti SRA

Director

St Ignatius Institutions

Prabhat Nagar, Honavar,

Karwar Dt., Karnataka, India

Cell: + 91 9448105552

Email: mariagoretti05@yahoo.co.in

Position: Chief Medical Officer

2. Project Location

Honavar taluk in Karwar district, Karnataka.

3. Beneficiaries

Direct Beneficiaries:

25 Rural School Dropouts Girls, Staff - 5

Indirect Beneficiaries:

50 Palliative and Geriatric patients, 125 family members of beneficiaries, 300 family

members of Palliative and Geriatric patients and community members.

4. Socio-economic conditions

4.1. Social Situation

Despite strictly following traditions and holding superstitious beliefs, the women in the

villages help supplement the family income by working as housemaids or as manual

labourers in their own places. However in the town area many women prefer staying idle at

home. Hence it is really ironical when it is seen that the women in the villages enjoy lesser

freedom. Girls are sent to school and are educated but preference for a boy over a girl is

seen even in educated families. The head of the family who is a male is the decision maker.

He takes care of the expenses and decides what is to be carried out in the houses. But in a

family where the head drinks heavily or is involved in gambling then automatically the

women takes over the management of the house. Thus situation is not as bad it was in the

Dharmajyothi Charitable Society

Vamanjoor, Mangalore Email: mariagoretti05@yahoo.co.in

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early 80’s or 90’s but one cannot still assert and say that women emancipation has been

achieved. The process is on.

Joint family system is now slowly giving way to nuclear families in the town areas. Either

the present houses are being divided further to provide for or the families are shifting to

rented houses. But on the whole the families do get together to celebrate festivals or

religious rituals.

4.2. Economic Situation

The economic standard of a family also depends on the caste to which they belong. The

richest are the land owners, majority of whom are Brahmins, the caste located at the

highest rung of the ladder followed by the Gouda Saraswat Brahmins (GSB) who are

predominantly merchants. The rest i.e. the Naik are mostly job holders or owners of small

plots of land. A few Muslims too enjoy a good standard of living because they work in the

Arabian Gulf. Christians are mostly middle class families or below average or poor because

they do not own land nor do they carry out lucrative business. They mostly work as coolies

or carry out insignificant jobs in the private offices.

4.3. Situation of Women

This proposal concentrates on women who constitute an important part of the society. In an

age of equality, freedom and liberty it is very relevant that we focus on girls who are drop

out not for their reason but because of the social structure, economic constraint or cultural

practices. Hence in this proposal while they are given a prominent place, they are also

streamlined to inculcate skills which build their confidence to move from one step to another

along with the feathers of success complemented with skills. While these will fetch them

money as steady income, it will also boost their moral and give a renewed social status in

the society.

Access of women and girls to secondary and higher education is necessary if more women

are to become socially active. The strengthening of their socio-economic status largely

depends on their education and the standards of general and professional trainings. Literacy

and education are the basic means improving their health, nutrition, education and family

status. Higher education standards are decisive for women to make conscious choices about

the size of their families. Education produces knowledge and helps understand outside the

household and family. It helps to achieve self-sufficiency and economic independence and

produces a feeling of confidence and dignity. Low educational levels are generally

accompanied by high rates of childbirth stemming from ignorance on family planning.

Dire consequences may occur without conscious efforts to support today’s girls who will

tomorrow become women, mothers, workers and wives. Their educational, professional and

cultural levels will shape the social environment. Before it is too late we must identify and

eliminate the nascent discrimination of girls in matters of nutrition, health, education,

leisure and employment

The conditions of the rural women deserve special attention as many of them face specific

problems related to the rural way of life, economic hardships, and local customs.

Sensitization of the general public on the education also should go hand in hand.

The situation of women here is no better. Their sufferings go unnoticed

Female poverty is wide spread and it is acute among the rural women.

Rural women face formidable barriers created by their family status

They suffer from socio-economic hardship and male dominance over them both

inside and outside the family.

The education facility is also is not conducive for the child aptitude

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5. Criteria used in the selection of the beneficiaries

The project deals with School dropout young girls from rural villages studied less than

standard 12 between the age group of 16 to 25 years. To select these beneficiaries

following criteria has been used.

Semiliterate and school dropout girls from rural area.

Desire to study and acquire the skills of nursing care.

Desire to work with the patients and health institutions.

Desire to support self as well as the family, especially to promote education,

health and hygiene in the family.

Preference will be given for the girls from Honavar taluka, later other talukas of

the district.

Age between 16 to 25 years.

Selection Mechanism of Beneficiaries

Co-ordinator of the project will organize general awareness programme about the need of

providing nursing care skills for the school dropouts girls and also the demand for this

profession in the locality as well as in the other districts, states and in abroad. Later,

interaction also will be held with village leaders, school teachers and priests to recommend

suitable candidates for the course.

Beneficiaries’ participation in decision making process

Beneficiaries have attended the preliminary discussions during the other programmes

organized for the general public, and expressed their willingness and need for designing

nursing care related course and sometimes, they have volunteered in the villages to

organize medical camps for the expecting mothers, children and geriatric patients.

They were regular for meetings, discussions and have provided valuable suggestions to

design this project.

6. Project Origins and specific problems to be resolved

St. Ignatius Institute of Health Sciences the unit of Dharma Jyothi Society organizing and

offering university recognized B.Sc. and Diploma in General Nursing Courses for the rural

girls since last 10 years. St. Ignatius Hospital is the laboratory for the nursing students to

acquire nursing skills.

During our interaction with rural girls, quite a high number of rural school dropout girls

expressed their desire to learn and acquire nursing skills. During the village health camps

too, they were expressing about their interest. At the same time, in the modern nuclear

families, geriatric, palliative care centres, there is a good demand for skilled nursing care

takers.

Considering both these possibilities, we have decided to introduce this training for rural girls

so that to help them to acquire nursing knowledge and be able to seek a job to lead their

daily life.

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Description of the specific problem/s is/are intended to be resolved by the project

THE PROBLEM TREE

E F F E C T S

Rampant

increase of Unemployment

Restrictions of

the society

Girls have less security

Depression

Low income

Debts

Low

nutritional

supplemen

t

Low life expectancy

Cannot afford

medication

Depression

Girls are thought to

helping at home

If she studies, loss of income of the family

Discouragement

No Expression of thought/ Loneliness

Depression

Suicidal Tendencies

Social

taboo

Religious

bonding

Tradition

Superstitions

Parents are afraid to send

the girls for higher studies

No safe environment Lack of

productivity

Thought to be not strong

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PROBLEM STATEMENT: Alarming Dropout rate of girls after the Xth Grade

of Honnavar Taluk

C A U S E S

Lack of information

on further studies

Preferring to work as house maids

High Risk Behaviour Among youngsters

Lack of awareness on Programmes

Lack of commitment

on the part of the

government

Lack of participation

of Parents in

Awareness

programmes

Illiteracy of

the parents

Distance

Indifferent

attitude

Don’t own the

problem as affecting them

Poverty

Lack of labor in the village

(work available only 120 days in a year)

Unemployment

Unskilled labor

No higher education

Poverty

Curiosity and

exposure to sex in the youth

Lack life skill education

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7. Logical Framework

Reasoning behind the intervention Verifiable indicators Sources for

verification G

OA

L Empowerment of rural girls through skill

development trainings in Nursing care and

thereby make them self reliant and self-

sufficient.

100% of school dropout girls from the project

areas will lead their life and continue nursing care

profession.

Employment

register, institution

register.

OB

JEC

TIV

ES

01 To enable the school dropouts girls to acquire nursing care skills.

25 girls will enrol for nursing care training and acquire required skills and knowledge in providing nursing care.

Evaluation Report,

Certificates.

02 To enable the school dropout girls to support

their families and to shoulder economic burden.

25 families of the beneficiaries will improve their socio

economic conditions and children in the families will be

regular to school.

Observation, Reports

03 To motivate and guide rural girls to get job placements in health / home based care institutions.

25 girls will be occupied in taking care of Geriatric, Palliative care patients in their respective houses or health care institutions.

Photos, Reports.

04 To provide legal and medical awareness to deal with day to day life.

25 girls will be aware about the law and legal procedures when they are threatened by the others and also health of the rural girls will be improved.

Photo, Reports.

05 To guide and motivate rural girls in small savings from their income.

25 girls will open saving bank account in the villages and their deposits will be recurred.

Bank account book

OU

TP

UTS

/ R

ES

ULTS

01 Rural girls will be confident in attending nursing care needs of Palliative, Geriatric care patients and Senior citizens.

Increased level of satisfaction and comforts of the patients.

Photo

2. 25 families will be socio economically self relevant Improved infrastructure facilities available and younger

siblings in the family will attend the school regularly. Observation, School

attendance

3. 25 girls will get employment and earn their income.

Girls will be self reliant in socio economic factors as well as bold in taking decisions in the family.

Observation

4. 25 girls’ health and hygiene matters will be

improved and knowledge about law and social

issue will be widened.

Physically and Psychologically fit to carryout day to day

activities in the respective house and working place and

will be good in dealing with legal matters for their safety.

Observation and

pictures

5. Income and saving of the 25 girls will be increased.

Girls will be able to save small portion of their income and invest money on interest.

Bank account

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8. Duration and activity schedule

Activity

1 2 3 4 5 6 7 8 9 10 11 12

1. Negotiation and agreement

with the building contractor

2. Construction of the building

3. Selection of staff

4. Selection of students

5. Syllabus and time table

6. Theory class

7. Allotment of practical training

8. Evaluations

9. Seminar / Conferences / field

study programmes

10. Job Placement

11. Follow up

Remark 1: Construction of the Ground floor is already under progress and expected to

begin the construction of 1st floor in the month of November 1st week (2013), if

sufficient funds are available.

Remark 2: The 1st batch of 25 rural girls will commence in June 2014 and admission

procedures will start from March 2014 onwards. The syllabus foreseen for the training is

already available (see attachment 2)

9. Material and human resources

9.1. Material resources.

Hostel Building for the girls

Cots – 25

Kitchen utensils and cylinder gas with stove

Dining Table – 5

Chairs for the Dining Table – 25

Cupboards – 5

T.V & CD Player with stand

9.2. Human Resources

Programme Coordinator cum warden - 1

Tutors - 2

Placement and training Officer - 1

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10. Budget

10.1 Consolidated Budget (1 Euro = Rs. 80)

item amount Rs. amount € local contribution/others Rs local contribution/others € requested amount

1/Investment

Construction 4.545.000 56.813 2.517.321 31.467 25.346

Equipment and material 200.000 2.500 0 0 2.500

2/Recurrent costs 0 0

Training 1.007.000 12.588 300.000 3.750 8.838

3/Personnel 360.000 4.500 200.000 2.500 2.000

4/Administrative costs 96.000 1.200 0 0 1.200

Subtotal Operational Cost 6.208.000 77.600 3.017.321 37.717 39.883

5/Administration ETM 3% 1.237

Total 41.120

10.2: Budget Breakups

A. CONSTRUCTION OF THE BUILDING :

SL.

NO. PARTICULARS

AMOUNT

01 429 Sq.mt. building to provide residence for the girls

with dormitories, toilets, kitchen, dining hall etc. 45,45,000.00

TOTAL 45,45,000.00

See plan in attachment 1.

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B. EQUIPMENTS AND FURNITURE

SL.

NO. PARTICULARS AMOUNT

1. Cots – 25

(Rs. 3500X25) 87,500.00

2 Kitchen utensils and cylinder gas with stove 35,000.00

3 Dining Table – 5

(Rs. 4,500X5) 22,500.00

4 Chairs for the Dining Table – 25

(Rs. 500X25) 12,500.00

5 Cupboards – 5

(Rs. 3,500 X 5) 17,500.00

6 T.V & CD Player with stand 25,000.00

TOTAL 2,00,000.00

C. SALARY FOR THE STAFF

SL.

NO. PARTICULARS AMOUNT

1 Programme Coordinator Rs.8000X12 96,000.00

2 Tutors

(Rs.8000 x 2 x 12) 1,92,000.00

3 Placement and training

(Rs. 6000 x12) 72,000.00

TOTAL 3,60,000.00

D. PROGRAMME EXPENSES

SL.

NO. PARTICULARS AMOUNT

01. Workshop / seminars for the students on nursing care

issues by the experts – 12 (Rs. 2000X12) 24,000.00

2 Training for core groups PRI/SHG - 1

Rs 200 x 15members x 2 days 6,000.00

3 Campaign in villages issue on girl child care 20 villages

x Rs.500 10,000.00

4 Motivational sessions for school teachers on Life skill

education for school dropouts.

20 Teachers x 1 day x Rs.100

2,000.00

5 Food and refreshment for the student nurses. (Rs.3000

x 12 months x 25) 9,00,000.00

6 Teena age out reach programmes for the rural girls – 5

(Rs. 3000X5 programmes) 15,000.00

7 Study Tour for the students to visit different care

centres. (Rs. 2000X25) 50,000.00

TOTAL 10,07,000.00

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E. ADMINISTRATION

Sl.

No. Particulars

Amount

Rs.

1 Postage/stationery Printing 2000 x 12 months 24,000.00

2 Building maintenance

(3000 x 12 months) 36,000.00

3 Documentation, photography and reporting 6,000.00

4. Electricity (Rs. 2500X12) 30,000.00

TOTAL 96,000.00

11. Viability

11.1. Socio-cultural Viability (programme viability)

25 girls will acquire nursing skills and will get certificate as nursing care provide

which will be sufficient for the students to seek a job in the locality as well as

outside.

The trained Nursing care providers will participate as guest resource person and will

share their experiences, knowledge and the challenges they have faced.

The community is well aware about the students being picked up by the organization

for skill training.

Number of school dropout girls in the district is high and admission for this course is

guaranteed since there is good demand for this profession the job market.

11.2. Economic Viability

Students will pay their actual expenses for food. Poor girls will be supported through the

individual scholarship programme.

St. Ignatius Hospital also will pay Rs. 1000 per month as a stipend after completion of

the project period.

11.3. Technical Viability

Qualified subject experts to guide the students are available in the locality.

St. Ignatius Hospital will provide the opportunity for the students to get practical

training.

Health care institutions, families will provide the job opportunities for the students

who completed the course.

12. Monitoring & evaluation

The programme will be monitored and the process of evaluation will be carried out

monthly by the Institute and the staff.

Monitoring and follow-up training will be incorporated in the design of our program so

that the knowledge and skills are current and relevant.

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ATTACHMENTS 1. Plan of the building ground floor and first floor

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2. SYLLABUS FOR NURSING AIDE COURSE

ANATOMY

Skeletal System

Bones, Types, Structures, Function.

Cardio - Vascular System

Blood, Composition, Clothing and blood group cross matching, blood products and

their use.

Hart

Position, Structure, conduction system, blood pressure and pulse.

Respiratory System

Structure and functions of respiratory organs

Excretory System

Structure of organs of Urinary System

Function of Urinary System

Nervous System

Structure & function of Nervous system

Sensory Organ

Structure of skin, eye, ear, nose, tongue

Digestive System

Structure and function of Digestive System

The Reproductive System

Structure of female Reproductive organ

Structure of male Reproductive organ

Function of Reproductive organ

NURSING ARTS

1. Nursing definition and meaning

2. Nurse definition and meaning

3. Bed and bed making

4. Source of infection

5. Transmission of Infection

6. Qualities of the nurse

7. Professional Etiquettes

8. Discharging a patient

9. Admission of a patient.

10. Assisting the physician.

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Basic nursing care and needs of the patient

1. Hygienic needs and physical needs

2. Importance of maintaining good and personal and environmental hygienic in health

and disease.

3. Care of the skin and mucous membrane

4. Bed bath, care of hair, eyes, nose, ears, teeth, genitalia, hands and feet nutritional

needs.

5. Maintenance of intake and output record.

Comfort devices and their uses, positions, body mechanics

Moving, shifting and lifting of patient

1. Care of pressure points, bed sores, causes, signs, Symptoms, prevention and

nursing care.

2. Shifting of patient from one side to another from bed to wheel chair and bed to

stretcher.

Assessment of patient/client

Temperature, pulse, B.P normal and abnormal

Therapeutic nursing care and procedures asepsis

1. Hand washing, hand scrubbing, use of mask, gown, gloves.

2. Disinfection techniques, sterilization techniques, autoclaving, boiling, flaming.

Care and sterilization of

1. Linen, bed, mattress, floor, walls, cupboards and other articles.

2. Rubber goods dressings, instruments, needles syringes, enamel articles.

3. Barrier nursing and isolation.

Care of Respiratory system

1. Inhalation

2. Collection of specimen, blood, sputum, urine.

Care of gastro intestinal tract

1. Preparation and giving of enema.

2. Suppository

3. Passing of flatus tube

Care of genito-urinary system

Perineal care of terminally ill patient and patient with catheter

Care of skin and mucous membranes

1. Cold application: Ice, cap, cold packs.

2. Hot application: Use of hot water bag.

Care of the dying

1. Last offices, packing of dead bodies.

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FIRST AID

Emergency Situation

1. Fire, burns, fractures, accidents, poisoning, drowning, hemorrhages, insect bites,

foreign bodies.

2. Transportation of the injured.

3. Bandaging and splinting

4. Infection and immunization

5. Communicable disease

6. Infection & Immunization

7. Communicable Disease

NUTRITION

Sources

1. CHO

2. Proteins

3. Fats

4. Minerals

5. Vitamins

6. Water

Diseases caused by deficiency of protein, fat, carbohydrate, minerals and vitamins.

Introduction to diet therapy

1. Diet and the patient

2. Serving of food

3. Feeding of helpless patients

Health Promotion

1. Nutrition

2. Human Body and Hygiene

3. Mental Health

I. Essential Nutrients

Importance of nutrition in health and sickness

Essential nutrients, functions, sources and requirements.

Classification of food and their nutritive value.

Natural requirements at different ages.

Balanced diet for different age group.

II. Nutritional Problems

Nutritional Deficiencies:

Deficiencies, correction, treatment and referral – protein energy malnutrition.

Vitamin and mineral deficiencies

Nutritional anemia in woman

Under-five nutrition.

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III. Promotion of Nutrition

Planning diets and special diets for a family

Methods of using locally available foods for special diet

Principles and methods of cooking

Promotion of kitchen gardens

Food hygiene and safe preparation

Storage and preservation

Food adulteration

Precautions during festivals and meals

ENGLISH Grammar

1. The sentence

2. Different parts of speech in brief.

Vocabulary

3. Conversation

4. Speaking skills

Written composition

5. Paragraph writing

6. Essay writing.

7. Letter Writing