Hazard Analysis and Critical Control Points

HACCP stands for Hazard Analysis and Critical Control Points. HACCP is a system for analyzing, understanding and controlling a food manufacturing process to ensure safety. There are two core elements: "prerequisite programs" (such as GMP's - Good Manufacturing Practices) and the HACCP plan/process itself. HACCP is designed to be applied to every aspect of the food industry from "farm to table", including growth, harvest, processing, distribution, and sales.

Overall the HACCP system strives to clearly discover potential problems in food safety and also identify what must be controlled to prevent hazards/risk. This requires the use of SOPs (Standard Operating Procedures / written instructions), the generation of accurate, accountable records for all process steps and measurements as well as the employment of appropriately trained staff.

Why Employ a HACCP Program?

There are many solid reasons to employ a HACCP program to prevent hazards which may arise during food processing. A few examples include:

• Ensure consistency of process, product quality, and safety
• Legal/regulatory requirements (depending on jurisdiction)
• Focus efforts and resources on "critical" priority areas in a process
• "prevent" problems rather than "react"
• Competitiveness - international recognition
• Improved fiscal returns/finances
• Alignment with other recognized quality systems (GMP, ISO, etc.)
• Reduce potential legal liability
• Enhanced consumer confidence
• Better sales and marketing of approved products

Finally, HACCP itself is a living process. Organizations typically start with too many critical control points in their initial HACCP documentation and pare these down to truly "critical" control points over the course of internal and external audits and review.

International Public Health: Health for All Movement

In 1977, the World Health Assembly adopted the historic resolution on 'Health for All by the Year 2000'. Several debates on the links between health and social, environmental, economical, political factors yielded this fruitful result.

'Health for All by the Year 2000' meant that, by the year 2000, people would use better approaches than they had before for preventing and controlling diseases and alleviating unavoidable illness and disability. People will attain level of health that will permit them to lead a socially and economically productive life through organized application of local, state, national, and international resources of health.

While almost all the countries aimed at the universal goal for Health for All movement, they also realized that the gap was widening between the health 'haves' in the affluent countries and the 'have-nots' in the developing countries. Thus, the obstacles in closing such wide gaps in the health status and resources were clearly recognized by the world community at the international conference jointly organized by WHO and UNICEF, at Alma-Ata in the then USSR, on September, 1978. This conference was another landmark in public health development and signaled a new era of public health.

Developing countries saw the Alma-Ata primary health care conference as an opportunity for restructuring their health systems to reach the goal of Health for All by 2000. A series of innovative approaches aimed at interesting Primary health Care were organized. there was considerable recognition of comprehensive health system in most of the developing countries.

But debates began either or not to favor for comprehensive primary health care approach. Later resources constraints and external pressure forced the government to be more selective in health development.

Democracy in developing countries aroused devolution of authority to local bodies. However, it was proving economically impossible to bear the cost of extension and expansion of public sector health services to the entire population.

But then, large-scale use of health volunteers, after receiving a minimal training program, proved successful in many countries.

Another notable program was the expanded program on immunization (EPI). In 1980, following a historic global campaign of surveillance and vaccination, the World Health Assembly declared smallpox eradication - the only infectious disease to achieve this distinction. With this inspiration, the WHO/UNICEF promoted the EPI program for six main vaccine-preventable diseases: polio, measles, diphtheria, pertussis, tetanus, tuberculosis. As a result, the lives of approximately two million children were saved. The outstanding coverage was possible because of improvements in the production, transport, and storage of vaccines, and also by extended social mobilization efforts.

Age of Socialized Public Health

The 1970s and 1980s were regarded as economically and politically unstable decades worldwide. The dominance of biomedical science approach, without adequate focus on the community, led to the failure of many mass disease control campaigns. By 1970, developing countries and the international community at large had become increasingly aware that, despite 20 years of large foreign investments and top-down development efforts, the socioeconomic status of the people including their health status had not risen to the desired level.

Many countries especially those that had achieved independence in the late 1960s and 1970s, were still struggling for socioeconomic growth. While the New World economic order was being formulated, a new philosophy of public health development with principles of social justice and equity slowly evolved.

The initial ideas of social medicine or the social dimension of public health had emerged around the early twentieth century.

New knowledge about NCDs (Non-communicable diseases), such as cancer, diabetes, and tobacco-related diseases, became available in the late 1950s and 1960s.

The social and behavioral aspects of diseases were also recognized and many social interventions were proposed as part of health promotion.

Education systems, institutions considered public health to be the same as preventive and social medicine. Socialized health care had become the most reasonable, workable and acceptable approach. Virchow had stated during mid-1880s that medicine was a social science and politics was medicine on a large scale.

People became more aware of the social and economic determinants impacting health. empirical evidence was collected from both the developed and developing countries.

There were debates on the links between health and social, environmental, economic and political factors. There were many comments on the need to give a social and political dimension to international public health.

Next, Go to International Public Health: Health for All Movement

Colonial Public Health

Trading around the world during the 18th and 19th centuries for the explanation and exploitation of natural resources led to the discovery of new territories. Europeans and Americans were engaged in an intense rivalry with each other for colonial possessions. In order to expand their control, these colonial powers made massive shifts of people from one continent to another, using both military and economic forces. 

The colonials established their own administrative, legal, and medical care systems with varying degree of anatomy and authority. To protect the health of their own people and the workers, the colonial rulers established laws similar to those in their home countries. For e.g. Public Health Act, Local Government Act, Vaccination Act, Civil Registration Act, etc. which some are still in place even today in many developing countries in Asia, Africa where British, Spanish, French, Americans or Dutch colonies existed. European countries adopted Bismark's model of national social health insurance scheme which later spread to other countries, especially in Asia and Americas.

Some colonial powers introduced their identity through religious group and education systems. The late eighteenth century saw an increasing momentum in public health education with the establishment of undergraduate and postgraduate courses designed specifically for public health, first in the home countries and later in the colonies.

Later the education system includes research in tropical diseases as well Through the support of the Rockfeller foundation, the London School of Tropical Medicine was transformed into the London School of Hygiene and Tropical Medicine in 1920, expanding the scope of research and teaching on tropical medicine, medical statistics, and epidemiology.

However, the actual development of Public Health and medical care services for the general public remained rudimentary in these former colonial countries and territories. Moving millions of people to unfamiliar areas had led to a high incidence of death and disability from diseases like malaria, typhus, small pox, typhoid, yellow fever, leprosy, yaws, syphilis, etc.

Later, colonials launched a major international public health initiative in the prevention and control of small pox, through vaccination, first among the people working in the colonial administration and later among the workers employed.

Another notable experience was the massive community health development projects for the prevention and control of communicable diseases, mainly initiated through the support of the Rockfeller Foundation in few Asian and Latin American countries. The attempt was aimed at developing pilot disease control projects that could be applied or replicated in other parts of the world.

Next, Go to Age of Socialized Public Health

Public Health Concept in Developing Countries

The history of Public health development in the developing countries can be traced in four major topics:

1. Empirical Public Health
2. Colonial Public Health 
3. Age of Socialized Public Health
4. International Public Health: Health for All Movement

Each topic has been explained as different sub-topics:

1. Empirical Public Health:

Since ancient times, human life has been threatened with diseases of all kinds. Diseases like syphilis, measles, smallpox, cholera, leprosy, tuberculosis, etc. were rampant in all parts of the world for many centuries. Traditional medicine was significantly followed for management of illness at an individual level rather than public level.

Sanitation measures were enforced through royal decrees. The treatise on economics and government by Kautaliya (around 300 B.C.), during the early Maurya dynasty in India, showed how a king ensured the health and prosperity of his subjects through various measures and regulations.

Quarantine and prohibition were major measures used historically to protect people from the transmission of the diseases. Miasma theory, disease due to decayed organic matter was also popular in these days.

However, most of the historians have related the development of modern public health to the advert of basic medical sciences. The discovery of microscope, animal cells and bacteria, chemicals and other substances, other scientific knowledge and skills including those related to statistical and epidemiological methods in the developed world had provided the basis for a scientific explanation of the causes of diseases and illnesses as well as their mode of transmission. All these discoveries had some influences in developing world as well. Industrial revolution encouraged social interest in the prevention and control of diseases.

Owing to the scarcity of records, the health situation in the developing countries in the early centuries is little known. However, interest in social, environmental, and political aspects of diseases and their prevention grew tremendously.


Next, Go to Colonial Public Health

Critical Review of differences on Public Health Concept

The term 'Public Health' came into general use around 1840. It arose from the need to protect the people from the spread of communicable diseases. later various national and local movements by great pioneers and advocates of public health like Sir Edwin Chadwick, led to the formation of law, Public Health Act in England in 1848. The act was formed in order to crystallize the efforts organized by society to protect, promote and restore people's health.

In 1920, CEA Winslow defined Public Health as "the science and art of preventing diseases, prolonging life, and promoting health through organized community efforts."

Later WHO Expert Committee on Public Health Administration, adopted Winslow's earlier definition and defined Public Health as: 

          "the science and art of preventing diseases, prolonging life and promotion health and efficiency through organized community efforts for the sanitation of environment, control of communicable infections, education of the individuals in principles of personal hygiene, organization of medical and nursing services for early diagnosis and preventive treatment of disease, and the development of the social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health, so organizing benefits as to enable every citizens to realize his birthright of health and longevity."

Likewise, a EURO symposium in 1966 suggested that the definition of public health should be expanded to include the organization of medical care services.

With adoption of the goal of 'Health for All', a new public health was evident worldwide, which may be defined as:

           "the organized application of local, state, national and international resources to achieve 'Health for All', i.e. attainment by all the people of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life."

Institute of Medicine (IOM), 1988 in classic report "the future of Public Health" has defined Public Health as 

           "an organized community efforts to address the public interest in health by applying scientific and technical knowledge to prevent disease and promote health."

Thus, Public health is both a body of knowledge and also a means to apply that knowledge. Public health, in its present form, is a combination of scientific disciplines (e.g. epidemiology, biostatistics, demography, etc.) and skills and strategies (e.g. epidemiological investigations, planning and management, interventions, surveillance, evaluation) that are directed to the maintenance and improvement of the health of the people.

Importance of Public Health Research

Public Health Research has a significant role to health benefits of society. It can give imperative data about disease patterns, trends and risk factors, results of treatment or public health interventions, patterns of care, and medicinal services, expenses and use. The distinctive approaches to public health research give comprehensive insights.

The importance of Public Health Research can be highlighted as follows:

• Foster innovations to applicability for health benefits
• Guide improvements in health system and develop new initiatives
• Explore etiology of diseases, risk factors (physical, social, environmental and beyond)
• Translate scientific knowledge into public health benefits
• Contribute to evidence based translation of health knowledge into policy and practice
• Forecast disease phenomena
• Better understanding of changing and emerging health determinants
• Set priorities of health problems critically concerning people's health
• Identify best possible interventions for disease prevention and control

Introduction of Qualitative Research

Qualitative Research is a phenomenon which cannot have numbers assigned. It is a strategy for systematic collection, organization and interpretation of textual information. Qualitative research uses inductive approaches to generate novel insights into phenomena that are difficult to measure quantitatively. For e.g. Barriers and facilitators of institutional delivery practice. 

Qualitative methods can generate a comprehensive description of processes, mechanisms or settings.

• Processes: e.g. Processes of implementing clinical care
• Mechanisms: e.g. How one intervention may achieve a particular outcome?
• Settings: e.g. What it is like to care for patients in a particular environment?

These methods can also characterize participant perspectives and experiences in great depth. e.g. Individual health behaviors, individual experiences in particular clinical settings. These methods can provide unique contributions to health services and clinical research.

Qualitative researchers study things in their natural settings, attempting to make sense of or interpret phenomenon in terms of the meanings people bring to them.

Qualitative Data Analysis

Qualitative data is an iterative process of individual and group level review and interpretation.

There are mainly three steps of qualitative data processing and analysis:

1. Data Collection
2. Process Data
3. Analyse Data

Figure: Qualitative Data Processing and Analysis

1) Data Collection:

We collect the data through observation, interview or even we may have things that we observe known as archive. All that is obtained are known as raw data.

2) Process Data:

The raw data are in the format of audio-recording or visual recording (photos, videos, etc.), jotted notes or note taking and memory and emotions. The jotted notes and, memory and emotions are considered as field notes. All these data formats are known as recorded data.

Besides recorded data, there may be also artifacts, documents, other’s observation or previous researches.

3) Analyse Data:

The recorded data are analysed in following steps:

      

        a. Sort and Classify:

First the recorded data are sorted and classified, categorized and segmented according to research objectives.

        b. Open Coding:

After sorting, we do the open coding. It is the process whereby we start to listen, observe, read all of our data obtained and try to make out sense of it.

        c. Axial Coding:

Then we perform axial coding in which we scrutinize or re-examine what we have done in open coding.  We start to identify any data that can relate each other. We start to group the data according to the variables.

        d. Selective Coding:

It is the final part of coding. We re-examine what we did in axial coding. We illustrate the variables, the concept that we try to explain in order to see the relationship (in-depth understanding). We compare the variables.

        e. Interpret and elaborate:

Finally, we interpret and elaborate the findings of the study.

To some extent, we go back to find more data to find further explanation of what we got in open, axial and selective coding. So, there is back and forth approach during the qualitative analysis. At a saturation point, when no more ideas and concepts are obtained we stop collecting data.

International Union for Health Promotion and Education (IUHPE)

IUHPE is an independent and proficient association for individuals and organizations committed to improving the health and well-being of the people through education, community action, and the development of healthy public policy.

The mission, goals and objectives of IUHPE are as follows:

Mission: To promote global health and to achieve equity in health between and within countries

Goals:

• Greater equity in health of populations between and within countries of the world
• Effective alliances and partnership for health
• Accessible evidence-based knowledge and practical experience in health promotion
• Excellence in policy and practice for effective, quality health promotion
• High levels of capacity in individuals, organizations and countries to undertake health promotion activities

Objectives:

• Increase investments in health promotion
• Increase in organizational, governmental and intergovernmental policies and practices favoring health and equity
• Improvements in policy and practice of governments at all levels influencing determinants of health
• Strong alliances and partnerships among all sectors based on agreed ethical principles
• Activities that contribute to the development, translation and exchange of knowledge and practice that advance the field of health promotion 

The priority areas of IUHPE are as follows:

• Social determinants of health
• Health promotion in sustainable development
• Non-communicable diseases prevention and control
• Health promotion system

Reference:
http://www.iuhpe.org/index.php/en/

Global Conferences on Health Promotion

1. Ottawa Charter for Health Promotion, 1986

In 1986, the Ottawa Charter for Health Promotion was introduced. This was the first global conference on Health promotion which was held in Ottawa, Canada, in November 1986. It defined health promotion as “the process of enabling people to increase control over, and to improve their health.’

The Ottawa Charter conceptualized health as-

• A fundamental right
• Equal access of opportunities
• Individual and collective responsibility
• An essential element of social and economic development.

The Charter identified five health promotion action areas:

a. Build healthy public policy: It is about putting health on the agenda of policy makers at all levels and includes legislation, economic measures, taxation and organisational change.

b. Create supportive environments: refers to living and working conditions that are safe, stimulating, satisfying, enjoyable and provide a positive benefit to health.

c. Strengthen community action: deals with empowering communities to exert ownership, control and action over their own activities and destinies.

d. Develop personal skills: covers providing information, education for health and enhancing life skills.

e. Reorient health services: acknowledges that health services need to focus more on prevention than simply treatment and cure. The responsibility for health is shared amongst individuals, the community, government, institutions and other organisations.

The strategies were:

• Advocate: Advocacy for health
• Enable: enable all people to achieve their fullest health potential.
• Mediate: mediate between differing interests in society for the pursuit of health

2. Adelaide Recommendations on Healthy Public Policy, 1988

It was held in Adelaide, South Australia on April 1988. It gave more priority to healthy public policy seeing the action areas of Ottawa Charter are interdependent. The main aim of health public policy is to create a supportive environment to enable people to lead healthy lives.

The Conference identified four key areas as priorities for health public policy for immediate action:

• Supporting the health of women: Women empowerment and develop women's healthy public policy
• Creating supportive environments for health
• Tobacco and alcohol: policy to reduce tobacco growing and alcohol production 
• Food and nutrition: elimination of hunger and malnutrition

3. Sundsvall Statement on Supportive Environments for Health, 1991

It was held in Sundsvall, Sweden on June 1991. It majorly focus on making the environment - the physical environment, the social and economic environment, and the political environment - supportive to health.

The Conference highlighted four aspects of supportive environments:

• The economic dimension, which requires re-channeling the resources for the achievement of Health for All and sustainable development.
• The social dimension, which includes the ways in which norms, customs and social processes affect health.
• The political dimension, which requires governments to assure democratic participation in decision-making and the decentralization of responsibilities and resources.
• The need to recognize and use women's skills and knowledge in all sectors.

The proposed strategies to promote the creation of supportive environments at community level were:

•  Building alliances for health and supportive environments
•  Strengthening advocacy through community action
•  Enabling communities and individuals to take control over their health
•  Mediating between conflicting interests in society

4. Jakarta Declaration on Leading Health Promotion into the 21st Century

The Fourth International Conference on Health Promotion is the first to be held in a developing country, and the first to involve the private sector in supporting health promotion. It was held in Jakarta, Indonesia on July 1997. Its main slogan was “Health promotion is a key investment”. The Jakarta Declaration on Health Promotion offered a vision and focus for health promotion to next century. It reviewed the determinants of health and explored the widest possible range of resources to tackle health determinants in the 21st century.

The declaration set priorities for health promotion in the 21st Century, they were:

•  Promote social responsibility for health
•  Secure an infrastructure for health promotion
•  Consolidate and expand partnerships for health
•  Increase community capacity and empower the individual
•  Increase investments for health development

In the declaration, global health promotion alliance formation was endorsed. The goal of this alliance was to advance the priorities for action in health promotion set out in this Declaration.

• Priorities for the alliance include:
• Raising awareness of the changing determinants of health
• Promoting solidarity in action
• Supporting the development of collaboration and networks for health development
• Fostering transparency and public accountability in health promotion
• Mobilizing resources for health promotion
• Enabling shared learning 
• Accumulating knowledge on best practice

5. Global Conference on Health Promotion: Bridging the Gap, Mexico City, 2000

The fifth Global conference on Health promotion was held in Mexico on June, 2000. This conference mainly focused on bridging the gap in equity after the failure of Health for all by 2000. The actions set in this conference are as follows:

• Health promotion should be a fundamental priority in local, regional, national and international policies and programmes.
• Support the preparation of country’s plans of action for promoting health
• Establish or strengthen national and international networks
• Active participation of all sectors and civil society, in the implementation of health promoting actions
• Advocate that UN agencies be accountable for the health

6. The Bangkok Charter for Health Promotion in a Globalized World, 2005

This was the sixth global conference on health promotion which was held in Bangkok, Thailand on August, 2005. It identified major challenges, actions and commitments needed to address the determinants of health in a globalized world by reaching out to people, groups and organizations. It identified various changing context since the development of the Ottawa Charter like increasing inequalities within and between countries, commercialization, global environmental change, etc.

The conference set various actions for health promotion in a globalized world:

• Advocate for health based on human rights and solidarity
• Regulate and legislate to enable equal opportunity for health and well-being for all people
• Build capacity for policy development
• Invest in sustainable policies, actions and infrastructure to address the determinants of health
• Partner and build alliances with public, private, nongovernmental and international organizations.

7. Seventh Global Conference on Health Promotion, Nairobi, 2009

The seventh global conference on Health Promotion was held in Nairobi, Kenya on October, 2009. This conference identifies key strategies and commitments that is immediately required for closing the implementation gap in health and development through health promotion.

There are three major gaps identified in this conference:

• the gap in health programmes 
• the gap in policy-making and intersectoral partnerships 
• the gap in health systems

To address these gaps, the following strategies and actions were identified as:

• Building capacity for health promotion, 
• Strengthening health systems, 
• Partnerships and intersectoral action, 
• Community empowerment, and
• Health literacy and health behaviours. 

8. Eighth Global Conference on Health Promotion, Helsinki, 2013

The eighth global conference on Health Promotion was held in Helsinki, Finland on June, 2013. This conference was co-hosted by WHO and the Ministry of Social Affairs and Health, Finland. The main theme of the conference was “Health in All Policies” (HiAP) and its focus was on implementation, the “how-to”. It was structured around six themes.

Health in All Policies is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity. It improves accountability of policymakers for health impacts at all levels of policy-making. It includes an emphasis on the consequences of public policies on health systems, determinants of health and well-being. It can provide a framework for regulation and practical tools that combine health, social and equity goals with economic development, and manage conflicts of interest transparently.

The actions set in this conference are as follows:

• Commit to health and health equity as a political priority 
• Establish conflict of interest measures
• Ensure effective structures, processes and resources 
• Build institutional capacity and skills 
• Adopt transparent audit and accountability mechanisms 
• Strengthen the capacity of Ministries of Health to engage other sectors of government
• Include communities, social movements and civil society in development, implementation and monitoring

9. Ninth Global Conference on Health Promotion, Shanghai 2016

The ninth Global Conference on Health Promotion was held in Shanghai, China, 2016. The Conference is entitled “Promoting health in the Sustainable Development Goals: Health for all and all for health”. The main goal of this conference was to highlight the critical links between promoting health and the 2030 Agenda for Sustainable Development.

The main themes of the conference were:

• Healthy cities: ensure that people are living in healthy and liveable cities
• Health literacy: ability of individuals to gain access to, understand and use information in ways which promote and maintain good health
• Good governance in favor of health
• Healthy China: It is a Chinese Government’s agenda for health and development that has the potential of huge benefits for the rest of the world. For e.g. strengthening China’s health science and technology innovation

Reference:

www.who.int/healthpromotion/conferences/en/

History of Health Promotion

Health promotion was rooted in much earlier shifts within public health that stretch back to the nineteenth century and beyond. The history can briefly be highlighted in the following chronological order:

• 19th century: A notion to improve environment and sanitation, believing poor environment, bad smell was the cause of disease (miasma theory).
• Towards the end of 19th century: Environmental understandings of public health were pushed in more specific direction (e.g. works of Louis Pasteur)
• 1900 – 1970: Social hygiene was concerned with the social influence on individual and public health, and aimed to encourage a focus on preventive medicine.
• 1930s – 1940s: Development of social medicine which helped to change the focus of public health in other ways too, particularly by bringing social sciences into health studies.
• By mid – 20th century: Role of preventing diseases and promoting good health was given much importance in many Western countries. National Health Service (NHS) was established in 1948.
• 1974: A New perspective on Health of Canadians (the Lalonde Report) acknowledged the importance of improving living standards and public health measures.
• Following the Lalonde Report, health promotion began to emerge as a recognizable part within public health. There were series of initiatives introduced by WHO in late 1970s and 1980s that stressed the importance of promoting good health as well as combating disease.
• 1977: WHO implemented “Health for All by The Year 2000”
• 1978: Declaration of Alma Ata advocated a multidimensional approach to health and socioeconomic development and urged active community participation in health care and health education at every level, with a particular focus on primary health care.
• 1986 – 2016: Global Conferences on Health Promotion

1. 1986: Ottawa Charter for Health Promotion: First International Conference on health promotion which was held in Ottawa, Canada. This Charter defined health promotion as “the process of enabling people to increase control over, and to improve their health”.
2. 1988: Adelaide Recommendation on Healthy Public Policy
3. 1991: Sundsvall Statement on Supportive Environments for Health
4. 1997: Jakarta Declaration on Leading Health Promotion into the 21st Century: The Fourth International Conference on Health Promotion is the first to be held in a developing country, and the first to involve the private sector in supporting health promotion.
5. 2000: Global Conference on Health Promotion: Bridging the Gap, Mexico City
6. 2005: The Bangkok Charter for Health Promotion in a Globalized World
7. 7)2009: Seventh Global Conference on Health Promotion, Nairobi: Closing the implementation gap in health and development through health promotion.
8. 2013: Eighth Global Conference on Health Promotion, Helsinki: The main theme of the conference was “Health in All Policies” (HiAP)
9. 2016: Ninth Global Conference on Health Promotion, Shanghai: The main goal of this conference was to highlight the critical links between promoting health and the 2030 Agenda for Sustainable Development.

Foundations of Health Education

There are mainly three foundations of health education, they are:

• Health Sciences
• Psycho-social Behavioral Science
• Educational Science

1. Health Sciences:

 Health Sciences are the applied sciences which address the use of science, technology, engineering or mathematics in the delivery of healthcare. Health education is drawn from various disciplines which come under health sciences like environmental science, physical science, biological science, etc. which makes health sciences as one of the foundations of health education.

2. Psycho-social Behavioral Science:

Psycho-social Behavioral Science deals with the study of human behavior at the level of own self, other individuals, family, and community members. It includes the traits of Social Psychology which influences the behavior of individuals. It also includes the theories and models such as Health Belief Model, Theory of Reasoned Action/Theory of Planned Behavior, etc. which explains the readiness of individuals to change the behavior or adopt change. 

3. Educational Science:

Educational Science is closely related to pedagogy, which is the process of teaching. More specifically, it is considered to be the study of improving the teaching-learning process. Its field can include the research of different teaching methods and how a group of students receive these methods as well as the process of improving the teaching methodologies.

National Population Policy – 2071

Nepal has its first National Population Policy embraced by the Cabinet. The approach was highlighted when world pioneers had quite recently consented to handle rising populace and development needs taking after the fruitful consummation of 20 years of Program of Action of the International Conference on Population and Development (ICPD), Cairo, 1994.

The policy contains nine focus areas and 78 strategies. It came when the nation is seeing numerous critical statistic changes in the course of the most recent two decades thus of declining fertility and death rates, increasing life expectencies, and expanding migration and urbanization. Revealed on March 30, the population policy, in addition to other things, aims for enhancing people's lives by addressing population issues, development of population, guaranteeing people's reproductive well-being and reproductive rights as crucial human rights and promoting equity and incorporation in all sustainable development strategies.

The arrangement mulls over population and its linkages with other developmental areas as verbalized in the post ICPD framework and strengthens Nepal's dedication that population related issues ought not be isolated from other development agendas. A rights-based approach highly emphasized that will eventually add to balancing the population and accomplish significant demographic targets in 20 years (2015-2034) in accordance with the proposed Sustainable Development Goals (SDGs) due to be supported by the UN member states in September 2015.

The National Population Policy of Nepal, 2071 can be summarized in the following points:

1. Establish coordination and cooperation between stakeholders by considering population management as an important part of overall development in order to maintain interdependence between population and development.

2. Develop reproductive health services including sexual health, family planning and safe abortion as a rightful program.

• Increase the accessibility, among all the citizens, of safe sexual and reproductive health by developing it as a basic rights
• Provide information on family planning devices and its utilization, and provision of contraceptives and its utilization
• Fulfill the unmet demand of family planning, increase its distribution and quality of services, and dissemination of relevant information to local level on a regular basis via appropriate media
• Ensure safe abortion and post abortion services. Services will be provided free of cost for women of poor and disadvantages group.
• ANC checkup for the improvement in health of mother and child; expansion of quality health services to address the problem related to delivery and postnatal.
• Special programs for the protection of disadvantages group such as Raute, Kusunda, Chepang, Rajbanshi, Chamr, Musahar, Baadi, Raaji, etc.
• Encourage the marriage only after the age of 20 and birthing procedure only after being capable in terms of psychological, social and economical.
• Conduction of program related to IEC and BCC aiming to increase age at marriage and appropriate birth spacing.
• Addressing the problem of fertility and sub-fertility as per the demand of people.
• Ensure the accessibility of reproductive health and sex education in a comfortable environment for men, women and third gender, and adolescents and youths.
• Advocacy and discussion program to prevent adolescents from drug abuse and sexual abuse
• Expansion of maternal health centered health services to reduce maternal mortality.

3. Build up appropriate lifestyle and environment for healthy livelihood.

4. Effective management of immigration and emigration, and urbanization.

5. Improvement in policy, laws and institutional arrangement to mainstream population and development via inclusion of disadvantageous group (gender, sexual, language, economy, social and region) along with physically, mentally and intellectually disable people

6. Strengthening the institutional structure for policy formulation with program design, implementation, monitoring and evaluation in the sector of population.

7. Feedback to concerned agencies for policy formulation and program designing by utilizing information technology in research and analysis of interrelationship between population and development.

8. Formulation of developmental projects and programs only after studying their demographic effects, and implementation of those on the basis of their justification on suitability.

9. Utilization of demographic dividend especially the young people in employment related activities.