last community based traning program ppt

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1. MIZAN AMAN HEALTH SCIENCE COLLEGE DEPARTMENT OF NURSING COMMUNITY HEALTH AND HEALTH RELATED ISSUES CONDUCTED BY SECOND YEAR NURSING STUDENTS IN AMAN KEBELE KETENA 01 AND 03, FROM 17/10/2016 TO 17/11/2016 JULY, 2024 AMAN, ETHIOPIA 7/9/2024 1

2. Outlines of present ation Introduction Significance Strategy of CBTP Objectives Methods & Materials Results and discussions Acknowledgement References 7/9/2024 2

3. Introduction " Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity“ (WHO,1948) Community is defined as a collection of people who interact with one another and whose common interest or characteristics gives them a sense of unity and belonging (Goodman et al, 2014) Community problems : are issues that society perceives as being common problem faced by their community and impeding its ability to function at a precise level (Wechsler & Weitzman, 1996) 7/9/2024 3

4. Conti……….. Community Based Education (CBE) is a means of training graduates who will be responsive to the society’s needs (Jimma University, 2023) CBE strategies should be designed in such ways that they related what students are taught in the class room to what is going on in the real life environment CBE the balance between varieties of educational setting is encouraged to assist students develop key desired skill to the acceptable level Approach of education is also known as ‘study service’ (Jimma University,2023) 7/9/2024 4

5. Conti……….. Community-based education (CBE) has four strategies :- Team Training Program (TTP) Student research program (SRP) Developmental Team Training Program (DTTP) Community-based training program CBTP:- Implemented in all undergraduate programs of the university in n-1 formula where n represents the duration of the program in years 7/9/2024 5

6. Conti……….. It is an integrated institutional program which is designed to train health science students To apply the theoretical knowledge into a practical application Role in preventing disease and injury, improving health and enhancing the quality of life 7/9/2024 6

7. S ignificance of the CBTP To teach the students, team spirit and problem solving ability To make them familiar to the community problem Helpful for governmental organizations as well as NGO of health plan Serve as a starting point for more research 7/9/2024 7

8. Strategy for CBTP Brief and summarized introduction was given by our supervisors Draft report was given to respective supervisors, corrections and comments were provided The data was collected from selected households by using written questionnaire vs obsrvation After all, we identified lists of problems and prioritize those identified problems based on prioritization criteria 7/9/2024 8

9. Objectives General Objective To assess community health and health related problems in amanen kebele ketena 01 and 03, Bench Sheko Zone, Southwest, Ethiopia, 2024 7/9/2024 9

10. Specific Objectives To assess environmental health condition To assess maternal health status To assess child health status. To intervene community health related problems To investigate status of communicable disease such as malaria To explore water supply among house holds To explore housing condition among house holds 7/9/2024 10

11. Materials and Methods Study Area and Period CBTP was conducted in aman kebele ketena 01 and 03 It was conducted from 17/10/2016 to 17/11/2016 7/9/2024 11 Figure 1 :Map of aman kebele ketena 01, Bench sheko zone, 2024

12. Cont .......... Study design A community based descriptive cross sectional study was conducted Sources population All households in aman kebele ketena 01 and 03 Study subjects Selected households which are found in ketena 01 and 03 in aman kebele 7/9/2024 12

13. Eligibility criteria Inclusion criteria Households who lived more than six months and Greater than 18 year olds age Exclusion criteria Individuals with severe illnesses lessthan 18 year olds age 7/9/2024 13

14. Sample size determination Sample size was determined by applying single population proportion formula = =384 Where n=sample size, Zα/2 = 1.96 standard scores corresponding at 95%CI, d=level margin of error to be tolerated (5%), p = proportion of any health and health related problems   7/9/2024 14

15. Cont........ nf= the required sample size when the target population less than 10,000 nf = n/1+n/N nf= 384/1+384/4210 nf = 352 Therefore, in this study the total sample size were 352, but due to time constraint and resource limitation our sample was fixed to 116 households 7/9/2024 15

16. Sampling Technique By using systematic sampling method Using N=4210 and n=352 K=N/n = 4210/352 = 12 Then we selected one HHs from the first 12 HHs by simple random sampling method Where , N=total number of HHs in ketena 01 and 03 n=sample size, K= Interval between HHs 7/9/2024 16

17. Cont....... 7/9/2024 17 Figure 2 : Schematic presentation for sampling technique and sampling procedures

18. 7/9/2024 18 Study variables Health and health related problems Hygiene and sanitation problems Housing condition Water supply Waste disposal Major communicable disease

19. 7/9/2024 19 Data collection tools The data collection tools was prepared by mizan aman health science college The data were collected by 2nd year nursing students of group one members Data collection Methods Face to face interview Observational method by using structured interviewer administered questionnaire and observation

20. Operational definitions Income - the amount of money or its equivalent relieves during a period and exchange of labor or service Household : A family or other group of people who live together in the same home and share a roof over their heads Good ventilation - The exchange of indoor and outdoor air Pit latrines : A traditional pit latrine consists of just digging the hole and building the higher home Ventilated improved pit (VIP) : has a built-in structure, a spotless floor, a slab cover, and a vent pipe 7/9/2024 20

21. Ethical Consideration CBTP was conducted after support letter was received from Mizan Aman Health Science College Both oral and informed consent were sought from the concerned body The overall information obtained from study participants and their privacy was kept strictly confidential using codes 7/9/2024 21

22. Results Socio-demographic characteristics of study participants Majority sex of population are female 271(51.4)% The most respondents were male 74(64%) The educational status 14(14.65%) of the population are not educated The majority repondents followed secondary education 35(30.17%) The occupational status the farmers occupies the highest percent 37(31.9%), 7/9/2024 22

23. Cont............................... 7/9/2024 23 Table 1: Socio-demographic characteristics of participants in Aman Kebele, 2024 . Variables Category Frequency Percent Sex of respondents Male 74 64 Female 42 36 Total 116 100 Age of respondents 18-29 25 22 30-45 61 53 46-60 23 19 >60 7 6 Total 116 100

24. 7/9/2024 24 Occupational status House wife 15 13 Farmer 37 31.9 Governmental worker 24 20.6 Merchant 21 19 Student 1 1 Unemployed 4 2.4 NGO worker 6 5.17 Daily labor 8 6.89 Cont............

25. 7/9/2024 25 Figure 3: Education status of the respondents in amana kebele, ketene 01 and 03, Bench sheko zone, 2024

26. 7/9/2024 26 Figure 4: Marital status of respondents in amana kebele, ketene 01 and 03, Bench sheko zone, 2024

27. 7/9/2024 27 Sanitation and Environmental conditions All HHs had corrugated iron sheet types of house Majority house status in terms of cleanliness 63(54.4 %) are medium M ost OF HHs (72.4%) get water source from less than 30 minute All Hhs (100 %) have latrine Nearly 62(53.3%) of HHs had p it latrine without slab Around 32(28%) of HHs dispose solid waste disposal in open field The majority HHs burning 44(38%) The most HHs 61(51%) using in pit liquid waste disposal system

28. 7/9/2024 28 Sanitation and Environmental conditions Category Frequency Percent Housing condition   Main material of roof Thatched Corrugated iron sheet 116 100 Floor material Earthen 49 42 Cemented 67 58 Cont............... Table 2: Sanitation and Environmental related characteristics of households in Aman kebele 2024.

29. 7/9/2024 29 Cont....................... Ventilation condition Good 60 51.8 Medium 52 44.8 Poor 4 3.4 Illumination condition Good 47 40.5 Medium 59 50.9 Poor 10 8.6 Presence or absence of kitchen Presence 116 100.0 Absence 0.0 Kitchen site from main house Separated 111 95.6 Not separated 5 4.4

30. 7/9/2024 30 Cont............... HH with arthropod Arthropods and Rodents in the house Presence 57 49.1 Absence 59 50.9 Types of rodents inside home Flea 14 24.5 Mouse 20 35 Bedbug 2 3.5 Flies 21 37 House with domestic animals 30 25.8 House without domestic animals 86 74.2

31. 7/9/2024 31 Cont............. Nearby drinking water source 83 71.5 HH without near drinking water source 33 28.5 Source of drinking water Pipe 90 77.58 Well spring 16 13.8 Un protected well spring 10 8.62 Storage of water at home In Jerrican 114 98.27 In pail 1 0.86 In tanker 1 0.86 Distance of water source from home ≤30 min long 84 72.4 >30 min long 32 28.6 Amount of water use per day <20 L 78 67 ≥20L 38 33  

32. 7/9/2024 32 Cont.......... HH with latrine in CPD 116 100 HH without latrine in CPD Functional latrine 116 100 None functional latrine Type of latrine Water carriage 2 1.7 Pit latrine without slab 62 53.3 Pit latrine with slab 52 45 Latrine with cover 67 58 Latrine without cover 47 42 Latrine with hand washing 52 45 Latrine without hand washing 64 55 Latrine without superstructure 9 8

33. Liquid waste disposal On open filed 42 36 In Pit 61 53 Others 13 11 Solid waste disposal Open field 32 28 Pit 40 34 Burn 44 38 7/9/2024 33 Cont............

34. 7/9/2024 34

35. Communicable and Non-communicable related condition of study participants 7/9/2024 35 Among particpants, 4(3.4 %) were diarrhea and 115(99 %) malaria cases Most of 69(88.5%) respondents reported that they use ITN There were 6(5.14%)cases of non-communicable diseases like HTN, DM and mental illness Most HHs 106(91%)have no chemical spraying

36. Variables Category Frequency Percent Malaria cases in last 1 month Entire family 42 36 Under five 11 10 Other groups of family 62 54 Insecticide chemical sprayed home 10 9 Insecticide chemical unsprayed home 106 91 Frequency of spray Once in the year 6 60 More than once in a year 4 40 ITN having in HH 78 67 ITN not having in HH 38 33 HHs uses ITN 69 88.5 HHs not uses ITN 9 11.5 7/9/2024 36 Table 3: Communicable and Non-communicable related condition of study participants in Aman kebele, 2024.

37. ITN use category All family 21 30 Only father and mother 29 42 Only children 19 28 Frequency of ITN use Always 34 51 Sometime 35 49 ITN utilization     Improper 15 21.7 Proper 13 18.8 Fair 41 59.5 Prevention and control Mechanism Early diagnosis and treatment 28 18.7 Environmental management 70 47 Use ITN 51 34.3 Cont................... .. 7/9/2024 37

38. Maternal and child related issues From this survey, 6(4.3 %) were pregnant women in a study area Majority of the study participants 52(51.4%) followed more than four times visit of ANC and 95 ( 94.1%) experienced health institution based delivery Most of the survey population uses injective and implanon methods. Among child bearing age women, the majority percent accounts TT2 46(39%) and TT3 37(32%) respectively The least TT4 2(2%) and 1(1%) women who are fully vaccinated 7/9/2024 38

39. Lists of identified problems Lack of cover for latrine Poor utilization of hand washing facility near to latrine Poor super structure of latrine High prevalence of malaria Lack of chemical spraying to control mosquito Ignoring ITN due to frequent malaria cases occurrence Lack ITN distribution Poor ventilation of house condition Poor cleanliness of house Lack of knowledge about NCD and CD Low awareness for TT vaccination Lack awareness about long term family planning Early marriage Poor management of solid waste disposal Poor management of liquid waste disposal Shortage of water supply Absence of solid waste storage container 7/9/2024 39

40. S/No Identified problems Magnitude (5) Severity (5) Feasibility (5) Gov’t concern (5) Community concern (5) Total (25) Rank 1 High prevalence of malaria 5 5 4 5 5 24 1 st 2 Presence of mosquito breeding site 5 5 4 4 5 23 2 nd 3 Lack of chemical spraying to control mosquito 5 5 3 5 3 21 3 rd Table 6: Prioritization of identified problems in Aman kebele by CBTP team, 2016 7/9/2024 40

41. Cont………... 4 Poor management of solid waste disposal 4 5 4 3 4 20 4 th 5 Poor utilization of hand washing facility near to latrine 4 5 4 3 3 19 5 th 6 Poor management of liquid waste disposal 4 4 3 3 4 18 6 th 7/9/2024 41

42. 7/9/2024 42 Table 7: Action plan for prioritized of problems in ketena 01 and 3 , 2016 S. no Prioritized Problems Objectives Strategies Activities Resources Responsible body Monitoring and evaluation Indicators Time frame 1.  High prevalence of malaria   To reduce the prevalence of malaria in ketena 01 and 03 by 5% Creation of awareness about proper utilization of ITN , Early diagnosis and treatments Mobilization of community Env’tal cleaning like discharging stagnant water Health education Participating community Human power Students Stakeholders , HEWs Community Inspection of stagnant water Reduction of malaria case     June/29/2016-July /17/2016E.C 2 Presence of mosquito breeding site To reduce mosquito breeding site Community mobilization Sanitation campaign Health education Env’tal cleaning like discharging stagnant water Health education about effect of stagnant H 2 O on mosquito harboring Participating community Human power Digging materials such as shovel, Students Community HEWs Stakeholders Daily inspection Absence of breeding site

43. 7/9/2024 43 3 Lack of chemical spraying to control mosquito To inform kebele and stakeholders administration Mobilizing stakeholders Stakeholder discussion Human power Students Community , HEWs And Stakeholders Daily active participation Chemical spraying to control mosquito June/29/2016-July /17/2016E.C 4 Poor management of solid waste To promote proper solid waste disposal practice from 28% to 35% To teach about proper disposal of solid waste HE about effect solid on health and env’t Campaign, Digging pits Human power Student  Env’tal hygiene Reduction of CD Reduction of vectors Follow up Env’tal hygiene Presence of pit

44. 5 Poor utilization of hand washing facility To increase hand washing facility from 45% to 55% in ketena 01 and 03 Health education Awareness creation Home to home education Preparing HW facility Human power Soap & Water Students Community HEWs Daily inspection Presence of HW facility in latrine June/29/2016-July /17/2016E.C 6 Poor management of liquid waste To teach about proper discharge of liquid waste HE Giving health information, Digging pits Student , house hold  Students. HH, HEWs Cleanness of environment Cleanness of environment 7/9/2024 44

45. 7/9/2024 45 SWOT analysis Strength Weakness    Good communication with adviser    Commitment    Good team sprit    Lack of experience on community diagnosis    Poor time managements   Opportunities Threats    Willingness of political wings such as Aman kebele administration and Health office in solving community helth problems      Malaria epidemic    Shortage of resource    Weather condition  

46. Stake holders 7/9/2024 46

47. 7/9/2024 47 Barriers or problems faced Shortage of resources Rainy weather Language barrier Attempted solutions Use of personal (students) resources Adjusting our self with the local weather condition and we using umbrella Using translations   Problems faced and attempted solutions

48. Acknowledgment First of all, we would like to thanks Mizan Aman health Sciences College, department of nursing for giving us this opportunity Our gratitude also goes to our advisors Mr. Tadele Shiwito and Mr. Yohannis Feyissa , who spent their time for sharing their skills and knowledge & giving technical support for our study Lastly , we would like to thanks Mizan Aman kebele administration health office, Aman Kebele administration, and residents for their cooperation 7/9/2024 48

49. References Abanyie , S. K., Amuah , E. E. Y., Douti , N. B., Antwi , M. N., Fei-Baffoe , B., & Amadu , C. C. (2022). Sanitation and waste management practices and possible implications on groundwater quality in peri‑urban areas, Doba and Nayagenia , northeastern Ghana. Environmental Challenges, 8(December 2021), 100546. https://doi.org/10.1016/j.envc.2022.100546 Bircher J, Kuruvilla S. Defining health by addressing individual, social, and environmental determinants: New opportunities for health care and public health. J Public Health Policy 2014;35:363–86. Cairncross S, O’Neill D, McCoy A, Sethi D. HEALTH, ENVIRONMENT AND THE BURDEN OF DISEASE; A GUIDANCE NOTE. DFID 2003. CSA . ETHIOPIA: Demographic and Health Survey 2016. vol. Volume 8. 2017. Goodman RA, Bunnell R, Posner SF. What is “community health”? Examining the meaning of an evolving field in public health. Prev Med ( Baltim ) 2014;67:S58–61. https://doi.org/10.1016/j.ypmed.2014.07.028. 7/9/2024 49

50. THANK YOU! 7/9/2024 50