TITLE: ASSESSMENT OF HEALTH AND HEALTH RELATED PROBLEMS IN

KALISHA KEBELE , LEMO WOREDA HADYA ZONE,SNNPR,ETHIOPIA.

COMMUNITY BASED TRAINING PROGRAM PROPOSAL SUBMITTED TO

WACHEMO UNIVERSITY COLLEGE OF MEDICAL AND HEALTH SCIENCE
DEPARTMENT OF SURGICAL NURSING

ADVISORS: Mr. TILAHUN AND Mr. JABIR

SUBMISSION DATE : MAR/21/ 2023GC. HOSSANA ETHIOPIA

No. STUDENT NAME ID NUMBER

1 AMANUEL TADDESE 1201500

2 ASMAMAW DAGNAW 1201623

3 BETHEL KALEB 1201563

4 BETELHEM BELAY 1200787

5 BETELHEM NIGUS 1201368

6 BETELHEM TEKA 1201108

7 BETIGIST ASMAMAW 1200468

8 CHALTU AMAN 1200727

9 DAWIT ABIYE 1201373

10 DERARA TAYE 1200346

11 FEVEN MELO 1201576

12 FIROMSA MOSISA 1201382

13 GUTEMA MERGA 1200806

14 HAYAT ADEM 1201260

15 HABTAMU TEKA 1201128

16 MASAME PETROS 130251

17 MULKEN ESUBALEW 12D0571

18 MELKAM GETACHEW 1200884

19 SAMUEL ASFAW 12D0443

20 SOLOMON DESALEW 005626

21 SUFIYAN FEYISO 12D0565

22 TSEGAYE BIRU 12D0724

23 TSIGEREDA GUTA 12D0735

24 ZE-ELIAS ABEBAW
Acknowledgment
First of all, we want to thank the Almighty God for giving us the strength in all the
ways we went through in developing this proposal.Next we would like to express
our deepest appreciation to Wachemo University College of medicine and health
sciences and department of surgical nursing for giving us this opportunity to do on
this proposal to community based training program. Also,we would like to thank
the sectors and offices of Kalisha Kebele for providing us with the needed
information and data and wish to express our deepest gratitude to our advisors
TILAHUN AND JABIR for their constructive comment and guidance during the
development of this proposal.

i
Acronym

ANC Antenatal Care

CBE Community Based Education

CBTP Community Based Training Program

CDI Community Direct Intervention

PHC Primary health care

EDHS Ethiopian Demographic Health Survey

EPI Expanded Program of Immunization

FP Family Planning

G.C Gregorian Calendar

HIV/AIDS Human immunodeficiency virus/Acquired immune deficiency

syndrome

HEW Health Extension Workers

TB Tuberculosis

SNNPR Southern Nation Nationality and Peoples Region

TT Tetanus Toxoid

WCU Wachemo University

WHO World Health Organization

PNC Post natal care

UNICEF United Nation international children emergency fund

ii
SRP Student research program

HEP Health extension program

IUD Intra uterine device

EC Ethiopian calender

Km Kilometer

MOH Minister of health

TV Television

CSA Central statical Agency

DTP Diphteria Tatanus pertussis

ICF International Classification of function

DALY Disability Adjusted Life year

iii
Abstract

Introduction
Health, according to WHO is “a state of complete physical, mental, economical, spiritual and
social well-being and not merely the absence of disease or infirmity”. Health is not just a key to
measure the quality of life but also a must for one’s existence.

CBTP is one of the means of teaching and learning which permits different classes of students of
the health profession to study together. It helps the students to understand the real community
life and needs practice how to identify the real community problems, and help the community to
solve those problems.

Objective
The main objective of the CBTP is to assess health and health related problems of the
community and give appropriate interventions in kalisha Kebale, Lemo Woreda Hadiyya Zone,
SNNPR, Ethiopia in 2023 G.C

Method
A Community based cross-sectional survey undertakes Systematic sampling method. Cross
section study carried out on performance of CBTP at school of health collage from perspective
of members of the community, community leaders and health professional in CBTP.

The study will be done from 08/07/2015 - 29/07/015 EC and the total cost will be 2842 birr to
complete the task.

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Contents
Acknowledgment ……………………………………………………….………….…i

Acronym ……………………………………………………………………….…… ii

Abstract …………………………………………………………………………….…….iv

CHAPTER ONE………………………………………….………………………………..1

1. Introduction………………………………………..…………………………………. 1

1.1. Background…………………………………………………………..………… 1

1.2. Statement of the problem………………….…………………………………… 2

1.3. Significance of the CBTP……………….……………………………………….3

CHAPTER TWO……………………………………………………………………………4

2. Literature review…………………………………..………………………...………..4

CHAPTER THREE……………………..…………………………………….…………….7

3. Study objectives………………………………………………..…………………….. 7

3.1. General objective…………………………….…………………………….……7

3.2. Specific objective………………………………………………………………... 7

CHAPTER FOUR……………..…………………………………………………………… 8

4. Methodology and materials……………….....…………...…………………………... 8

4.1. Study area …………..……………………………...…………………….……...

8

4.2. Study design and period………………..…………..…………………………… 9

4.2.1. Study period………………………………………………………..…….. 9

4.2.2. Study design…………………………………………………………….. …9

 4.3. Population………………………………...……………………..……………… 9

4.3.1. Source of population..…..……….….…………………………………... …9

4.3.2. Study population………………….……………………….…….……….. 10

4.3.3. Study unit…………………………….……………..…………..………… 10

4.4. Sample size determination and sampling technique…………………..…………10

4.4.1.sampling size determination…………………….………….…………… 10

3.4.2.sampling technique………………………………..……………………… 11

4.5. Variables of the study…………………………………….…………………….... 12

4.6. Selection criteria for respondents…………..…………..………………………… 12

4.6.1. Inclusion criteria…………………………………………………..…….. 12

4.6.2. Exclusion criteria…………………………………………………………..13

4.7.Data collection tools and procedures ………….………..………...……………… 13

4.7.1. Data collection tools…………………………………….……………….13

4.7.2. Data collection procedure………………………………………………….14

4.8. Data collection technique…………….………………..……….………………….16

4.9. Data quality assurance.……………………………..……………………………...16

4.10. Data processing, analysis and presentation………..…..…………………………16

4.11. Ethical consideration…………………………………………………………… 16

4.12. Dissemination of results………………………………………………...………..17

4.13. Work plan………………………………………………………………………...17

4.14 Budget…………………………………………………………………………….18

Reference………………….…………………………………………………..…………..19

Annex…………………………………………………………………………………….. .20
CHAPTER ONE
1. INTRODUCTION

1.1BACKGROUND

Health, according to the WHO is “a state of complete physical, mental, economical, spiritual and
social well-being and not merely the absence of disease or infirmity”. Health is not just a key to
measure the quality of life but also a must for one’s existence.

Good health for the African consists of mental, physical, spiritual, and emotional stability for
oneself, family members, and community; this integrated view of health is based on African
unitary view of reality.

Community is a group of people living in the same place or having a particular characteristic in
common.

Community health is a field of public health concerned with the environmental, social, and
economic resources to sustain emotional and physical well-being among people in ways that
advance their aspirations and satisfy their needs in their unique environment.

CBE is a means of achieving educational relevance to community needs. In order to realize the
educational philosophy of CBE, three strategies have been developed. These are: CBTP, TTP
and SRP.

The CBTP is one of the means of teaching and learning which permits different classes of
students of the health profession to study together. It helps the students to understand the real
community life and needs practice how to identify the real community problems, and help the
community to solve those problems. CBTP also gives us a chance to work as a member of the
health team in identifying community’s health problems and develop communication skills.

CBTP is gradually exploded since 1983, at Jimma university which is an innovative community
oriented training providing institute for health professional in Ethiopia.This was provided at
Jimma University in response to the country’s commitment and adoption of PHC as a strategy
for improving health service. The strategies adopted to materialize the commitment are CBTP
and TTP.

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Health and health related issues are the major concerns of the world. Even though it is still
worsening in most developing countries, many developed countries succeeded in infectious
disease control. In Africa, we are still unable to decrease the prevalence of communicable
diseases like TB, HIV, malaria, amebiasis, and water and food borne diseases which are related
to lack of environmental and personal hygiene in the community.The government of Ethiopia is
giving special emphasis to the health of its citizens since recent years and the allocation of the
budgeting system has been increasing. Most of the country’s higher education centers are now
working to improve the health status of the community by producing health professionals who
can identify and treat health-related problems.

The Health Extension Program (HEP) serves as the primary vehicle for the prevention, health
promotion, behavioral change, communication, and basic curative care.

Wachemo University College of Medicine and Health Science is also working to solve the
problem of the society (community) by designing programs like CBTP, TTP and SRP.

The importance of this study will be to identify contemporary health and health-related
problems, and to indicate the proper intervention and action plans that could be done to solve
these problems by the responsible body.

1.2 STATEMENT OF PROBLEM

Ethiopia is one of the developing country in which most of its population (85%) mainly depends
on agricultures. Different factors like lack of professional committeemen, population awareness
about the problems of waste disposal, adequate and necessary medical equipment, inaccessible
health facility and low health seek behavior leads to the community to have low health status.
Communicable dieses, nutritional problems, maternal and child health problems are the major
challenging health care related problems in Ethiopia.

Even though the sanitary coverage is relatively good, there is still lack of proper utilization of
latrine. Although the towns’ municipalities and rural peoples had being attempting to manage the
solid and liquid waste by converting in to compost for agricultural activities, there is a problem
in collection, transportation, and disposal of wastes on time as a result this the community is
exposed to different communicable diseases. Pneumonia and diarrhea are major communicable
disease in kalish kebele.

Pneumonia affects 65% of children under five years and diarrhea affects 50% of children under 5
years. In Kalisha Communicable diseases, nutritional problems, maternal and child health
problems are the major challenging health care related problems.

2
Better nutrition is related to improved infant, child and maternal health, stronger immunity
system, safer pregnancy and child birth, lower risk of non-communicable diseases and long life
of society. It is a major, modifiable, and powerful factor in promoting health, preventing and
treating disease, and improving quality of life.

The most common nutritional situation are under nutrition (hunger), which causes decreased
physical and mental development, compromised immune system, and increased susceptibility
infectious diseases

Maternal and child health includes the promotive, preventive, curative, and rehabilitative health
care for mothers and children.

Accessible to clean water, improved toilet and sanitation are among the factors for increasing
preventable disease like diarrheal disease. Health indicators maternal , infant and under 5
mortality which can be minimized by utilization of health service ,like family planning, ANC ,
Delivery , PNC ,TT vaccination , nutrition and immunization, are significantly high in Ethiopia.

1.3 SIGNIFICANCE OF CBTP

This study will provide relevant information on health and health related problems in Kalisha
kebele and serve as an input to prioritize, plan and properly execute appropriate, feasible, timely
and cost effective public health interventions and evaluation of the continuity of the intervention.

It also provides the platform for concerned bodies to intervene, create awareness and mobilize
the community for maximum and sustainable results.

The study will also serve as a baseline to perform further study on the subject by an individual,
governmental and non-governmental organization in the future. CBTP help the students to gain
practical knowledge other than the academic one.

As most of the health related problems in Ethiopia are preventable and minimized by good health
services management and strong political commitment as well as community participation,
community health assessment is an important tool to identify health status, health related
problems, and factors that could affect the society’s health. The result of this survey will be used
by governmental and non-governmental institutions to solve the community health related
problems.

3
CHAPTER TWO
2. Literature Review
Related to Household Drinking Water and Sanitation Facility
According to 2016 EDHS about two –thirds of households in Ethiopia (65%) obtain their
drinking water from an improved source. Overall, 20% of households have water on their
premises, 77% in urban area versus only 6% in rural areas. More than 9 in 10 households (91%)
don’t treat their drinking water; this is more common in rural area than in urban area (92% to
88%) [7].

Six percent of households in Ethiopia use an improved and not shared toilet or latrine facility.
Another 9 percent of households (35 percent in urban areas and 2 percent in rural areas) use
facilities that would be considered improved if they were not shared by two or more households.
Half of households in urban areas (50 percent) use an unimproved toilet facility, compared with
more than 9 in 10(94percent) of households in rural areas [8].

Related to Family Planning

Overall, 36% of currently married women are using method of family planning: 35% are using a
modern method, and 1% is using traditional method. Among currently married women, the most
popular methods are injectable (23%), implant (8%), IUD and pill (2% each). By region,
contraceptive prevalence rate ranges from 2% in Somali to 56 % in Addis Ababa [9].

The 2016 EDHS results show that 62 percent of women who gave birth in the five years
preceding the survey received antenatal care from a skilled provider at least once for their last
birth. Three in 10 women (32 percent) had four or more ANC visits for their most recent live
birth. Urban women were more likely than rural women to have received ANC from a skilled
provider (90 percent and 58 percent, respectively) and to have had four or more ANC visits (63
percent and 27 percent, respectively)[7].

Related to Child Health and Nutrition

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In Ethiopia, 58 percent of infants lower than 6 months are exclusively breastfed. Contrary to
recommendation by WHO those children under age 6 months should be exclusively breastfed, 17
percent of infants 0-5 months consume plain water, 5 percent, each, consume no milk liquids or
other milk, and 11 percent consume complementary foods in addition to breast milk. Five
percent of infants under age 6 months are not breastfed at all [11].

The study conducted show that 38% of children under five are considered short for their age or
stunted, and 18% are severely stunted in Ethiopia. Stunting ranges from a high of 46% in the
Amhara region to low of 15% in Addis Ababa. Overall, 10 of children in Ethiopia are wasted and
3% are severely wasted. Regional variation exists with Somali and Afar having the highest
percentages of children who are wasted, 23% and 18% respectively [7].

Related to Vaccination

Globally, 116.5 million children’s received DTP3 in 2010 compared with 24.4 million in 1980.
In 2016, DTP3 coverage ranged from 74% in the WHO Africa region to 97% in the western
pacific region [11].

In Ethiopia 39% of children aged 12-23 months have received all basic vaccination in 2016. 16%
of children in this age group haven’t received any vaccination. There is little difference in the
vaccination coverage rate between male and female children. However, fully vaccinated
coverage is much higher in urban than rural area (65% to 35%). Fully vaccinated coverage is
highest in Addis Ababa 89% and lowest in Afar 15% [7].

Related to Communicable and Non-Communicable

Communicable diseases are a leading cause of morbidity and mortality around world. According
to WHO, infectious and parasitic diseases cause every year around 10.9 million deaths and result
in a loss of an estimated 350 million DALYs. Of these about 56% deaths are caused by
HIV/AIDS, TB and Malaria (World Health Report 2004) [11].

5
Communicable and non-communicable diseases are common in Ethiopia. According to
UNICEF’s study developing countries commonly early up to 1000 hook worm and round worm
at a timeline gram of feces can contain, 10,000 viruses, 10,000,000 parasitic cyst and 100
parasitic eggs and some non-communicable diseases. The fact in Ethiopia indicates that about
80% of diseases are related to poor sanitation and unsafe water supply. Diarrhea and parasitic
infections are the leading among the top ten diseases causing high mortality and morbidity
especially in less than five years

Solid waste management

The scope of solid waste management encompasses planning management systems, waste
generation processes and organizations, procedures and facilities for waste handling. Developing
strategies comprise specific objectives and measures in these areas. They need to consider the
specific interests, roles and responsibilities and numerous factors including households;
community based organizations and other service users, local and national government
authorities and non – governmental organizations. As a result, effective solid waste management
depends upon an appropriate distribution of responsibilities between national, provincial and
local governments [31]. The rapid rate of uncontrolled and unplanned urbanization and high rate
of population growth in the developing nations and Africa brought environmental degradation.
Indeed, one of the most pressing concerns of urbanization in the cities and towns of developing
world especially in 25 Africa has been the problem of solid, liquid and toxic waste management.

CHAPTER THREE
3. Objectives

6
3.1General objective

To assess health and health related problems of the community and give

appropriate interventions in kalisha Kebale, Lemo Woreda, Hadiyya

Zone, SNNP, Ethiopia in 2022 G.C

3.2 Specific objective

 To determine the socio- demographic characteristics and it's mapping.

 To evaluate housing condition of the community.

 To appraise the water supply status and coverage.

 To determine family planning practice.

 To determine the EPI coverage in under two years old children

 To identify nutritional status and proper food handling.

 To determine insect and rodent control.

CHAPTER FOUR

4. METHODOLOGY AND MATERIALS

4.1 STUDY AREA

This community survey will be carried out in Ethiopia, SNNPR, lemo wereda, Hossana city,
kalisha kebele from August 16 - 23 2014E.C

7
Kalisha is found in southern Ethiopia; Located in hadiya Zone of the Southern Nations
Nationalities, and Peoples Region about 227 kilometers south of Addis Ababa and 3.4 kms from
Wachemo University. Geographically it lies between 7°34'21.6"N Latitude and 37°53'00.3"E
Longitude

It is bounded by:

 kidigsa in the North

 Ambicho Gode in the west
 Hossan Nararamo in the East
 chemo hossana in the South

It has primary school, one health post, one Green area, one mosque, two churches and one
administration. The total population of this kebele is 1805 in which 910 were females and 895 of
males among the total population and there is 368 total household. Infants less than 1 year age
are 57, children under 3 year age are 148, children under 5 year age are 277.The total area of the
kebele is about..... hectares2. The climatic condition is Woyenadega. The economy is mainly
based on agriculture and well known for it's wheat production. 63% of population Protestant,

8
17% orthodox, 10% Muslim. The major language is hadiyissa. The community is known by their
cultural foods like kocho.

4.2 STUDY DESIGN AND PERIOD

4.2.1 STUDY PERIOD

The time period will be from August 16-23 2014 E. C.

4.2.2 STUDY DESIGN

Cross section study carried out on performance of CBTP at school of health collage from
perspective of members of the community, community leaders and health professional in CBTP.
In cross sectional study, the investigator measures the outcome and the exposure in the study
Participants at the same time.

4.3 POPULATION

4.3.1 SOURCE POPULATION

All Kalisha Kebele Community population.

4.3.2 STUDY POPULATION

All household of Kalisha kebele community.

4.3.3 STUDY UNIT

9
The Selected households.

4.4 SAMPLE SIZE DETERMINATON AND SAMPLING TECHNIQUE

4.4.1SAMPLE SIZE DETERMINATION

The sample size was determined by using a formula for estimating a single population proportion
assuming confidence level of 95%, 5% marginal error with proportion of 41.5% (proportion of
determinants of family planning use among married women in kalisha and 10% allowance for
non-respondent rate.

n = [Zα/2]2 p (1-p)/d2) considering the following assumptions:

Where,

P = 41.5%

d = marginal error of 5%=0.05.

Z = confidence interval of 95% and Zα/2 is the value of the standard normal distribution
corresponding to a significance level of alpha (α) 0.05, which is 1.96.

n = the required sample size when the target population greater than 10,000.

n=Z2*pq/d2

= (1.96)2*0.415*0.0.585/ (0.05)2=373

Since the source population is less than 10,000, an adjustment formula is used.

Where,

10
n = Source population is less than 10,000(368)

nf = the required sample size when the target population less than 10,000.

nf = n/1+n/N

nf = 373/1+373/368

nf = 185

adding non respondent rate 10%

nf = 185+10% = 204

4.4.2 SAMPLING TECHNIQUE

The village that had been assigned to our group had 1805 households and selecting the
households by using systematic random method by taking every Kth value added and we have
calculated the Kth value by dividing the total household in the village to required sample size.

K = N/n = 368/204 = 1.8 = 2

Where N-total households, n-selected households

So, we chose the first household randomly from two households and every kth value. During no
response in selected house we take the next house in clockwise direction.

4.5 Variables of the study

 Age

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 Sex

 Religion

 Marital status

 Occupational status

 Educational status

 Environmental health condition (housing, kitchen, latrine, waste disposal, water source and
consumption)

Maternal and Child Health status

Morbidity and Mortality

Family Planning

Skilled Birth attendant

Sanitation

Water supply

Contraceptive

Sexual transmitted infection

 Communicable and non communicable disease

4.6 SELECTION CRITERIA FOR RESPONDANTS

4.6.1INCLUSION CRITERIAS

 An individual who lives at least six months in Kalisha Kebele,

 Selected household whose age is 18 years and above
 An individual who is mentally conscious

4.6.2 EXCLUSION CRITERIAS

 Individuals who are unconscious.

 Severely ill individuals during the interview.

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  Household members who lived for less than 6 month in the kebele.
 Absence of household members during visit.
 Children less than 18 years old.

4.7 Data collection tool and procedures

4.7.1 Data collection tool

The tools which will be used to collect the data include; semi-structured Questionnaires for
interview, direct observation and using secondary data such as vaccination card and birth
certificate. The questionnaires contains socio-demographic characteristics (age, sex, educational
level, ethnicity, religion, income, and occupation), mortality and morbidity factors, nutrition
related factors, maternal and child related factors health service related factors and environment
related factors (housing conditions, water supply, sanitation and hygiene related factors…).

The questionnaires will be originally prepared in Amharic version. This original version will be
used for collecting the data, but in the time of writing result questionnaires are translates to
English. In households where there are married couples, the husband or wife will be considered
as respondent.

In other circumstance when there were no married couples, the head of the house hold was
considered as respondent to questionnaires. In condition where the appropriate respondent may
not be available in the house during initial visit one more revisit will be conducted to contact the
appropriate person.

Material used: The materials we was used for our data collection are:-

 Questionnaires
 Pencil
 Sharpener
 Pen
 Chalk
 Ruler
 Calculator
 Papers

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  Tablet
 Mobile phone
 Letter

4.7.2. Data collection Procedure

This section outlines some of the key considerations that may arise during various steps in the
data collection process.

Data collection methods can further be classified into quantitative and qualitative, each of which
is based on different tools and means.

How data is gathered and analyzed depends on many factors, including the context, the issue
that needs to be monitored, the purpose of the data collection, and the nature and size of the
organization.

The main consideration is to make sure that any information collected is done in a way and for a
purpose that is consistent with the Code and complies with freedom of information and privacy
protection legislation. In the interest of effectiveness and efficiency, it is recommended that
efforts be made to collect data that will shed light on issues or opportunities. To protect the
credibility and reliability of data, information should be gathered using accepted data collection
techniques.

Step 1: Identify issues and/or opportunities for collecting data.....

The first step is to identify issues and/or opportunities for collecting data and to decide what next
steps to take. To do this, it may be helpful to conduct an internal and external assessment to
understand what is happening inside and outside of your organization.

What is the history of the organization?

How are decisions made?

Does the organization have a clear system of discipline?

Step 2: Select issue(s) and/or opportunity(ies) and set goals...

The focus of Step 2 is choosing a priority issue(s) and/or opportunity(ies) for collecting data, and
then setting goals and objectives.

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Some of the questions an organization can consider when deciding to prioritize an issue and/or
opportunity for gathering data include:-

Is there a fundamental reason or opportunity to collect data from which other issues and/or
opportunities seem to arise?

Step 3: Plan an approach and methods...

In Step 3, organizations will make decisions about who will be surveyed, how data will be
collected, the sources of data that will be used, and the duration of the data collection project,
among other questions. It includes:-

Who will the data be collected about?

Who will the group of interest be compared to?

What locations or geographical areas will the data be gathered from?

What categories will be used to identify the group of interest and comparator group?

How should data be collected?

How long will the data be collected (the scope of data collection)?

Step 4: Collect data

Step 5: Analyze and interpret data

Step 6: Act on result

4.8 Data collection technique

Some techniques will be used to collect the data such as face to face interview using semi
structured questionnaire and observation. Secondary data will also be reviewed and collected
from kalisha kebele health center.

15
Qualitative and quantitative data obtained from Health office personnel of the kebele,
Health extension workers, Head of the health center and health professionals of the Health center
too.

4.9. Data quality assurance

In order to keep the quality of data, every questionnaire will be discussed and checked by the
team members. Every items of the Selection of households during sampling will be kept random.
Data collection supervision by assigned supervisors will undertake in order to solve any problem
that may arise during data collection. After everything is done the data will be observed for
absoluteness and revised before it is being summed up.

4.10 Data processing, analysis and presentation

The data will be analyzed manually by using scientific calculator and tallying. The result will be
summarized by using figures & tables. Charts like pie chart, bar chart, and histograms will be
used to summarize categorical variables. The completed questionnaires will be checked for
completeness and consistency. Data cleaning will be performed to check for accuracy, and
consistencies starting from the day of data collection. Data analysis was performed using
descriptive statistics and frequency tables (tally, organize, and categorize) after cleaning, editing,
and coding. The highest problem will be identified by ranking the higher percentage as due
consideration and considering descriptive statistics.

4.11 Ethical consideration

Ethical Review Board of College of medicine and health Sciences of Wachemo University will
offer approval and permission. An official letter of cooperation will be written from the
department of medicine to kalisha administration office. The essential explanation about
objective of the research and its steps will be done and informed. Permission will also be avails
from each respondent. Hesitant participants in the study will not be forced. More over any
mistake will not present to secure privacy of mysterious interviewer.

4.12 Dissemination of results

This CBTP work will be presented to;-

16
  Wachemo University, School of medicine.
 Kalisha kebele administration and health office of the Lemo Woreda.

4.13 WORK PLAN

Numbers Types of activities Responsible August Puagme Remark

of person Week Week Week Week Week
activities 1 2 3 4 1
1 Proposal development
2 Proposal presentation to
resident supervisors Group
3 Comment incorporation & members
final proposal submission
4 Duplication of Resident
tools/questionnaire/ supervisors
5 Data collection
6 Data Cleaning, tallying
analysis, Report writing & Group
priority setting members
7 Rehearsal
8 Presentation to resident Group
supervisors and evaluation members
9 Written exam and and
Presentation/Symposium Resident
supervisors
10 Feedback & limited Resident
intervention supervisors
11 Grade submission

4.14 BUDGET

No  Type Unit Quantity Unit Total

price(birr) cost(birr)
1 A4 size Box 1 400 400
paper

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2 Calculator Pcs 1 300 300
3 Pen Pcs 21 20 420
4 Ruler Pcs 21 20 420
5 pencil Pcs 21 10 210
6 Sharpener Pcs 21 5 105
7 Rubber Pcs 5 5 25
8 Stapler Pcs 1 150 150
9 Binder Pcs 5 5 25
10 chalk Box 1 72 72
11 Face mask Box 2 100 200
12 Hand Liter 2 120 240
sanitizer
13 Marker Pcs 11 25 275
Sub total Total
1232 Birr 2842 Birr

Reference

1. WHO definition of health in the WHO official language.

2. http://www.google.com/definition of community health.

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3. ETHIOPIA Demographic and Health Survey2016 Key Indicators Report Central Statistical
Agency Addis Ababa, Ethiopia, the DHS Program ICF Rockville, Maryland, USA October 2016.

4. World Health Organization (WHO) and United Nations United Nations International
Children’s Emergency Fund (UNICEF). 2014. Progress on Drinking Water and Sanitation—
2014 Update. Geneva: WHO and UNICEF.

5. Ministry of Health (MOH), health and health related indicators. Planning and program
Department, FDRE, Addis Ababa, Ethiopia 2009/10.

6. World Health Organization (WHO). 2003. World Health Report 2003. Geneva: WHO.

7. Ethiopia Demographic and Health Survey 2011..

8. UNFPA (2012): A decade of change in contraceptive use in Ethiopia; in-depth analysis of

EDH 2000-2011: Addis Ababa, Ethiopia

9. National Center for Health Statistics (2006) Health, United States, with chart book on

trends on the health of Americans. Hyattsville, MD

10. World Health Organization (WHO) (2012) ‘Family Planning’, Accessed November
11, 2012 <http://www.who.int/topics/family_planning/en/>

12. United nations 2015.trends in Contraceptive Use Worldwide

13. Central Statistical Agency (CSA) [Ethiopia] and ICF. 2016. Ethiopia Demographic and
Health Survey 2016.Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF.

Annex: questionnaire
Informed consent

Dear respondent my name is -----------------------medical student from Wachemo University

college of medicine and health. Since this is a part of our academic requirement, we need to
conduct this study in health and health related problem in kalisha kebele. Your voluntary
contribution and accurate reply to these questions has a crucial value for the achievement of this

19
study. So you are kindly wanted to collaborate in responding the following questions. Your
confidentiality will be insured.

Do you agree A. Yes B. No

Questionnaires code ------------------

Part 1 Socio demographic status

1) House number ------

2) What is the family size?
3) Number of children
4) Age family members
5) Ethnicity
6) Religion
□Orthodox
□Islam
□Protestant
□Catholic
□Adventist
□Other
7) Educational status
□Illiterate
□Preschool
□primary School
□secondary School
□college/university
8) Marital status
□Married
□Single
□Divorced
□Widowed

9) Occupational status

□Government employee

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 □Trader
□Farmer
□Daily labor
□Student
□Other (specify) __________________

1) Approximate monthly income__________________

2) Accessibility to information

a. Radio set (yes, no)

b. TV set (yes, no)
c. Telephone in the house (yes, no)
d. Access to postal service (yes, no)
e. Access to newspaper (yes, no)

12-Any birth in the last 12 month in the family (yes, no)

13- If yes:

a) Status of the birth (live birth, still birth)

b) Sex of the newborn (male, female)
c) Place of delivery (house, health institution)

Attendant of delivery (TTBA, professional, untrained person)

14- Was there any death in the last 12 months (yes, no?)

15- If yes:

1. Sex (male, female)

2. Age at death (<1, 1-5, 5-18, >18)
3. Perceived cause of death (due to illness, accident, unknown)

16- Sick family members during the last two weeks (yes, no)

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17-If yes:

a) Sex (male, female)

b) Age (<1, 1-5, 5-18, >18)
c) Ailments (fever, diarrhea, cough, others)

18- Days lost because of illness (<3 days, 3-7 days, >7 days)

19- Did the person seek any help? (Yes, no)

20- If yes, where? (Health institution, traditional healer, home level self-treatment, religious
treatment, others)

Part 2 Housing condition

1.1 Number of rooms?

No of rooms Ventilation(window) Adequate light Cleanness
1
2
3

Keys: 1, Good 2, Fair 3, Bad

1.1. Who is the owner of the house?

A: private B: rented C: other

1.3. What is the total area of the house in square meters?

1.4. What type of materials is the wall made out of?

A: Mud B: Stone C: Wood D: Cement E: Concrete f: other

1.5. Type of material used for constructing the roof

A: Iron sheet B: Thatched C: If other, specify

1.6. Constructing material for the floor?

A: wood B: concrete C: Soil D: If other, specify

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1.6.1. Any crack visible in the floor?

A: yes B: No

1.7. Number of windows in the house?

1.8. How often do you clean the house?

1.9. Is there any domestic animal living in or around then house?

A: yes B: No

2.0. If yes, are they living together with people?

A: yes B: No they have separate quarters

2.1. What is the status of the kitchen?

A: Separate room attached to the main house

B: separate room but detached from the main house

C: No kitchen at all

2.2. If no kitchen, then where do you usually cook your food?

A: Inside the house B: Outside the house

2.3. If kitchen is available, how is the general sanitation of the kitchen, utensil and food storage
site?

A: Good B: Fair C: Poor

2.4. What source of energy is used for cooking purpose?

A: Wood and coal B: Electric C: Dung D: If other, specify

2.5. What is the source of water for the house? And is it clean or drinkable? Is it inside or outside
the house?

2.6 Does the house require maintenance?

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 A: No, house is in good condition

B: Not now, house is in fair condition

C: Yes, the house is in poor condition and requires urgent maintenance

2.7. Any trouble with Rodents and insects inside the house?

A: Yes B: No

2.8. If yes, what measures are taken to prevent such conditions?

Part 3 FOOD SANITATION

1 Which of the following procedures do you implement during food preparation?

a) Washing hands

b) Washing vegetables

c) Proper and adequate cooking

d) Material cleaning frequently

e) Preventing contamination

f) Other……………………

2. What method do you use to preserve food?

a) Refrigerator

b) Drying

c) Other……………

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Part 4 Water supply

1 Source of water supply: a) pipe water b) underground water c) other specify

2 How much is your daily consumption in liters?

3 What type of container do you use to store the water? …………….
4 for how long you store it?...........
5 do you have cover for a container? A) yes B) no
6 do you clean the container? A) yes B) no
7 If yes, how frequent do you clean the container?

Part 5 Waste disposal

1. Is there any scheduled program to collect the waste?

a) Yes b) No

2. What is the final disposal method used for disposing collected waste?

a) Sanitary land field

b) Burning

c) Composting

Other _________________

3. Is there any Problem with insect and other vermin

A) Yes b) No

4. If yes what type a) Housefly fleas b) Bedbugs c) Lice

5. Do you have latrine facility?

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a) Yes b) No

6. What is the status of the toilet?

A: Separate room attached to the main house

B: separate room but detached from the main house

C: No toilet at all

7. If yes, what type of toilet do you have?

A: Pit latrine B: Water carriage C: If other, specify

8. If separate, how far is the latrine from source of water?

9. What is the location of water source from the latrine?

A: Downhill B: up hill

10. What is the current status of your toilet?

A: Clean and in good maintenance B: Dirty and needs maintenance

11. If Pit, how far is it from the house? ------------meters

13. What is the status of ownership of excreta disposal?

a) Owned by the family

b) Shared or communal

14. If there is no latrine, is there adequate space for construction of a new one?

a) Yes b) No

15. Is latrine construction affordable for the family?

a) Yes B) No

16. What is the waste disposal system of your latrine?

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a) Closed

b) Rained to pipes

c) Clearing the septic tank

Part 6 Family planning
1. Do you know about contraceptive?
A. yes
B. no
2. If yes to question number one, which one do know?
A. Pills
B. Implants
C. Injections
D. Condom, diaphragm
E. Others, specify
3. If yes to question number 3, do use any of the methods?
A. Yes
B. No
4. If yes to question number 3, specify the type
5. If yes to question number 3, what is the reason you use the contraceptive?
A. Health problem
B. For spacing
C. Financial reasons
D. Others, specify
6. If no to question number 3, what is your main reason?
A. Side effects
B. Cost
C. Don’t know sources
D. Lack of partners consent
E. Not available

27
 7. If no to question number 3, what do you do when you want to space the next
pregnancy?

8. How does your partner feel about birth control method?

A. I don’t know
B. He feels positive
C. He is indifferent
Part 7 Pregnancy and delivery
1. Age at first marriage, if ever married
2. Age at first pregnancy, if ever pregnant
3. Total number of
a) Pregnancies
b) Live births
c) Abortions
d) Still births
4. Where did you deliver your last child?
a) Home
b) Clinic
c) Hospital
d) Other, specify
5. If it was at home, who attended the delivery?
6. Did you have any health problems during?
a) Pregnancy
b) Delivery
7. Did you go to nearby health center during pregnancy?
8. If yes for above question, why?
a) Regular check up
b) Health problem, specify
9. Did you take any precaution during pregnancy in the following areas?
a) In the kind of work, you do. If yes specify
b) In hygiene

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 c) In nutrition
 Are there forbidden foods?
 If yes, list them
 Do you know why they are forbidden?
d) Do you make any special preparations before pain starts that would make
delivery easier? And if yes, mention them
Part 8 Childcare practice
1) When do you wash the child after birth?
2) When do you start breast feeding after birth?
3) For how long do you breast feed the child?
4) At what age do you start complementary feeding?
5) Are there forbidden foods for infants?
A. Yes
B. No
6) If yes to above question, why?
7) Are there recommended foods for infants?
A. Yes
B. No
8) If yes to above question, why?
9) If yes to question number 7, mention them
10) Do you use bottle for feeding your child?
11) Does your under 5 child attend children’s clinic for checkup? If yes, where?
12) Which of the following do you practice on your children?
A. Female circumcision
B. Extraction of milk teeth
C. Uvula cutting
D. Other, specify
E. None

Part 9 prevalence of communicable and non -communicable disease

29
4.1 Was there any malarial infection in the last 12 months (yes, no?)

4.2 If yes

a) Sex (male, female)

d) Age (<1, 1-5, 5-18, >18)
e) Days lost because of illness (<3 days, 3-7 days, >7 days)
f) Did the person seek any help? (yes, no)
g) If yes, where? (health institution, traditional healer, home level self-treatment, religious
treatment, others)
4.3 Mechanism of prevention that you have used?
a) Mosquito netting over beds (yes.no)
b) Removal of stagnant water from environment (ye.no)

4.1 Was there any measles infection in the last 12 months (yes, no?)

4.5 If yes

a) Sex (male, female)

b) Age (<1, 1-5, 5-18, >18)
c) Days lost because of illness (<3 days, 3-7 days, >7 days)
d) Did the person seek any help? (Yes, no)
If yes where? (Health institution, traditional healer, home level self-treatment, religious
treatment, others)
4.2 Have you ever take a vaccine for measles(yes.no)
4.3 If yes
a) Duration of vaccination (1st dose.>1st dose)
b) Place of vaccination ( health center, community health post, hospital, home)

4.4 Was there any non-communicable infection in the last 12 months (diabetes, genetic disorder,
cancer, hypertension, mental illness)

4.5 If yes

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a) Sex (male, female)
b) Age (<1, 1-5, 5-18, >18)
c) Did you visit health center(yes, no)

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