FEKEDE

EGZI

COLLEGE

FACULTY OF HEALTH SCIENCE

DEPARTMENT OF NURSING_C
TITlE: THE ASSESSMENT OF HEALTH AND HEALTH RELATED PROBLEM IN ETHIOPIA,
SOUTH GONDER ZONE :DEBRETABOR CITY KEBELE 07,

Community based program proposal submitd to fekede egzi college

faculity of health science department of BSC nursing.

Advisors:kefyalew A.(BSC,MPH)

Submission date:30/7/2017 E.C

Investigated by : Nursing room B students

.....f

ACKNOWLEDGMENT

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First and for most, we would like to thank the almighty God who blessed us in every step of our life
and entitled us for this opportunity.Next we would like to express our deepest appriciation to Fekede
Egzi College department of nursing For giving us this opportunity to do on this proposal to CBTP.
We also like to thank our advisor M.r kefyalew A.(BSC,MPH) for his appreciable and successful
advice during the preparation of this proposal.Also we would like to thank you the sectors and
office of 07 kebele in DEBRE TABOR for providing us with the needed information and
data.Finaly we wants to thank the participant community members( households) for their willing ness
for giving information .

Abrivation$acronym
CBTP.............community based training program
CBE...............community based education
SRP...............student research program
PHC..............primary health care
EPI...............expanded program of immunization

Contents
Acknowledgments...................................... ........................... ....5
Acronyms...................................... ........................................... ....5
SUMMERY..................................... .................................................... ...7.
1.Introduction ...................................... ........................................ ....7
1.1Back ground ...................................... ..........................................2

2
 3.Study objectives...................................... ......................................6
3.1 General objective...................................... ...............................7
3.2 Specific objective...................................... ................................7
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 ...................................... .......................................... ....10
4.3.1 Source of population...................................... ...........................11
3.3.2 Study population...................................... ..................................11
3.3.3 study unit ...................................... .......................................... 11
4.4 Sample size determination and sampling technique....................12.
4.4.14.4 Sample size determination ....................................... ....13
4.4.24.4 sampling technique...................................... .....................13
4.5 Variable of the study...................................... ...................................14
4.7 Data collection tool and procedure...................................... ..............17
4.7.1 Data collection tool ...................................... .................................18
4.7.2 Data collection procedure...................................... .......................18
4.8 Data collection techniques ...................................... ........................ ...19
4.9 Data quality assurance ...................................... ...................................20
4.10 Data processing,analysis and presentation. .................................... .20
4.11 Ethical considerations...................................... ....,................................21
4.12 Dissemination of result ...................................... ..................................21
4.13 Work plan...................................... .................................................... ....22
4.14 Result........................................................................................................21
4.15 Action plan...............................................................................................22
4.14 Budget ...................................... .......................................... ...................22
References

SUMMERY
The CBTP is one of the means of teaching and learning process wich permit different classes of
students on the health profession to study together.It helps the students to understand the reality
on the communities life and helps to know how to identify the community problems and directs
how to solve those problems . CBTP also gives us a chance to work as a member of the health
team in identifying community s health problem and develop communication skills.It helps to
seek understanding about the way of concerning in more specific and big problems in the

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community level.It is also used by creating desire on the students for future speciality programs
by giving chance to know more problematic tasks which seeks more attention.

Objective

The main objectives of the CBTP is to assess health and health related problems of the
community and give appropriate intervention in ETHIOPIA, SOUTH GONDOR ZONE,
DEBRE TABOR CITY, KEBELE 07at 2017 E.C

Method
A community based cross sectional survey undertakes by cluster sampling method.The sample
size is 40 households.The data will be selected by written questionary and collected at from
29/7/2017-30/7/2017.

INTRODUCTION

1.1 BACKGROUND

.
CBE is a means of achieve educational relevance to community need. In order to realize the
educational philosophy of CBE,three strategies have been developed this are :CBTP,TTP,SRP.

The CBTP is one of the means of teaching and learning wich permit different classes of students
of the health profession to study together.it helps the students to understand the real community
life and need practice how to identify the real community problem and help the community to
solve those problem . CBTP also gives us a chance to work as a member of the health team in
identifying community s health problem and develop communication skills.

CBTP is gradually exploded since 1983 , at jimma university which is an innovative community
oriented training providing institut for health professional in Ethiopia.this was provided at jimma
university in response to the countrys commitment and adoption of PHC as a strategy for
improving health service . The strategy adopted to materialize the commitment are CBTP and
TTP.

Health and health related issue are the major concern of the world.even though it is still
worsening in most developing countries ,many developed countries succeeded in infectious
disease control . In Africa we still unable to decreas the prevalence of communicable disease like
TB,HIV,Malaria,amebiasis and water and food borne disease which are related to lack of
environment and personal hygiene in the community . The government of Ethiopia is giving

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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 by producing health profession who
can identify and treat health- related problems.the health expansion program (HEP)serves as the
primary vehicle for the prevention health promotion behavioral change comunication , and basic
curative care

Fekede egzi health and bussines college is also working to solve the proplem the sociaty
(comunity)by designed problems like CBTP, TTP and SRP.

The importance of this study will be identify con temporary health and health related
problem ,and to indicate the proper intervention and action plan that could be done to solve these
problem by the responsibele body.

3.Objective

3.1 General objective

_ to assess health and healthy related problem of the community and give appropriate intervention in
DEBRE TABOR CITY KEBELE 07 at 2017 E.C.

3.2 . specific objective..

_ to determine The socio_demografic 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 5 years old children.

_ to identify nutritional status and proper food handling.

_ to determine insect and rodent control.

_ to determine communicable and non comnicable diseases

4.Methodology and materials

4.1study area

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This community survey will be carried out in Ethiopia , SOUTH GONDOR ZONE, DEBRE TABOR CITY 07
kebele from Mar 29-30,, 2017 E.C kebele 07 is found in southern ethiopia, located in south gonder zone of the
southern nations

The town is located 103 kms from the capital city of the regional stat.north west of ethiopia
which located at 667 kms away from addis abeba.

It is bounded by :

-Ebnat in the north

-Woreta in the west

-gasagn in the east

-lewaye in the south

It has primary and secondary school , 4 health post and more primary clinic,one green area ,one mosque 10
churches and one administration . The total population of this kebele is around 7155 in were females and
males among the total population and there is 1431 total household. children under 5year age are 609 . the
climate condition is weynadega .the economy is commonly is mainly based on Government worker .94% of
population Christian 5%Muslim , 1%Protestant .the major language Amharic .the community is known by
their cultural foods like enjera.

4.2 study design and

period
4.2.1 study period

The time period will be

from March 29 to 30 2017
E.C

4.2.2 study design

Cross section study carried out on performance of CBTP at school of health college from perspective of
members of the community ,community leaders and health professional in CBTP.in cross sectional study ,the
investigater measure the prevalence of communicable and non comnicable diseases and general lifes that
matter the health status in the study partisipant at the same time.

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4.3 population

4.3.1 source population

All 07 kebele community population

4.3.2 study population

40 household of 07 kebele community

4.3.3 study unit

The selected household

4.4 Sampling techniques and sample size

The sample size for the study will be determined taking critical value
at 95 % confidence level, degree of precision 0.05, missing or absent
health care professionals 10% and the source population of 6334(number
of total population ) will be used by taking.

(Z α/2 )* P * (1- P) = (1.96)2 * 0.5*(1-0.5) = 384

D2(0.05)2 (0.05)2

We assume p=q=0.5 (which is the most conservative method to calculate

the sample size) D=0.05

Since number of total populations is less than 10,000 corrected sample

size formula will be used;

Where

n~sourse of population <10,000=368

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nf = corrected sample size

N = total number total community

n = initial sample size

nf = 384/ (1+ ((384-1)/368))

188.2≈ 188

Non response rate – 10%

Total sample size = total sample size determined + (Sample size * Non
response rate)

= (188*10%) +188

= 208

Sampling technique: Sampling units are selected using

randomized (probability sampling) cluster sampling method .

There for -sample size is 40

Normal Standards in WHO

Toilet far from house is 6 meter

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Toilet far from water sources 30 metres
After toilets all members are wash hands
Normal house is two doors
One door in south
an others door in wast
WHO advised 3-5windows

4,5 VARIABLES OF THE STUDY

age

sex

religion

marital status

Occupational status

education 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

contracptive

sexual transmitted infection

communicable and non communicable disease

Addiction problem

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Death of family membet

4.7 Data collection tool and procedures

4.7.1 Data collection tool

The tool which will be used to collect the data include ; semistructured Questionary for
interview, direct observation and using secondary data such as vaccination card and birth
certificate. the Questionary contain socio-demographic characteristics (age ,sex,educational level
ethinicity, religion income and occupation ) mortality and morbidity factor nutrition related
factor maternal and child related factor, health service related factor and environment related
factor (housing condition water supply sanitation and hygiene related factories ...)

the questionnaire will be orginally prepared in Amharic version .this orginal version will be used
for collecting the data ,but in the time of writing result questionnaire are translated to English. In
household where there are married couples, the husband or wife will be consider as respondant.

In other circumstance when there were no married couple the head of the household was
consider as respondant to questionnaire in conditions where the appropriate respondent may not
be available in the house during initial visit one more revisit will be conduct to contact the
appropriate person.

Material used: The material we was used for our data collection are፦

- Questionnaires

- pen

- ruler

- calculator

- papers

-table

-mobile phone

-letter

4.7.2 data collection procedure

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This section outlines sime of the key consideration that may arise during various steps in the
data collection process

- data collection method 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 away and for
apurpose that is consistent with the code and compliers with freedom of information and privacy
protection legislation in the interest of effectivivenss and efficiency it is recommended efforrt be
made to collect data that will shed light on issues or opportunitie. To protect the credibility and
riability 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 decision made

Stpe 2: select issue (s) and /or opportunity (ies) and 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

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

Is there a fandamental reason or opportunity to collect data from which other issue and/or
opportunities seem to arise

Step 3:plan an approach and method ...

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In step 3,organization will make decision about who will be survived, How data will be
collected, the source of data that will be used,and the duration of data collection project,among
other question. It includes:

 Who will the data be collected about?

 Who will the group of interest be compared to?
 What locations or geographic areas will the data be gathered from?
 What Categories will be used to identity the group of interest ?
 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

Step 6:act on result

4.8 data collection techniques

Same techniques will be used to collect the data such as face to face interview semi structured
questionnaire and observation. Secondary data Will also be reviewed band collected from
Debretabor 07 kebele health center.

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

4.9. data quality assurance

In order to keep the quality of data, every questionnarre will be discussed and checked by the
team members. Every iteams of the Selection of households during sampling will be keep
random

Data colleection 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 summer up.

4.10 data processing ,analysis and presentation .

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in data will be analyzed manually by using scientific calculater 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 cheek 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 h consideration and
considering descriptive statistics.

4.11 ethical consideration

ethical review board college of fekede egzi health science will offer approval and pennission,an official
letter of cooperation will be written from the department of nursing to Debretabor 06 kebele
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 intetviewer.

4.12 dissemination of results

this CBTP work will be presented to:-fekede egzi college school of nersung,06 kebele administration and
health office of the DEBRE TABOR CITY.

4.13 work plan

Number Type of activity Responsible March Remark

of person
activity Day Day Day Day Day
25 26 27 28 30

1 Proposal development

2 Proposal presentation to residents go Group

supervisor memberrs

3 Comment incorporatetion and final

proposal submission

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4 Dublication of tools Resident
supevisors

5 Data collection

6 Data,cleaning,talling,analysis,Report Group
writing and priority seting

7 Rehearsal

8 Presentation to resident supervisors and

evaluation

9 Written exam and presentation

Symposium

10 Feedback and limited intervention

11 Grade submission

4.14 Results
1.Social demographic Data

Classification Total
Family head •Father =30

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 •Mother =10

•Son =0

total=40
Total family •M =84
members
•F =105
Occupational status •gov.t employe = 17

•Self employe = 14

•Farmer =0

. housewife =5
Marital status •Marriage =25

•Un marriage =10

•Divorce =3

•Widowed =2

Religious •Orthodox =40

•Muslim =0

•Other =0
Educational level illiteracy =8

Literacy =14

Primary =6

15
 College and above =12

2.Status of house

House character Abundance

Numbers

Type of floor Concrete 21

1 Mud 16

Wood 3

2 Type of roof Tin 28

Wood and grass 12

3 Type of wall Wood and mud 20

Stone and cemint 20

4 Number of rooms 1 4

2 3

3 19

4 and above 14

5 Ventilation Good 24

Moderate 16

Bad 0

6 Is there Kitchen Yes 39

No 1

7 Is kitchen separated from home Yes 39

No 1

16
8 Is kitchen have exhale Yes 33

No 7

3.vector prevention

Number Questions Abundance

1 Is there any vector in your house Yes 16

No 24

2 Type of vector Mosquito 13

House fly 1

Flea and other 1

3 Is you apply any measures to prevent Yes 10

these vector
No 3

4 What type of measure Bed net 5

Insecticide 2

Other Cultural 1

4.Waste handling

Question Abundance

1 Solid waste disposal Burning 10

technique
Fertilizer 16

Common burrows 13

On the street 1

2 Liquid waste disposal On the street 1

17
 technique Liquid waste 39
disposal burrow

3 Where yuo deficate Personal toilet 35

Commosal toilet 5

On open land 0

4 How far commensal toilet Less than 6 meter 12

from home
Greater than 6 28
meter

5 Type of toilet Burrow 30

Work by water 5

8 Is there hand washing Yes 26

water at the inlet of toilet
No 14

5. water supply and food handling

Classification aboundance

Water source .private pipe =33

.Neighboring pipe =o

.Population pipe =7

water accumulated style .gerican =31

.barrel (bermil ) =9

.Other =0

18
use water refinary methods .Yes =24

.No =16

which one ? .boiling =5

.refine =20

.add chlorine =1

Water consumption per daily .20-40 litter =11

.40-60 litter =18

.under 20 litter =7

food preserving methods .refrigerator =17

.drayer =8

.salt =2

Food processing techniques .hand washing =24

before cook

.vegetables washing
=20
.Material washing
=40
All
=22

Iodide salt consumption Yes =26

No 14

When use salt After cooking =18

During cooking =22

6.Maternal and child health

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Child health

Classification Total

age of child .Neonatal age =0

.infant =1

.Under 5 =17

Vaccine use .Yes =18

0
.No
Vaccine situation .use all =17

.Age dependent =1

.not ended =0
Breasts feed initiation .at birth =14

.After 1 hours =4

.Not breasts =0
feeding
Exclusive breast milk for 6 months
.Yes =16

.No =2
How many times bteast .3-4 =5
feeding
.4-5 =6

20
 .more than 5 =7
When to initiat before 6month =5
complement food
after 6 mouth =13

warm by sunlight Yes =16

No =2
at 6 mouth take V- A yes =15

No =3

7.Family planning

Question Abundance

1 Do you know about family Yes 16

planning
No 24

2 Current contraception used Don't use 6

Inplant 3

Depo 5

COC 4

Any natural methods 0

3 Cervical cancer screening No 8

Yes 32

8.Antenatal and post natal services

21
 Antenatal and post natal status Abundance

1 Restricted food Yes 2

No 4

2 Type of restricted Alcohol 1

food
Salt 1

4 Consumption of iron Yes 4

sulphate
No 2

5 Completion of iron Yes 4

sulphate
No 2

6 If don't complet iron Feer of side effects 0

sulphate why
Chest burning 0

Eexces in number of tablets 0

Forgotten 0

Negative attitude 0

7 Appetite during Increase 2

pregnancy
Decrease 3

Constant 1

8 Site of delivered At health center 6

At home 0

9 Immunization for TT No 0

TT 1 2

TT 2 0

TT 3 1

TT4 3

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 TT5 0

9.Family health

Health probles Abundance

M F

1 Diabetic 0 2

2 Hypertension 0 1

3 Pneumonia 2 1

4 HIV AIDS 0 0

Epilepsy 1 00

10.Psychiatry and social status

Type Age Total

M F Greater Less than 30

than 30

Addictive Alcohol O 0
person

Chat 0 0

23
 Sigara 0 0

Psychiatry Stress 4 2 0 23

Menta 3 1 0 26
illness

Cause of Punishment
mental From God
illness
Bad aura 4

Genetics 2

Stress 3

Excessive 1
addictive

Treatment of Health 5
mental center
illness
Religion 7
practice

Cultural
practice
4

11.Death indicator

Age(year) Sex Cause of death

1 8 M Pneumonia

2 79 F HTN

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4.13 budget
No Type Unit Quantity Unit Total cost
price(birr)

1 Paper box 1 400 400

2 Calculators Pcs 0 0 0

3 Pen Pcs 21 20 420

4 Ruler Pcs 0 0 0

5 Pencil Pcs 0 0 0

6 Sharper Pcs 0 0 0

7 Rubber Pcs 0 0 0

8 Stapler Pcs 1 15 15

9 Binder Pcs 0 0 0

10 Chalk Box 0 0 0

11 Face mask Box 0 0 0

12 Hand Liter 0 0 0
sanitizer

13 Marker Pcs 0 0 0

25
 Total 835 birr

Reference
1,who definition of health in the who official language

2, https/www google.com/definition of community health

3, Ethiopian demographics and healthy server 2016 key indicators report centeral
statically

26
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 found (unicef)2014.progress on drinking water and
canitation_2014 update.geneva:who and unicef

5, ministry of health and health related indicators.planing and program

department,fdre, Addis Ababa, Ethiopia 2009/10.

6, world health organization (who).2003 world health report 2003.geneva :who.

7, Ethiopian demographics and health survey 2011..

8, unfpa(2012):a decade of Chenge in contraceptive with 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_planing/

Cn/>

12, united nations 2015.trends in contraceptive use world wide

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.

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