TITTLE; ASSESSMET OF HEALTH AND HEALTH RELATED PROBLEMS IN KETENA 03 ,

WOREDA 02, ASSOSA TOWN.

A COMMUNITY BASED TRAINING PROGRAM RESEARCH TO BE SUBMMITED TO MCM DEPARTMENT OF

PUBLIC HEALTH

WORKED BY;
1. TEWACHEW ABEBE
2. BIKILA ABEBE
3. TAMIRU DAGNEW
4. MULUALEM ASSGIE
5. ZINASH ETANA
6. MISRAK DESTAW
7. BINIAM TAMIRAT
8. ISRAEL YEMANE

SUPERVISOR ABNET .K [BSc]

SUBMITED TO MCM

ASSOSA, ETHIOPIA JAN 2022

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2
Acknowledgement
We would like to express our deepest gratitude and thanks to people who have helped with the
whole process of our CBTP course and mainly in our data collection process. In particular, all
Assosa town Ketena 03 residents for their good hospitality and kind support for our mission,we
would like to thank Ketena 3 administration who gave as their valuable time for providing us
with all necessary data and support in guiding locations. And our supervisor Mr.Abnet

Contents
3
Acknowledgement.......................................................................................................................2
Abstract..........................................................................................................................................3
Acronym.........................................................................................................................................v
CHAPTER ONE: Introduction....................................................................................................6
1.1 Background Information........................................................................................................6
1.2 STATEMENT OF THE PROBLEM.....................................................................................3
CHAPTER TWO: SIGNIFICANCE OF CBTP..............................................................................5
CHAPTER THREE: OBJECTIVE..................................................................................................6
General objective:........................................................................................................................6
Specific objectives:......................................................................................................................6
CHAPTER FOUR: METHODOLGY AND MATERIALS......................................................7
4.1 Study area and period.............................................................................................................7
4.2 Study design...........................................................................................................................7
4.3 Population..............................................................................................................................7
4.3.1Source population.............................................................................................................7
4.3.2Study population...............................................................................................................7
4.4 Inclusion and Exclusion criteria.............................................................................................7
4.4.1. Inclusion criteria:............................................................................................................7
4.4.2. Exclusion criteria:...........................................................................................................7
4.5 Sample size determination and sampling technique..............................................................7
4.5.1 Sample size determination...............................................................................................7
4.5.2 Sampling technique.........................................................................................................8
4.6 Study Variables....................................................................................................................10
4.6.1. Dependent Variables....................................................................................................10
4.6.2. Independent Variables..................................................................................................10
4.7 Operational definition:.........................................................................................................10
4.8. Data collection Tool:...........................................................................................................10
4.9. Data collection Procedure:..................................................................................................10
4.10. Data quality assurance:.....................................................................................................10
4.11. Data processing and analyzing:.........................................................................................11
4.12. Ethical consideration:........................................................................................................11

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 4.13. Dissemination of results....................................................................................................11
CHAPTER FIVE: RESULTS AND DISCUSSION......................................................................12

ACCRONYMS/ABRIVATION
CBE- Community based education

CBTP- community based training program

AIDS…………Acquired Immune Deficiency Syndrome

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 ANC……….Ante Natal Care

EBF…………Exclusive Breast Feeding

EDHS………Ethiopian demographic health surveying

FP……………Family Planning

HH……………House Holds

MCH………..Maternal and Child Health

ORS………..Oral Rehydration Solution

TBA……….Traditional Birth Attendant

TTBA……….ained Traditional Birth Attendant

DHS-Ethiopia Demographic and Health survey

Abstract
Background: Community based education is a way of succession of educational relevance to the
needs and wants of the community. It was inaugurated to the world in the late 1970s to achieve a
popular need and demand that education should render service to communities. Health and health
related problems are worsening globally. The problems are more prevalent in developing nations
as compared to the developed countries. Community based training program (CBTP) is study
program it includes teachers and other collaborating sector which enable to extract and the
possible intervention of community health related problems such as; maternal and child health
problem, nutritional and general socio-demographics .
Objective: To identify major health and health related conditions and problems in Assosa town
residents through community diagnosis by third year public health students January 2014 E.C.
Methods: A community based cross-sectional study was conducted to identify health and health
related problems in Assosa town Ketena 3, western Ethiopia from January 19-27, 2014. The
systematic random sampling is used to get sample household from total households. Sample
fraction (k=16). Data was analyzed and descriptive frequency with respective percentage was
used to present findings by using tables, charts and diagrams accordingly.

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Result: The mean family size of the households of the ketena is 6 members/household which is
greater than the regional mean family size (4.9 member/ household).

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CHAPTER 1: INTRODUCTION
1.1Back ground
Health is the core and determinant thing for the life of human being. Nothing great can be done
if there is no well-being in universe. However, the world is facing enormous health and health
related problems. The situation in African countries, especially in sub-Saharan countries is still
huge and worsening.[1]

Community based training program is the study that involves student, community, teachers and
other collaborating sectors, it also it allows students to combine service in the community with
academic inquiry transits students over time question of the real settings. CBTP is one of the
components of CBE. It was started in late 1970s G.C and Jimma University was the first to
adopt it in Ethiopia. [1].

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1.2 STATEMENT OF THE PROBLEM
Health and health related problems are worsening globally. The problems are more prevalent in
developing nations as compared to the developed countries. For instance water and sanitation is
one of the primary drivers of public health. Once we can secure access to clean water and
adequate sanitation for all people. For example 1.8 million people die every year from diarrheal
disease, 90% are under 5 mostly in developing countries. 88% of diarrheal diseases are attributed
to unsafe water supply, inadequate sanitation and hygiene. Poor water supply and poor sanitation
increase diarrheal morbidity by 21%, 37.5% respectively. (1)
Better management of water resource reduce transmission of malaria and other vector borne
disease. For instance 1.2 million people die of malaria each year, 90% of whom are children
under 5. There are 396 episodes of malaria every year, most of the disease burden is in sub
Saharan African countries. When we come to see access to water supply and sanitation, in 2000,
2.4 billion people lacked access to improved sanitation. 81% of these were in rural areas.
Similarly 1.1 billion people lacked access to improved water source. (1)
When we come to see the urge of family planning in Asia, Latin America and Caribbean
countries with relatively high prevalence of contraceptive, the level of unmet need are 10.9% and
10.4% respectively. In Africa 23.2% of women of reproductive age have unmet need of modern
contraceptive. (2)
It has been estimated that every minute 8 under five child die in sub-Sahara Africa of the 46
countries in the African region, 36 have under five mortality rate of 100 per 1000 live births. 2/3
of under-five death in the African region due to preventable causes. (3)
The median under five case fatality rate for SAM typically ranges from 30% to 50%. The current
global figures of SAM burden produced by WHO, UNICEF and World Bank(2013) estimate
that 17.6 million children could be classified with SAM at any point in time.(4)
Since Ethiopia is one of developing nations these problem also exist here. To start up from some
physical characteristics of households, the environment is important determinant of health status
of house hold members, especially children. Among those services increasing access to improved
drinking water is one of millennium development. According to 2011 EDHS 11% of rural house
hold have access to drinking water from protected spring and 8% have access to drinking water
from protected well. Similarly the number of population using no water treatment is 90.2%.
These data show the prevalence of water born disease is extremely high. For example, according
to 2011 EDHS 13% of children less than five years were reported to have had diarrhea. (5)
When we compare the contraceptive prevalence rate for all Ethiopian age 15-49 is 20%. This
shows that how a prevalence rate of STI and other STDs like HIV and increasing number of
population. According to 2011 EDHS 10% of birth in Ethiopia are delivered at health facility,
9% in public facility and 1% in private facility. That means 9 women in every ten delivery at
home. Especially in SNNPR percentage of births delivered in health institution is less than 10%.
In order to overcome these and other health related problem, different interventions have been
implemented. Among these CBTP is believed to contribute for the achievement of intervention
mechanism. (5)

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1.3 Significant of the study
Since CBTP assesses all health and heath related problems, it contributes a par amount of roles
in the community, especially to Assosa town Ketena 3 woreda 2 in the process of identifying and
addressing the community Health problems. It also provides a base line data for governmental
organization that interest to intervene in the community problem as well as finding out the
possible solution for the prominent problem of the society. It also provides a good knowledge for
us to identify, intervene and solve the community health and health related problems, not only
but also provide important skill and knowledge to write graduation research proposal and
research report.

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CHAPTER 2: LITERATURE REVIEW
The crude birth rate in Ethiopia is 34.5 births per 1,000 population. As is the case with other
fertility measures, there is a substantial differential in the CBR by urban-rural residence. The
CBR is 37 percent higher in rural areas (36 per 1,000 population) than in urban areas (26 per
1,000 population). The GFR in Ethiopia is 161 live births per 1,000 women of reproductive age.
The rate is considerably higher in rural areas (184) than in urban areas (89) [1].

Just 34% of Ethiopian women receive some antenatal care from skilled providers. Most
commonly from a nurse or midwife(28%) only 11% of women’s had an ANC visit before their
fourth month of pregnancy as recommended and 19% receive the recommended four or more
ANC visit,17% of women took iron supplement during pregnancy, 6% took intestinal parasite
drug. One in five women informed of sign of pregnant complication during ANC follow up. Less
than half 48% of women most recent birth were protected against neonatal tetanus (EDHS 2011).
10% of birth occurs in health facility, primary in public sector facility. Home birth are almost
twice as common as rural area(95%) as in urban area(50%) one in 10 births are assisted by
traditional birth attendant and 57% by untrained relative or friends. postnatal care helps to
prevent complication after child birth. Just 7% of women received postnatal checkup within two
days of delivery. The vast majority (92%) women do not have postnatal checkup (EDHS 2011).

The 2011 EDHS asked women about death of their sister to determine maternal mortality, death
associated with pregnant and child bearing. The maternal mortality ratio for Ethiopia is 676 per
100,000 live births. Immunization coverage is one of the indicators used to monitor progress
towards the achievement of MDG and the reduction of child morbidity and mortality, as it is one
of the most cost-effective public health interventions for reaching these goals. In Ethiopia
overall, 24% of children age 12-23 months were fully vaccinated at the time of the surveys for
coverage for specific vaccines, 66% of children had received the BCG vaccine, and 56% had
received the measles vaccine. A relatively high percentage of children received the first DPT
dose (64%). However, only 37% went on to receive the third dose of DPT reflecting a dropout
rate of 43%. More than eight children of every ten (82%) received the first dose of polio, but
only about four in ten (44%) received the third dose, reflecting a dropout rate of 46%. Even
though DPT and polio vaccines are often routinely administered at the same time, polio coverage

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is higher than DPT coverage. This is primarily due to the success of the national immunization
day campaigns, during which polio vaccines are administered [1].

In the two years before the survey shows 7% children under 5 was ill with cough and fast
breathing symptom of an acute respiratory infection (ARI) of those children 27% was taken to
health facility and 13% of Ethiopian children under age 5 had diarrhea. This rate was highest
(25%) among children 6-11 month old, 32% of children with diarrhea was taken to health facility
4 in 10 children with diarrhea were treated by oral rehydration solution(ORS) according to 2011
EDHS the vaccine coverage in BG was 24%.

Breast feeding is common in Ethiopia with 98% of children ever breast fed. Over half of children
(52%) of children under 6 month in Ethiopia are exclusive breast feed and 10% of infant under 6
month receive complimentary food. On average children breast feed until age of 25 month and
are exclusive breast feed (EBF) for 2.3 month. The EDHS measures the children nutritional
status by comparing height and weight measurement against an international reference standard.
According 2011 EDHS 44% of children under 5 are stunted or too short for their age. Stunting is
most common in children aged 24-35 month and is least common among children of more
educated mother and wealthier families. 29% of Ethiopian children are under weight of too thin
for their age, 44% of children are stunted in BG.

According to 2011 EDHS 27% of Ethiopian women are overweight (obese). Women living in
rural area are more likely to be thin than living in urban area (29% versus 20%). Less than 1% of
women took iron tabulate for at list 90 days during their last pregnancy.

According to 2011 EDHS 43% of women and 64% of men know that the risk of HIV infection
can be reduced by using condom and limiting sex to one faithful uninfected partner; 42% of
women and 47% of men know that it can be transmitted by breast feeding and the risk of mother
to child transmission can be reduced by taking drug during pregnancy. Less than 1% women and
1% men aged 15-49 report that they had sex with two or more partner in the past 12 months,
from this 6% of them use condom at their last sexual intercourse. Currently 36% of women’s and
38.5 f men’s have ever been tested and received their last result. 20% of women and 21% men
have been tested for HIV and received their result in the 12 months before the survey. One in the

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five pregnant women in the 2 years before the survey where tested for HIV. During ANC and
received their result. Testing HIV during ANC is more in urban area (6%) than rural area (14%).
According to EDHS 2001 HIV testing of over 15,000 women age 15-49 year and over 13,000
thousands men age 52-59, 89% of women and 82% men agree to be tested for HIV. 1.5% of
women and men age 15-49 are HIV positive compared 1.4% in 2005 EDHS. Currently HIV
prevalence is 1.9% f0r men.

HIV prevalence in BG is 0.9% less than 1% of never married women and men are HIV positive
compared with 12% widowed women and 1&5% widowed men. HIV prevalence is also higher
among women and men who are divorced or separated.

Knowledge of family planning in Ethiopia is nearly universal, 97% of all women and 98% of all
men aged 15-49 knows at least one method of family planning. More than one in four married
women’s (27%) currently use modern methods of family planning. Public sources such as health
center and governmental health post currently provide contraceptive to 5% of current use. The
private medical center supplies contraceptive to 13% of user’s. Condoms are most commonly
obtained at shops (51%) while most other methods are obtained at governmental health center.
Family planning users has almost doubled since 2005, when only 14% of married women were
using modern method. This is primarily due to a continued increase in the use of injectable in
BG. Currently 25% of married women aged 15-49 who are using modern method of FP.

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CHAPTER THREE: OBJECTIVE
3.1General objective:
To assess major health and health related conditions and problems in Assosa town woreda 2
Ketena 3, Assosa town, BG from January 19-27, 2014 E.C.

3.2 Specific objective

 To describe the Socio- demographic condition of population
 To identify health and health problems of Ketena 03
 To prioterize identified problems
 To develop an action plan for prioterized

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 .

CHAPTER FOUR: METHODOLGY AND MATERIALS

4.1 Study area
The study was conducted in ketena 3, from January 19-30, 2014E.C

Fig 1 map of assosa woreda 02 ketna 03

4.3 Study design
Community based cross sectional study were applied fromJanuary19-26, 2014 E.C.

4.4 Population
4.4.1 Source population
All house hold of Ketena 03

4.4.2 Study population

Our study population was selected households in woreda 2 Ketena 3

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4.5 Inclusion and Exclusion criteria
4.5.1. Inclusion criteria:
All households who lives in woreda 2 Ketena 3 for more than 06 months

4.5.2. Exclusion criteria:

 Who refuse the interview
 Close households
 Who can’t response (language barrier)
4.6 Sample size determination and sampling technique
4.6.1 Sample size determination
The sample size was calculated by using a single population proportion sample size calculation
formula (n = [Zα/2]2 p (1-p)/d2) considering the following assumptions:

Where,

P =50% (assuming proportion of respondents who are suffering with health related problems.)
d=marginal error of 5%=0.005.

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

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

n=Z2*pq/d2

= (1.96)2*0.5*0.5/ (0.005)2

= 384

This yields a sample size of 384. Since the source population is less than 10,000, an adjustment
formula

Where,

N = Source population 268- all ketene 3residents in the study period

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

nf=n/1+n/N

=384/1+384/1552=308

Although, our sample was 308 we took only 108 which was given by our supervisor due to
shortage of time and cost.

4.5.2 Sampling technique and procedures

Systematic random sampling was used to get sampled households from the total households.
Using sampling fraction (K=14).Before entering to data collection we applied survey of the
Ketena to get the sampling frame. After getting the sampling frame the first house was obtained
by lottery method then we appliedsystematicrandomsampling method to get each household.

4.6 Study Variables

4.6.1. Dependent Variables:
 Place of delivery
 Utilization of ANC
 Knowledge of ANC
 Utilization of family planning
 Knowledge of family planning
 Breast feeding duration
 Nutritional status

4.6.2. Independent Variables:

 Sex
 Age
 Ethnicity
 Religion
 Source of information
 Family income
 Education status
 Occupational status
 Family size

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4.7 Operational definition:
Health related problems: The problem that arises and affect the community.

Adequate: Reproductive aged Women get at least two health services from health institution
which is near to the society such as (family planning services, antenatal care services, postpartum
care services, TT and child immunization, testing and counseling about HIV and like)

Inadequate: getting one or none of the health servicessuch as (family planning services,
antenatal care services, postpartum care services, TT and child immunization, testing and
counseling about HIV and like

Monthly income-done based on Ethiopian government employer monthly salary

standard and this is calculated by changing their item of production in to money
according to current market price.
Ventilation:
 Good - a house which has one or more windows for room which are
functional.
 Fair-a house in which has one window but function partially
 Bad - no window or closed all the time /non functional.
Illumination
 Good – a house in which lead/pencil written materials can be read by
natural light.
 Fair-a house in which ink written materials can be read by natural light.
 Bad-ink written material is illegible
Need of maintenance
 Good-no sign of deterioration and the house is erect.
 Fair-sign of deterioration but erect.
 Bad –deteriorated and not erect.
Stakeholders: are individuals who are accepted as well as respected in the community
like religious leaders, administrative bodies, and elders.

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4.8. Data collection Tool:
Data were collected using semi-structured and an interviewer guided questionnaire and including
observation to identify health and health related problems among residents of Ketena 03.The
instrument was prepared in English and translated in to Amharic. The instruments comprise
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.

4.8.1 Material used

 Questioner
 Pencil
 Sharpener
 Pen
 Chalk
 Ruler
 Calculator
 Papers
 Laptop

4.9. Data collection Procedure:

The data was collected by team members having standardized and structured questioner, team
members used interview, guided questioners and observational technique to gather information
from the community of Ketena 03.

4.10. Data quality assurance:

To keep quality of data, the team members discussed on each and every items of the
questionnaires. Selection of households during sampling was tried to keep randomization.
During data collection supervision by assigned supervisor was undertaken in order to solve any
problem that mightarise during data collection. After data collection data was seen for
completeness and edited before it is being tallied.

4.11. Data processing and analyzing:

The completed questionnaires were checked for completeness and consistency. Data cleaning
was performed to check for accuracy, and consistencies starting from the day of data collection.
Data analysis was performed using descriptive statistics and frequency tables (Dummy table,

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tally, organize, and categorize) after cleaning, editing, and coding. The highest problem is
identified by ranking the higher percentage as due consideration and considering descriptive
statistics.Data will be analyzed by group members, by preparing tally sheet, converting it to
frequency then to percentage, scientific calculator and word Excel were also used to analyze and
draw graphs.

4.12. Ethical consideration:

For legality of the study, official letter was secured from MCM which can clarify the study
purpose to concerned authorities. Respondents were introduced about the study by data
collectors before they were recruited in the study. Informed consent was sought before clients are
assured to participation in the study. During data collection privacy of respondents was kept to
possible extent to prevent any assumption of respondents that his/her privacy is being violated.

4.13. Dissemination of results

This CBTP work will be presented using PowerPoint and every interested people will be invited
on presentation. Also the document will be submitted to MCM department of public health and
Ketena03 administration and health office of the Assosa town.

CHAPTER FIVE: RESULTS AND DISCUSSION

5.1 Socio-Demographic characteristics:
The study was conducted on 108 HHs and 92.4 %(100) was the response rate. The reason for
none response were closed houses during three visit [4], language barrier [3] and due to refusal
[1]. There are 538 people in our sampled households, from the sampled households (255) 47.4%
were males, (283) 52.6% were females. Out of 538 households population (47) 8.7% were under
five age, (195) 36.2% were aged 5-14, (247) 45.9% were age 15-59, (21) 15.12% were age>50.
Table 1 Socio- Demographic characteristics of households of Assosa town woreda 2 Ketena 3
Assosa town, western Ethiopia, 2014
Variables Options No % Remark
Sex Male 255 47.4
Female 283 52.6

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 Total 583 100
Age <1m 3 0.56
<1yr 25 4.6
<5yr 47 8.7
5-14yr 195 36.2
122 22.7
Male
15-49yr
female 125 23.2
>50yr 21 3.9
Ethnicity Amhara 42 42
Oromo 32 32
Shinasha 8 8
Berta 9 9
Others 9 9
Religion Orthodox 45 45
Protestant 20 20
Muslim 34 30
Others 5 5
Education status Can’t read and write 20 20
Can read only 22 22
Primary 23 23
Secondary and above 35 35
Marital status Married 78 78
Single 9 9
Divorced 8 8
Widowed 5 5
Occ Farmer 0 0
upational status House wife’s 33 33
Students 15 15
Government employer 22 22

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 Merchants 13 13
Tella seller 7 7
Carpenter 0 0
Unemployed 0 0
Others 10 10

5.2 Means of communication

Among 100 households, the majority of 49 (49 %) of the sampled households tend to possess TV
while20(43.75%) tend to possess radio.

Chart Title
100 88

49

20
Axis Title

10
6

1
Radio TV Mobile Telephone Newspaper
Axis Title

Figure 2: that shows means communication in Ketena 3

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5.3 Family incomes
Among 100 households 5(5%) households earn less than 4000 birr in a year, and 8(8%) households earn
between the intervals 4000 and 8000 and 87(87%) households family have annual income above 8000
Birr.

A nnualy Fam ily incomes

100

90 87

80

70

60

50

40

30

20

10 8
5
0
<4000 Birr 4000-8000 Birr >8000 Birr

Fig 03 annual income of the households in Ketena 03.

5.4 Vital statistics

5.4.1Child Birth
Among 100 HHs, there was birth in 28(28%) HHs in the last 12 months from which 12 (42.85%)
and 16(57.14%) of them were male and female live birth respectively.

Among total of 28 births, 96.428 %( 27) and 3.57% (1) of women gave birth at HI and home
respectively from which 3.57 %( 1) and 96.42 %( 27) were attended by TTBAs and professionals
respectively.

Table 2: Child birth status among households of Ketena 03woreda 2, Assosa zone, western
Ethiopia 2014

Variables Options Number % Remark

Was thereBirthin Yes 28 28
the last 12 months? No 72 72
Status of the birth Alive 28 100

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 dead 0 0

Sex of the new born Male 12 42.85

Female 16 57.14
Place of delivery Home 1 3.57
HI 27 96.428
Attendant of the TTBA 1 3.57
delivery HP 27 96.428

Attendant of birth
TBA; 3.57

HP; 96.428

Figure 04 shows birth attendant in Ketena03

5.4.2 DEATH
Out of 100 households, there was death in 5 (5%) households. From total of 3 death, 60 %) were
males and 40% (2) were females.

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Table 03 that shows death occurrences among HHs in the last 12 months of Ketena 3, woreda2
Assosa town, western Ethiopia, 2014 E.C

Death Options Number % Remark

Yes 5 5
No 95 95
Sex at Male 3 60
death Female 2 40

Age at <5years 2 40
death 5-14years 0 0
15-49years 2 40
>50 years 1 20

5.4.3 Morbidity
From among 100 HHs studied, there were morbidity in 22 (22%) HHs in the last two weeks;
among those 14(63.6 %) and 8(46.4%) were male and female respectively. According to the
study at age group who faced morbidity were age group of 15-49, (52.63 %).

Tables 4 that show morbidity in HH

Variables Options Number % Remark

Morbidity Yes 22 22
No 78 78

Sex of sick M 14 63.6

F 8 46.4

Age <5year 5 22.7

5-14 4 18.18
15-49 10 45.45

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 >50 3 13.6

Ailments Fever 8 36.36

Diarrhea 4 18. 18
Cough 7 31.8
Other 3 13.6
Days lost <7days 13 59.1
7-14days 9 40.9

Seek help? Yes 15 68.2

No 7 31.8
HI 15 68.2
Seek help where? Traditional 3 13.6
Home 4 18.18

5.4.4 Reproductive history of respondent

Variables Option Number % Remark

Conceived in past Yes 88 88

No 12 12

Age at first 15-24 62 62

pregnancy
25-34 38 38

Number of gravidity One 22 25

Two 24 27.3

Three and above 42 47.7

Is the last pregnancy Yes 80 90.9

is planned
No 8 9.1

Did you give birth in Yes 85 96.6

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a past No 3 3.4

Number of child One 20 22.7

Two 23 26.1

Three and above 42 47.7

None 3 3.4
Number of alive Zero 3 3.4
child
One 20 22.7

Two 23 26.1

Three and above 42 47.7

Still birth Yes 2 2.3
No 86 97.7
Hear about breast Yes 72 72
cancer
No 28 28

Did you know about Yes 32 44.44

breast cancer
prevention
No 40 65.6

Did you hear about Yes 82 82

cervical cancer
No 18 18

Did you know risk Unsafe sexual 19 21.5

factors for cervical intercourse
CA
Multiple sexual 24 29.3
partner
Other 39 47.6
Did you now Yes 60 73.2
screening test for
cervical cancer No 22 26.8

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Tables05 that shows reproductive history of respondents

5.4.5 Family planning

Among 100 households,(89) 89% households know about family planning and
(11) 11% households do not know about family planning.

Tables07 that shows FP trends of respondents in the Ketena 03

Variable Options No % Remark

Hear about Yes 89 89
family planning No 11 11
method
Source of Health care Provider 60 67.4
information

Mass media 18 20.22

Friends 9 10.1
Other/ specify 0 0
Not know where they 2 2.24
hear
Knowing type of Pills(COC tablet 43 48.3
family planning
method Depot 20 22.5
Implant 9 10.11
Condom 2 2.25
IUCD 6 6.7
Other 9 10.11

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 Women using Yes 80 80
currently No 20 20
contraceptive
Family planning Pills 38 42.7
method they are Depot/injectable 18 22.5
currently using Implant 9 11.25
Condom 2 2.5
IUCD 4 5
Other 9 11.25
Where do you Health facility 75 93.75
get from
Private clinic 5 6.25

5.4.6 Nutritional assessment

From the total of 100 HHs, in all sampled HHsInjera is used as staple food. Out of 100 HHs,
Bread 95 %( 95). Majority of HHs, 82 % (82) eat three times daily and in all HHs there was no
death due to lack of food.

Table 8 that show HHSnutrition in the last 12 months ofKetena 3, woreda2 Assosa zone,
western Ethiopia, 2014

Variables Options Number %

Staple food Injera 100 100
Bread 95 95
Vegetables and fruits 88 88
Other 30 30
Do you get diary Yes 80 80
food No 20 20
Do you get Yes 100 100
carbohydrate No 0 0
Daily number of One times 0 0
meal Two tines 8 8

29
 Three times 82 82
Four times 6 6

Other 4 4

Death due to lack of Yes 0 0

food No 100 100

5.4.6.2Child nutrition
Among the total of 88 HHs, 85(96.6%) had breast fed the child. 82(93.18%) and 3 (3.4%) were
the child which received and not received supplementary food in breast feed child respectively.

Table 09: Child nutrition in of Ketena 3, woreda2 Assosa zone, western Ethiopia, 2014

Variables Options No % Remark

Breast feed the child Yes 85 96.6
No 3 3.4
Child receive Yes 82 93.18
supplementary food No 6 6.82
Age at which they <4 months 4 4.9
start supplementary 4-6 months 56 68.3
feeding 7-12 months 13 15.9
After 12 months 7 8.54
Duration the keep on <6 months 9 10.9
breast feeding 6-12 months 66 77.64
>12 months 8 9.4
Others 4 4.7
Frequency they When the child want 65 24.3
breast feed Greater than 8 times 20 32.43
Combination of food Food made of cereal only 2 2.44
they use to feed Milk alone 10 12.2
child Milk and cereal combined 70 85.4

30
5.4.7 Environmental health survey
5.4.7 .1 Waste disposal
Among 100 HHs, for almost all HHs major source of waste was domestic, 25(25%) had scheduled
program to collect.

Table2: waste disposal characteristics of households of Ketena 03 in woreda 02, Assosa town, western
Ethiopia, 2014

Variables Options No % Remark

(n=100HH)
Source of waste Residential 95 95
Commercial 5 5
Schedule program to collect waste Yes 25 25
No 75 75
Disposal method Composting 5 5
Burning 45 45
Open dumping 42 42
Sanitary 8 8
Total 100 100
Presence of latrine Yes 88 88
No 12 12
Total 100 100
Distance of latrine from the house <10m 45 51.13
11-15m 25 28.4
>15 10 11.4
Total 88 88
Ownership status of the latrine Owned 24 24
Shared 64 64
Total 88 88
For non-latrine users(n=7) Yes 12 80

31
 Availability of adequate space No 3 20
for construction
Total 15 100
Affordability of latrine Yes 3 25
construction
No 9 75
Total 12 100
Waste disposal system of latrine Closed 59 100

5.4.8 .2 Water supply

From 100 HHs, 300(98.36%) of them got their water supply from tap water and 5(1.64) got their
water supply from stream. From tap water users no one employ any method of water
purification, from stream water users only 1(20%) employ traditional filtration methods of water
purification and 4(80%) didn’t employ any method of water purification of the total 59% HHs
consumed 20-40 and 41% consumed more than 40 liter per day.

Table3: Water supply of ketene 3 households in wereda 2, Assosa zone, Wastern Ethiopia, 2014.
Variables Options No % Remark
Source of water supply Tap 95 95
stream 5 5
total 100 100
Water purification Yes 1 1
No 99 99
Total 100 100
If yes (n=1)method of Traditional 1 100
water purification filtration
Total 1 100
Daily water consumption 20-40lit 65 65
per litter per HHs
>40 35 35
Total 100 100

Food sanitation

32
Among 100HHs, all HHs responded as they were practicing washing hands, washing vegetables,
proper and adequate cooking, frequently cleaning and preventing contamination.
Housing conditions
Out of 100 HHs, (30%), (30%) and (45%) house had god ventilated, cleaned and adequately
illuminated house respectively.

Table 4: Housing condition of ketene 3 inworeda 2, Assosa zone, Wastern Ethiopia, 2014.
Variables Option No % Remark
No of rooms 1 50 50
2 30 30
3 20 20
Ventilation Good 30 30
Fair 50 50
Bad 20 20
Illumination Adequate 45 45
Inadequate 55 55
Cleanness Good 30 30
Fair 50 50
Bad 20 20

Type of floor Cement 75 75

Soil 25 25
Crack on the floor Yes 20 26.6
No 55 73.4

33
Presence of Yes 30 30
livestock around the
No 70 70
house
Livestock living Yes 10 33.3
together with
No 20 76.7
humans
Type of kitchen Separated room but attached to 35 35
the living room
Separated kitchen but detached 55 55
to the living room
No kitchen at all 10 10

5.2 DISCUSSION
The total population in this study were 583 and from, those population 255 (43.7%) and
283(46.3%) are males and females respectively.The mean family size of the households is
583/100=5.8members HHs which is greater than the regional mean family size (4.9
member/HH).From 100 HHs members on average270(31.50%) are children age bellow 15yrs
which is less when compared to Ethiopian household consists of an average 46% of the people
are children.12 (3.94%) of the household headed by women which is less when compared to
Ethiopian household 26% are of the house hold headed by women. From people age 7years and
above, 387 (27.49%) can’t read and write from which 231 (59.69%) are females and
156(40.31%) are males; maternal educational status is very low from 297 mothers 204 (68.69%)
cannot read and write, the illiteracy rate is high, when compared to EDHs 2011 shows that 52%
of women and 35% of male have never attended school. this indicates that among people who
can’t read and write females are the dominant sex groups,

On nutritional assessment our finding shows that from 100 HHs, 98 (98.0%) of the mothers had
breastfeed their child whereas EDHs 2011 shows that in Ethiopia 98% of children ever breast

34
 feed. From those 135(91.21%) starts supplementary feeding and from those child who starts
supplementary feeding 22 (16.2%) starts between4-6months this is greater than that of EDHs
2011 shows that 10 % of infant under 6th months’ receive supplementary feeding and the
majority 100(67.56%) of infant under 6th months are feed exclusive breast feeding this is high
when compared to EDHs 2011 shows over half of children (52%) of infant under 6 th months are
feed exclusive breast feeding. Greater than half mothers keeps their children on breast-feeding
greater than 12 months’ and they feed more than 8x a day, whereas EDHs 2011 shows that On
average children Brest feed until age of 25 months.

Our finding on knowledge of FP shows that 90 (90.%) of women know at least one modern FP
methods and which is low when compared to EDHS 2011 founds that in Ethiopia knowledge’s
of FP is nearly universal, 97% of all women age 15-49 knows at least one modern methods of
sFP. The of source their knowledge are health care providers and media this is similar when
compared with EDHs 2011 shows that Health care providers, media and other source of
information increase the awareness of the public about FP methods. Women who use FP
Methods currently accounts (95(58.6%) of women currently utilize modern FP methods which is
high when compared to EDHs 2011 shows that 27% of women currently in Ethiopia use
modern methods of FP.

The finding on ANC service in this study shows that 89(89%) of are visited for ANC which is
high when compared to EDHS 2011 shows that 34% of women receives ANC from skilled
health care providers. 115 (80.4%) of the women tested for HIV during ANC follow up which is
high when compared to EDHS 2011 found that one in five (20%) pregnancy women in the 2 year
before the survey were tested for HIV during ANC visits and receives their results and testing
HIV during ANC is more in urban area.

From women who had given child birth in recent time 1(3.75%) are give birth in home and
attended by TBA, which is more better when compared to EDHS 2011 found that 90% of
pregnant women in Ethiopia delivered at home and attended by TBA.

Table showing Prioritization of identified problems

No Problem Magnitude Severity Feasibility Communit Government Total Rank

35
 y concern concern

1. Home 4 4 5 3 5 21 1
delivery

2. Living 5 5 3 1 2 16 5
together with
livestock

3. Frequency of 3 3 4 3 5 18 4
ANC follow
up

4. Poor access 3 4 1 5 2 15 6
of water

5. Inappropriate 5 5 3 2 5 20 2
time of
starting
supplementar
y feed.

6. Awareness of 4 3 4 3 5 19 3
utilization of
family
planning

7. Poor kitchen 4 5 3 1 1 14 7

8. Rodent 3 2 4 1 1 11 10
infestation

9. Lack of 2 2 4 1 4 13 8
latrine
facility

36
10. Open 3 3 2 2 2 12 9
dumping as
final waste
disposal
method

Prioritized problems

1. Home delivery

2. Inappropriate time of starting supplementary feed

3. Awareness of utilization of family planning

4. Frequency of ANC follow up

5. Living together with livestock

6. Poor access of water

7. Poor kitchen

8. Lack of latrine facility

9. Open dumping as final waste disposal method

10. Rodent infestation

Action plan

No. Prioritized Objectives Activities Strategies Target Responsible

problem population body

1. Home To reduce the Discussing the Teaching All -woreda

delivery prevalence of importance of women of reproductive admin. And

37
 home delivery institutional reproductive age women health office
from 31.18% delivery over age about the of wastaso
-ketena
to 7.78% home importance of
3health
delivery. institutional
center,& head
delivery and
office
the harm of
home 3th year MCM
delivery. HO students

2. Inappropriate To create Health To gather Women of 3th year HO

time of awareness education women reproductive students &
starting among about around health age group Health
supplementar women about supplementary post and especially extension
y feeding appropriate feeding teaching them who have workers
supplementary about children
food initiation supplementar below one.
y feeding

3. Awareness of To increase Creating Giving health All - ketene

utilization of the utilization awareness education to reproductive 3Woreda2
family of family about the all age women’s administration
planning planning from importance of reproductive and men’s.
-health center
55.20% to family age women’s
& health post
86.20%. planning, and men’s.
office
especially
long acting -ketena 3
family woreda 2 head
planning office.
method.

4. Frequency of To increase 4th Discussing the Teaching All pregnant -ketena 3

ANC follow visits by importance of women’s who Woreda 2

38
 up creating completing are child mothers. administration
awareness on FANC. bearing.
- health center
complication
& health post
during ANC
office
follow up.
-
assosaketene3
headoffice.

5. Living To make the Educating the Gathering & All residents -ketena
together with health of the ketene3 Teaching the of ketena 3 3Woreda 2
community community local administration
Livestock
healthy and to about the community
-assosa health
reduce the effects of about the
center &
problems that living together effects of
health post
happened b/c with livestock living together
office
of living with livestock
together with the -assosa ketene
livestock’s. advantages of 3 head office.
constructing a
separate home
for the
livestock’s.

39
Conclusion

From the total population majority of the people 270 (31.50%) is composed of age group below
15 years and the sex ratio of female to male is 1.38. The average family size of the HHs were 5.8
members /households. Majority of people are Amhara and followers of orthodox religion.
Generally based on our study low PNC care utilization, inability to complete all visit of FANC ,
inability to complete all TT vaccination as well as low utilization LAFP method, lack of
awareness on breast cancer and cervical cancer of the, lack of awareness on danger sign new
born and danger sign during pregnancy are the problems encountered in HHs. Therefore, it is
worthy to prioritize and tackle these problems since they have significant effect unless they are
solved as early as possible by collaborating with the concerned bodies.

Problems encountered
 Language barrier
 Absenteeism of HHs
 Shortage of time
 Non punctuality of government workers of the study area

Solutions attempted
 Translator invited
 Revisiting

Recommendations
To government officials

 It is better if, work on improving maternal education, extensive health education on

Maternal and child health
 To establish affordable health service
 To work on eliminate barrier for not using FP method such as fear, side effect and other
 To increase or improve number of visit during ANC
 To increase knowledge concerning safer or preferable place to give birth

40
To MCM

 It is better if;
 To make further investigation in ketene 3
 To work in collaboration with the community.

To the community;

Participating and cooperation in action implemented by administrators by

contributing money, knowledge, and labor.

REFERENCE

1. Ethiopia Demographic and Health Survey 2011 Central Statistical Agency Addis Ababa,
Ethiopia ICF international Calverton, Maryland, USA March 2012

2. Worku Awoke, JemalMuhammed, GedefawAbeje, Institutional Delivery Service

Utilization in Worldia, 2014

3. Gelaw BK, TegegneGT,Bizuye YA, Assessment of Community Health and Health

Related Problems in DebreMarkos Town, East Gojjam, Ethiopia, 2013.

4. http;//sapiens.reves.org/130#.

41
5. Determinants of maternal health care utilization in Holeta town, central Ethiopia Science
Journal of Public Health. Vol. 1, No. 2Kidist Birmeta*, Yohannes
DibabaandDesalegnWoldeyohannes

6. Ethiopia Demographic and Health Survey 2011 Central Statistical Agency Addis Ababa,
Ethiopia ICF international Calverton, Maryland, USA 2014

42