UNIT 10 SOCIETY AND HEALTH
Key Unit Competence
Relate society, family, and special group to health and illnessIntroductory activity 10
1. What does the image A display?
2. Describe the interconnectedness showed in image B in terms of societyand health.
10.1. Definition of society and FamilyLearning activity 10.1
Referring to the image aside define the
following terms
a) Societyb) Family
a. Society
A society is a group of individuals involved in persistent social interaction, or a
large social group sharing the same spatial or social territory, typically subject
to the same political authority and dominant cultural expectations. Societies are
characterized by patterns of relationships (social relations) between individuals
who share a distinctive culture and institutions; a given society may be described
as the sum total of such relationships among its constituent of members. In the
social sciences, a larger society often exhibits stratification or dominance patterns
in subgroups.
Societies construct patterns of behavior by deeming certain actions or concepts
as acceptable or unacceptable. These patterns of behavior within a given society
are known as societal norms. Societies, and their norms, undergo gradual and
perpetual changes.
• Society can enable its members to benefit in ways that would otherwise be
difficult on an individual basis; both individual and social (common) benefits
can thus be distinguished, or in many cases found to overlap.
• A society can also consist of like-minded people governed by their own norms
and values within a dominant, larger society. This is sometimes referred to as
a subculture, a term used extensively within criminology, and also applied to
distinctive subsections of a larger society.
b. Family
The family is an intimate domestic group made up of people related to one another
by bonds of blood, sexual mating or legal ties. It is the smallest and most basic
social unit, which is also the most important primary group found in any society.
It is the simplest and most elementary group found in a society. It is a social group
consisting of a father, mother and one or more children. It is the most immediate
group a child is exposed to. In fact, it is the most enduring group, which has
tremendous influence on the life of an individual, from birth until death. It also
accounts for the most enduring social relation¬ship found in society. Every family
provides an individual with a name, and hence, it is a source of nomenclature. Each
member of family shares duties and responsibilities.
The family is the central and important social institution for health development in
which individuals are born and receive resources for their growth and development.
It has the primary influence on the health and development of children. The family
influences healthy behaviors, and provides care and facilitates recovery from the
illnesses.
The family is commonly linked to positive health outcomes. Two parent biological
families are particularly shown to be more protective for mental health of children
and adolescents.
Marriage has a protective role on health since married individuals report healthier
lifestyle, less risky behaviour, early screening and testing for disease, more health
checkups and timely treatment-seeking. But the benefits of marriage for health are
strongly dependent on the quality of the marital relationship and conjugal harmony
Intra-family dynamics and relationship has a key role in health outcomes of the
family. Supportive family/kinship relationships have reportedly decreased the
likelihood of the onset of chronic diseases and mental illness and delayed mortality.
Families provide the support and conditions needed for healthy living, prevention
of disease and opportunities for early diagnosis and treatment to avert or delay
complications. Interventions for health to be effective, must necessarily take intoaccount the social determinants of health.
Self-assessment 10.1
Select the best response
1. Social dispute contributes to good health
a) True
b) False
2. A society consist of
a) People
b) Institution
c) A and b
d) None of the above
3. The definition of family
a) Is consistent across communities
b) Is defined by our government to include all current family structures
c) Can include only biological family members
d) Varies from community to community and from state to state
4. A homeless woman is more likely than other women to have all of the
following characteristics except:
a) To have less than a high school education
b) To have grown up in foster care
c) To be employed
d) To have had an abortion by age 16
10.2.Family Structure
Learning activity 10.2
Relating to family structure, describethe image aside
The following types of families exist today, with some families naturally falling into
multiple categories.
a. Nuclear Family
The nuclear family is the traditional type of family structure. This family type
consists of two parents and children. Children in nuclear families receive strength
and stability from the two-parent structure and generally have more opportunities
due to the financial ease of two adults.
b. Single Parent Family
The single parent family consists of one parent raising one or more children on his
own. This family may include a single mother with her children, a single dad with his
kids, or a single person with their kids.
c. Extended Family
The extended family structure consists of two or more adults who are related, either
by blood or marriage, living in the same home. This family includes many relatives
living together and working toward common goals, such as raising the children and
keeping up with the household duties. Many extended families include cousins,
aunts or uncles and grandparents living together.
d. Childless Family
While most people think of family as including children, there are couples who
either cannot or choose not to have children. The childless family is sometimes the
“forgotten family,” as it does not meet the traditional standards set by society.
e. Stepfamily
For the divorced individuals, many choose to get remarried. This creates the step
or blended family which involves two separate families merging into one new unit.
It consists of a new husband, wife, or spouse and their children from previous
marriages or relationships. Stepfamilies are about as common as the nuclear
family, although they tend to have unique challenges, such as adjustment periods
and discipline issues. Stepfamilies need to learn to work together and also work
with their exes to ensure these family units run smoothly.
f. Grandparent Family
Many grandparents nowadays are raising their grandchildren for a variety of
reasons. One in fourteen children is raised by their grandparents, and the parents
are not present in the child’s life. This could be due to parents’ death, addiction,
abandonment or being unfit parents. Many grandparents need to go back to workor find additional sources of income to help raise their grandchildren.
Self-assessment 10.2
Compare and contrast stepfamily from nuclear family
10.3.Special groups in the society
Learning activity 10.3What does the following images indicate?
Though the concepts of society and family were well described, it is very important
to pay attention on the health of special peoples within the society which include:
a. Sex workers
Sex workers are a diverse group of people. They are men, women, and transgender
people. Some are parents, members of religious groups, and members of the society.
Some sex workers enjoy their work and see it as a way to express their sexuality.
Others like the income and flexibility. Yet, whoever sex workers are and whatever
they do, they deserve the same protections as everyone else. This includes the
right to health care, and to safety. Stigma against sex workers leads to extreme
barriers to health care. A UNFPA report found that nearly 1 in 4 sex workers have
been denied health care because of their occupation. And, not surprisingly, more
than 60% of sex workers fear and distrust health care workers.
Different report highlight that sex workers are more likely to be HIV+ than the general
population because they are less able to access health care service. Many sex
workers face rejection from the family and that lead to lot of psychological problem
among them. Sex workers have reported facing daily harassments and stigma and
many have even attempted suicide as a consequence to such maltreatment from
the society. It is therefore very important for health care workers to understand the
complexity and health challenges of sex workers and consider them in the planning
of preventive and curative interventions to them.
b. Prisoners
A prisoner is a person legally committed to prison as a punishment for a crime or
while awaiting trial. Hundreds of men and women are imprisoned in different prison
around the world. Most of these prisoners are from poor and vulnerable communities.
Prisons are not healthy places. Communicable diseases are frequently transmitted
among prisoners, and the rates of HIV, hepatitis and tuberculosis are much higher
among them than in the general population.
There is also a high prevalence of mental health problems, including substance
abuse disorders, and a higher prevalence of non-communicable diseases.
Unhealthy conditions such as overcrowding and poor hygiene are common in many
prisons. Prison health is part of public health and prisons are part of our society.
One third of prisoners leave prison every year and the interaction between prisons
and society is huge. Health care workers must contribute to initiative designed to
ensure that prisons are not becoming breeding places for communicable and noncommunicable
diseases, and must also seek to use the experience of imprisonment
for the benefit of prisoners and society.
c. Disabled persons
Disability refers to the interaction between individuals with a health condition. Over
1 billion people are estimated to experience disability. This corresponds to about
15% of the world’s population. disabled persons are then part of the society. The
number of people experiencing disability will continue to increase due to a rise
in chronic health conditions and population ageing. WHO report that people with
disability face barriers, stigmatization and discrimination when accessing health
and health-related services and strategies.
There are attitude, physical, financial and communication related barriers to
healthcare among disabled persons which include:
Attitudinal barriers
• People with disability commonly report experiences of prejudice, stigma and
discrimination by health service providers and other staff at health facilities.
• Many service providers have limited knowledge and understanding of the
rights of people with disability and their health needs and have inadequate
training and professional development about disability.
• Many health services do not have policies in place to accommodate the
needs of people with disability. Such policies could include allowing longer
and flexible appointment times, providing outreach services and reducing
costs for people with disability.
• Women with disability face particular barriers to sexual and reproductive
health services and information. Health workers often make the inaccurate
assumption that women with disability are asexual or are unfit to be mothers.
• People with disability are rarely asked for their opinion or involved in decisionmaking
about the provision of health services to people with disability.
Physical barriers
• Health services and activities are often located far away from where most
people live or in an area not serviced by accessible transport options.
• Stairs at the entrance to buildings or services and activities located on floors
which do not elevator access are inaccessible.
• Inaccessible toilets, passages, doorways and rooms that do not accommodate
wheelchair users, or are difficult to navigate for people with mobility
impairments, are common.
• Fixed-height furniture, including examination beds and chairs, can be difficult
for people with disability to use.
• Health facilities and other venues for activities are often poorly lit, do not have
clear signage, or are laid out in a confusing way that makes it hard for people
to find their way around.
Communication barriers
• A key barrier to health services for people who have a hearing impairment
is the limited availability of written material or sign language interpreters at
health services.
• Health information or prescriptions may not be provided in accessible formats,
including Braille or large print, which presents a barrier for people with vision
impairment.
• Health information may be presented in complicated ways or use a lot of
jargon. Making health information available in easy to follow formats including
plain language and pictures or other visual cues can make it easier for people
with cognitive impairments to follow.
Financial barriers
• Over half of all people with disability in low-income countries cannot afford
proper health care.
• Many people with disability also report being unable to afford the costs
associated with travelling to a health service and paying for medicine, let
alone the cost of paying to see a health service provider.
Disability inclusion in health care is critical to achieving universal health coverage
without financial hardship, because persons with disabilities are: Three times more
likely to be denied health care, four times more likely to be treated badly in the
health care system and 50% more likely to suffer catastrophic health expenditure.
d. Elders persons
People worldwide are living longer. Today most people can expect to live into their
sixties and beyond. Every country in the world is experiencing growth in both the
size and the proportion of older persons in the population. ageing is associated to
lot of conditions. Common conditions in older age include hearing loss, cataracts
and refractive errors, back and neck pain and osteoarthritis, chronic obstructive
pulmonary disease, diabetes, depression and dementia. As people age, they are
more likely to experience several conditions at the same time.
Older age is also characterized by the emergence of several complex health states
commonly called geriatric syndromes. They are often the consequence of multiple
underlying factors and include frailty, urinary incontinence, falls, delirium and
pressure ulcers.
A longer life brings with it opportunities, not only for older people and their families,
but also for societies as a whole. Additional years provide the chance to pursue
new activities such as further education, a new career or a long-neglected passion.
Older people also contribute in many ways to their families and communities.
Yet the extent of these opportunities and contributions depends heavily on one
factor: health. Maintaining healthy behaviours throughout life, particularly eating
a balanced diet, engaging in regular physical activity and refraining from tobacco
use, all contribute to reducing the risk of non-communicable diseases, improving
physical and mental capacity and delaying care dependency. All countries face
major challenges to ensure that their health and social systems are ready to make
the most of this demographic shift. Therefore, health care workers must also be
ready to contribute in preserving health of this special group.
f. Homosexual person
Homosexual persons are also part of special people within the society. in health
care, the relationship between users and health services is considered essential
to strengthen the quality of care. However, the Lesbian, Gay, Bisexual, and
Transgender population suffer from prejudice and discrimination in access and
use of these services. A sympathetic study reveal that the homosexual population
have difficulties of access to health services as a result of heteronormative attitudes
imposed by health professionals. The discriminatory attendance implies in human
rights violations in access to health services. though there is what done, a lot must
still be achieved to ensure access to health services for sexual minorities, through
the adoption of holistic and welcoming attitudes.
Self-assessment 10.3
1. Is being lesbian, gay, or bisexual a mental disorder?
2. Mention 3 most common medical conditions elders people tend toexperience.
10.4. Social distribution of diseasesLearning activity 10.4
Describe image A and B below in terms of social distribution of diseases
Epidemiology is the discipline that studies the distribution and cause of disease.
Social epidemiology is a branch of epidemiology that studies the distribution and
determinants of health and disease in populations. Social epidemiology focuses
particularly on the effects of socio-structural factors on states of health.
In the society people interact each other and this allow easy transmission of
diseases especially communicable diseases. The distribution of the disease may
either start in utero, get developed in families and then in general community. Due to
interconnectedness of societies and regular travel of people in the society disease
vector may propagate in the whole country or even worldwide causing disease as
for the recent case of Covid-19 pandemic.
Parents can transmit some diseases to their children during pregnancy, birth or
during breastfeeding. At home where family members share beddings, bathrooms
etc; there is high risk of sharing some communicable diseases especially when the
hygiene is poor. In the community children, pregnant women and elderly people
are more at risk of getting ill because of their low immunity. In Rwanda, Children
are mostly contaminated by communicable diseases like worms (eg. ascariasis),
amoebiasis, malaria, diarrhea, pneumonia among others and also children are
exposed to malnutrition conditions like anemia, kwashiorkor and marasmus.
Pregnant women are most likely to have anemia, malaria and other pregnant related
diseases. Elderly people are mostly exposed to non-communicable diseases like
hypertension, diabetes, stroke among others. Diseases are different from towns
comparing to rural areas.
Self-assessment 10.4
Select the best response
1. A disease vector is a
a. organism that transmits a disease
b. symptom of a disease
c. environmental condition associated with a disease
2. An epidemic that becomes unusually widespread and even global in its
reach is referred to as a
a. Pandemic
b. Hyperendemic
c. Covid-19
3. Social epidemiologists are interested in learning about
a. Social distribution of disease in population
b. the frequency and geographic distribution of diseases
c. the causal relationships between diseasesd. All the above
10.5. Implication of society in healthcareLearning activity 10.5
The central purpose of governments is the promotion of health and social
development for their people. However, we ought to take into account that the
health of every human being largely depends, besides their genetic endowment
and personal behaviors, on social determinants that are only very partially within
their control. Lifestyle plays a major role in the development of most illness globally.
Six of the 10 leading factors contributing to the global burden of disease are
lifestyle related: unsafe sex, high blood pressure, tobacco use, alcohol use, high
cholesterol and obesity. Lifestyle-related illnesses also contribute to the rising costs
of healthcare. Given the well-documented relationship between lifestyle, disease
burden and healthcare costs, it makes economic and medical sense to hold
individuals morally responsible for their health-related choices. Although individuals
should play an important role in maintaining their own health, they should not be
held entirely responsible for it. Assuming that responsibility for health rests either
with individuals or with society, it follows that society should also help to promote
health and prevent disease.
Undoubtedly, ensuring access to healthcare is an important social responsibility,
but societies can also participate in promotion of health, such as through sanitation,
pollution control, food and drug safety, sport activities, health education, diseasesurveillance, urban planning and occupational health as well as in health research.
Self-assessment 10.5
1. Mention at least 4 lifestyle related behaviors which contribute to global
burden of disease globally
2. Mention 2 health promotion activities that your society regularly beinvolved in.
10.6. Approach to Family Health NursingLearning activity 10.6
1. Describe image aside
2. Relate to the image aside
and define the term Familynursing.
Family health: A condition including the promotion and maintenance of physical,
mental, spiritual, and social health for the family unit and for individual family
members.
In health care, there are many different approaches throughout the field of nursing.
When considering the field of family nursing, there are four different approaches
to caring for patients. The approaches that will be discussed include family as a
context, family as a client, family as a system, and family as a component to society.
The approach that nurses use is determined by many factors including the health
care setting, family circumstances and nurse resources.
a. Family as a context of care
Family as a context is an approach that focuses on care of an individual client in
which the family is the context. Although the nurse focuses the nursing process
on the individual’s health status, the nurse also assesses the extent to which the
family provides the individual’s basic needs. These needs vary, depending on the
individual’s development level and situation. Because families provide more than
just material essentials, their ability to help the client meet psychological needs must
also be considered. Family members may need direct interventions themselves.
b. Family as a client
In this approach, the family nursing care centers on the assessment of all family
members. the family nurse is interested in the way all family members are individually
affected by the health event of one family member. The family is the foreground and
individuals are in the background. In this approach, the family is seen as the sum
of individual’s family members. The nurse focus is concentrated on each and every
individual as they affect the whole family. From this perspective, a nurse might
ask a family member who has just become ill. Example, “tell me about what has
been going on with your own health and how you perceive each family member
responding to your mother’s recent diagnosis of liver cancer”.
c. Family as a system
In this approach the family is viewed as an international system in which the whole
is more than the sum of its parts. This approach focuses on the individual and family
members become the target for nursing interventions. Eg: the direct interaction
between the parent and the child. The system approach to the family always implies
that when something happens to one affected. It is important to understand that
although theoretical and practical distinctions can be made between the family as
context and the family as client, they are not necessarily mutually exclusive, and
both are often used simultaneously, such as with the perspective of the family as
system.
d. Family as a component of society
In this approach, the family is seen as one of many institutions in society, along
with health, educational, religious, or economic institution. The family is a basic or
primary unit of society, as are all the other units and they are all a part of the larger
system of society. The family as a whole interacts with other institutions to receive
exchange or give communications and services. Community health nursing has
drawn many of its clients from this perspective as it focuses on the interface between
families and communities. Family health nursing practice like any nursing practice
begins with the nursing process. By using this process, the nurse practicing with
family perspectives is potentially able to effectively intervene at any of the levels.
After an assessment of the individuals, family unit, and supra system, the nurse isready to begin to identify areas of concern or need.
Self-assessment 10.6
Match approach to family nursing in column A with specific examples providedin column B
10.7 Theories related to family health nursing
Learning activity 10.7
Describe the figure aside by showing
how these areas are connected to thefamily as well as to the society.
a. Functional theory
Also called structural theory. Functional was written in 1898 by an English
Philosopher and biologist Herbert Spencer (1820-1903). This theory sees society
as a structure with interrelated parts designed to meet the biological and social
needs of the individuals in that society. Spencer saw similarities between society
and the human body; he argued that just as the various organs of the body work
together to keep the body functioning that how the various parts of society work
together to keep society functioning. The parts of society that Spencer referred
to were the social institutions, or patterns of beliefs and behaviors focused on
meeting social needs, such as government, education, family, healthcare, religion,
and the economy.
According to this theory, the society is held together by shared values, languages,
and symbols. He believed that to study society, a sociologist must look beyond
individuals to social facts such as laws, morals, values, religious beliefs, customs,
fashion, and rituals, which all serve to govern social life.
b. Family interaction theory
Family interaction theory (FIT) stems from symbolic interactions that are applied to
the family. This approach focuses on the way by which family members relate to
one another. The family is viewed as a set of interacting personalities. The family
dynamics and the relationships of the child to the family significantly affects the
emotional development. According to FIT, the parent-child relationship is perceived
to influence the important aspects of the child’s personality. The child’s attachment
to the family of origin and social institutions such their experiences in school are
believed to be central to the child and also parenteral satisfaction and low parentchild
conflict are also perceived to influence the well-being of the child. The parentchild
interactions can significantly impact the development of the child’s emotional
competence, which specifically includes self-esteem.
c. General system theory
General system theory was written by Von Bertalanffy in 1950’s. Von Bertalanffy
introduced General systems theory as a universal theory applicable to many fields
of study which provides a way of examining interrelationship and deriving principles.
The author started by defining a system as a set consisting of integrated, interesting
parts or components that function as a whole. Each part is necessary to make a
complete and meaningful whole.
General system theory describes how to break the whole apart and then learn how
the parts work together.
• Emphasizes the relationships between parts.
• Describes how parts function and behave.
Principles of General system theory and its application in Nursing
1. The principle of wholeness: It is the core of General system theory; this
principle provides the guidance or methodology to us in order that we can
study all kinds of objects effectively.
2. The principle of optimization: The principle of optimization of a system
is to achieve an optimal state in certain condition and to perform its best
function by organization and coordination. With the principle of optimization
3. The principle of modeling. Modeling is to design a model similar to a real
system first, then to describe and understand the characterization and level
of real system by studying the model.
d. Developmental theories
Child development theories focus on explaining how children change and grow over
the course of childhood. Such theories center on various aspects of development
including social, emotional, and cognitive growth. The study of human development
is a rich and varied subject. We all have personal experience with development, but
it is sometimes difficult to understand how and why people grow, learn, and act as
they do.
Some of the development theories are: Freud’s Psychosexual Developmental Theory,
Erikson’s Psychosocial Developmental Theory, Behavioral Child Development
Theories, Piaget’s Cognitive Developmental Theory, Bowlby’s Attachment Theory,
Bandura’s Social Learning Theory, Vygotsky’s Sociocultural Theory.
Example, Attachment theory written by John Bowlby who believed that early
relationships with caregivers play a major role in child development and continue to
influence social relationships throughout life. Bowlby’s attachment theory suggested
that children are born with an innate need to form attachments. Such attachments
aid in survival by ensuring that the child receives care and protection. Not only
that, but these attachments are characterized by clear behavioral and motivational
patterns.
In this theory, both children and caregivers engage in behaviors designed to ensure
proximity. Children strive to stay close and connected to their caregivers who in
turn provide a safe haven and a secure base for exploration. Children who receive
consistent support and care are more likely to develop a secure attachment style,
while those who receive less reliable care may develop an ambivalent, avoidant, ordisorganized style.
Self-assessment 10.7
Select the best response
1. Functional theory
a. Form a whole which is more than the sum of its parts
b. The family is viewed as a set of interacting personalities
c. The society is held together by shared values, languages, and symbols
d. All of them
e. None of them
2. The family dynamics and the relationships of the child to the family
significantly affects the emotional development. Which theory is this?
a. Attachment theory
b. Family interaction theory
c. General system theory
d. None of them
3. General system theory describes how to break the whole apart and then
learn how the parts work together. Which theory is this?
a. Functional theory
b. Family interaction theory
c. General system theory
d. All of them
4. Focus on explaining how children change and grow over the course of
childhood
a. Family interaction theory
b. Development theory
c. Attachment theory
d. None of them5. John Bowlby is the author of which theory?
10.8. Role of family in health promotion and diseases
preventionLearning activity 1.9
Describe image A and B in relation to the role of family in health promotion anddisease prevention.
The family is the central and important social institution for health development in
which individuals are born and receive resources for their growth and development.
It has the primary influence on the health and development of children. The family
influences healthy behaviors, and provides care and facilitates recovery from the
illnesses. The family is a source of nurture and emotional support as well.
Families provide the support and conditions needed for healthy living, prevention
of disease and opportunities for early diagnosis and treatment to avert or delay
complications. Social support for family’s needs to be responsive to the dynamics
of today’s family structure and the composition, condition, and challenges faced by
families. Family as the foundation for health development of individuals; changing
family structure, demography, roles, and responsibilities poses challenges in
nurturing healthy behaviors. Intersectoral interventions to empower families are
crucial to build adequate support systems for healthy family development; to strive
towards social inclusiveness increasing family access to public services; to enable
institutions to assess family at-risk before crisis; and, to design family centred
support systems. Active participation of families is crucial for family empowerment.
Empowering women to promote family health and well-being to gain control of their
own lives, income and fertility contributes directly to their family health and health
development.
In Rwanda, health promotion activities families get involved in regularly include:
ensuring the immunization of their children, designing kitchen garden to fight
against malnutrition, participating in umuganda, ensuring hygiene at home and in
the community, avoidance of water and air pollution etc.
To conclude; Important areas where families impact health includes healthy
behaviour, self-care, care during pregnancy and childbirth, child and adolescent
health, care of the aged, nursing and nurturing the sick, individuals with special needs(including those with stigmatizing health conditions) and disaster preparedness.
Self-assessment 10.8
What is the major role of the family in disease prevention?End unit assessment 10
Respond to all questions from both sections
SECTION A: Select the best response
1. A homeless woman is more likely than other women to have all of the
following characteristics except:
a) To have less than a high school education
b) To have grown up in foster care
c) To be employed
d) To have had an abortion by age 16
2. What is the definition for the nuclear family?
a) Individual living together
b) Two adults with their own biological children
c) Single person
d) All of the above
3. Maliko mom has just remarried and is expecting baby. Name the type of
his family
a) Blended family
b) Extended family
c) Lone family
d) Residential care family
4. Which is a developmental task for the family with teenagers?
a) Releasing young adults into the world
b) Adjusting to retirement
c) Helping children cope with independence
d) Promoting education
5. Which family function is providing a home (shelter), clothing and food to
the best of your ability?
a) Basic needs
b) Spiritual
c) Recreation
d) Adaption
6. There certain things in our society that have been happening before
civilization and still happening, such as prostitution, which people refer
to as sex worker?
a) someone that exchange sex for money
b) someone that engage sex for pleasure
c) someone hire for sexual activities
d) all of the above
7. Equity and inclusion for children with disabilities means equal…
a) Opportunities
b) Treatment
c) Rights
d) All of the Above
8. What does the disabled person require from the society?
a) Peer support
b) Housing
c) Transport
d) All the above
9. Most of the health problems in rural areas of Rwanda are due to:
a) Parasitic worms and microorganisms
b) Psychological tension resulting from work
c) Air pollution
d) HIV
10. In Rwanda children are most likely to suffer from
a) Hypertension
b) Diabetes
c) Kwashiorkor
d) HIV
SECTION B: Open ended questions
11. Differentiate system approach to family nursing and family as a component
of society approach to family nursing are.
12. Mention at least 3 reasons why sex workers are more likely to get HIV+and other STI than the general population.