COMMUNITY BASED TRAINING PROGRAM

ASSESSMENT OF HEALTH AND HEALTH RELATED CONDTION

IN Hakim woreda,NOC KEBELE 18 ,HARAR REGION, EASTERN
ETHIOPIA

A PAPER SUBMITTED TO HARAR HEALTH SCIENCE COLLEGE,

COMMUNITY BASED TRAINING PROGRAM OFFICE FOR THE
PARITAL FULFILMENT OF COMMUNITY BASED TRAINING
PROGRAM (CBTP) COURSE

Name of Supervisor: Mr. Siraj Adem(BSc, & MSc )

Dec 2024

Harar, Eastern Ethiopia

Acknowledgement

We would like to thank Harar Health Science College for giving us the chance to conduct and
present this community based training program. Our heartfelt appreciation also goes to our dear
supervisor Mr. Siraj Adem, for their valuable scientific guidance and tireless effort to help us
prepare the CBTP paper correctly.

We extend our earnest gratitude to the residents of Hakim woreda, Noc kebele, Harar region for
their collaboration in giving us the information during data collection.
 Acronyms

AIDS: - Acquired Immune Deficiency Syndrome.

ANC: - Antenatal care.

BCG: - Bacillus Calmete Guerin.

CBE: - Community Based Education.

CBTP: - Community Based Training program

DPT: - Diphtheria pertussis and Tetanus.

EDHS: - Ethiopia Demographic Health survey.

EPI: - Expanded Program for Immunization.

FGM: - Female Genital Mutilation.

FP: - Family Planning.

HIV: - Human Immune Deficiency Virus.

MCH: - Mother and Child Health.

OPV: - Oral Polio Vaccine.

TTV: - Tetanus toxoid Vaccine.

VCT: - Voluntary Counseling Test.

VIP: - Ventilated Improved Pit latrine.

WHO: - World Health Organization.

 CHAPTER ONE
INTRODUCTION
Background
Healthy society is the basis of the development of the country. Improving health status of the
society is one of the fields, which need a lot of effort. To achieve this goal the cooperation of
educated professional with the community is highly essential. To do this government sector and
many Universities gives attention to Community based education (CBE) (1).

Community based education (CBE) is concerned with the active creation of positive, nurturing
and intentional community. Students are encouraged to actively participate, apply academic
knowledge, concepts and information during accomplishment of this program.it is a means of
achieving educational relevance to community needs .It consists of learning programs and
learning activities that use of the community extensively as learning environment(2).

This program was first started by Jimma University in 1978.Community based education (CBE)
training intervention activities and the strategies of implementing CBE at Jimma University are
designated on three main programs. Community based training program (CBTP), team-training
program (TTP), and student research project (SRP) (2).

Community based training program (CBTP) is one parts of community based education (CBE)
which is designed to train health science students, about community diagnosis to identify the
problems related to health in the community, it provide health science students to apply the
theoretical knowledge in to practical application (2).

Since most rural population of Ethiopia has, no access to modern health care services
Community involvement in the health development is widely acknowledged essential in the
development of health service. Establishing effective and responsible health delivery is an
integral part of development that aims to reduce poverty, achieving economic growth and
development (3).
Sustaining a healthy community is the goal of every part of the world. However, achieving this
goal requires careful planning and organized community members, health organizations,
academic institutions, and various government agencies (1).

Statement of the problem

The world population is increasing at alarming rate. The large population that cannot match the
available resource causes this leads to poverty and other environmental problem, all these
environmental issues. Globally it is believed that most of the disease are due to lack of sanitation
and inadequate water supply, illiteracy and low health service. This issue is especially higher in
developing countries (4).
Neglected populations living under poverty throughout the developing world are often heavily
burdened by communicable and non-communicable diseases, and are highly marginalized by the
health sector due to their limited access to health and social support services. The population
density and diversity of urban communities offers formidable challenges for healthcare delivery
(5).
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, in accessible
health facility and low health seek behavior leads to the community to have low health status(6).

Communicable dieses, nutritional problems, maternal and child health problems and prevalence
of HIV/AIDS are the major challenging health care related problems in Ethiopia. Communicable
diseases are considered as major causes of morbidity and mortality, as well as disability in
Ethiopia. The high prevalence of communicable diseases in the country is linked to the poorly
developed socio-economic and environmental factors that have been inherent for centuries.
Seventy five percent up to eighty percent of the disease burdens in Ethiopia are assumed
preventable using measures like improving environmental health status and nutritional
interventions (7-9).
Majority of the population are living in houses that are cramped and unable to protect them from
bad weather, insect, and disease. The people are living within houses that have adverse effect on
health, education of children, job performance, and overall quality of life. Rodents and poor
sanitation are breeding grounds for bacteria.

Collapsing walls and poor protection from bad weather and insects is a daily battle for many of
the population who have small chance of improving their situation without assistance (6).

Improper solid waste disposal system complies, as environmental health problem resulting in
hazardous smell from the fire, flea-breading place that are source of diarrheal disease, cholera,
typhoid fever etc. (10).

The unsatisfactory housing condition which is one of the basic human right, expose the occupant
to extreme heat and cold, noise and invasion by dust, insects and rodents which are important
criteria for good housing condition and found to be associated with communicable disease,
intestinal parasite, pneumonia, TB and mental illness (10).

According to the 2011 EDHS, 38% have toilet facility of these 82% use unimproved toilet. Lack
of piped source within the dwelling, yard or plot may limit the quality of suitable drinking water
that is available to the household, even if the water is obtained from an improved source, it may
be contaminated during transportation and storage. The proportion of Ethiopian household with
an access to piped water is 34% (6).

It is reported that up to 60 percent of the current disease burden in Ethiopia is attributable to poor
sanitation where 15 percent of total deaths are from diarrhea, mainly among the large population
of children under five. Some 250,000 children die each year. As well as diarrhea, there is a high
prevalence of worm infestations (causing anemia) which have a synergistic effect on the high
levels of malnutrition. This, in turn, impacts on school attendance and level of education attained
(11).

Improved sanitation and hygiene have been shown to prevent disease transmission. Robust
epidemiological studies by Esrey and others when assuming a critical mass of more than 80
percent of adopters demonstrated that, Pit latrines, when used by adults themselves and for the
disposal of infant’s stools, can reduce diarrhea by 36 percent or more, cholera by 66 percent, and
worm infestations by between 12 and 86 percent. Hand washing with soap (or a substitute) and
water after contact with stools can reduce diarrheal disease by 35 percent or more. Eye and skin
infections can be reduced with more frequent face and body washing. Improved water supply is
generally associated with a 15 percent reduction in diarrhea. A combined safe water supply,
sanitation and hygiene can reduce diarrhea by 65 percent (12).

Impact on disease burden due to inadequate and unsafe water, lack of sanitation and poor
hygiene behavior is a complex issue. The occurrence and severity of Hygiene related outbreaks
in endemic areas is greatly enhanced by human behavior with regards the practice of healthy
hygiene. Improvements in hygiene behavior are the most important barrier to many infectious
diseases, because with safe behavior and appropriate facilities, people reduce their risk of
becoming exposed to diseases (13).

In developing countries including Ethiopia, a large number of women are died due to factors
related to pregnancy and childbirth. Implementing and assuring utilization of maternal health
care service is potentially one of the most effective health intervention for preventing maternal
morbidity and mortality.

Poor maternal health not only affects the mother but also the child, family and community as a
whole. Family planning and early marriage are another major problems of the country. Early
marriage is deeply rooted in the traditions of Ethiopia, perpetuate by poverty, lack of education,
lack of economic opportunity and social customs that limit the right of women and girls (14).
According to Ethiopia MOH, HIV/AIDS is the key challenge for the overall development due to
reducing the productive man power. Ethiopia has an estimated two million people living with
HIV/AIDS and is the third highest number of infection in Africa .The barrier to HIV prevention,
testing and care in Ethiopia are huge. 85 percent of the populations live in rural area and suffer
from severe lack of access to public health service (15).

Without improved delivery of health services, the present obstacles – accessibility, affordability
and utilization of the health systems-will perpetuate disparities and likely increase the risk
factors, incidence and prevalence of treatable and manageable health conditions as the size of
vulnerable and marginalized urban populations grows. Reduction in disease burden would enable
these communities and groups to become more economically active and, thereby, further reduce
the socioeconomic factors contributing to disease occurrence (16).

Significance of the study

As most of health related problems in Ethiopia are preventable. 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 serve as to identify and take measure on major
health and health related problem of the community. It gives deep understanding about source of
the problem, which is useful for governmental and nongovernmental organization in planning
and implementing programs to solve community health problem. It also crucial to create
awareness in the community so that they can develop problem-solving capacity and develop
healthy behavior that promotes health. This study can also be used as a base line data for further
study in the area.
FOR TEAM MEMBERS

The study had provided our team members valuable experience on how to conduct community-based
training program. It helped us to know how to identify, prioritize problems and intervene accordingly to
improve health status of our community by managing available scarce. It had increased team work spirit,
tolerance and problem-solving ability of our team members.