HARAMAYA UNIVERSITY COLLEGE OF HEALTH AND

MEDICAL SCIENCES
DEPARTMENT OF ENVIRONMENTAL HEALTH SCIENCE
PROJECT DEVELOPMENT ON REDUCING PREVALENCE OF
DIARRHOEA AMONG UNDER FIVE CHILDRENS, IN HARAR
TOWN, EASTERN ETHIOPIA, FEBRUARY 2017.

GROUP MEMBERS ID NO

1. TADESSE GETNET 4185/06

2. TEGENU ALEMU 4182/06

3. YILMA TADESSE 4184/06

4. ZERUBABEL MIHRET 4196/06

SUBMITTED TO: YOHANNES M. (BSc, MPH)

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ACKNOWLEDGEMENT
First of all, our deepest and prior gratitude goes to Haramaya University College of health &
Medical science department of Environmental Health for organizing this course (Project
development and management) and also we would like to acknowledge our instructor Yohannes
M. for which he allows us to do on the project development and management course to develop
our skill on project development work practically and for his assistant at every step of our project
proposal writing. Additionally we would like to acknowledge Administrator of Harari people
regional state of health bureau. At the last but not least, we thank all librarians of Haramaya
university collage of health and medical science and environmental health science department
staffs and secretary.

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Contents
ACKNOWLEDGEMENT..................................................................................................................................I
List of Table.................................................................................................................................................II
Cover Letter................................................................................................................................................III
Executive Summary....................................................................................................................................IV
Organizational Information (Introduction)..................................................................................................1
Vision:..........................................................................................................................................................1
Mission:.......................................................................................................................................................1
Motto..........................................................................................................................................................1
Core Values..................................................................................................................................................1
Background..................................................................................................................................................3
Statement of the problem...........................................................................................................................3
Project goal..................................................................................................................................................4
General objective........................................................................................................................................4
Specific Objectives.......................................................................................................................................4
Out put........................................................................................................................................................4
ACTIVITIES...................................................................................................................................................4
Input............................................................................................................................................................7
Monitoring and Evaluation..........................................................................................................................7
Table 1: Work plan......................................................................................................................................9
Table 2: Budget..........................................................................................................................................10
References.................................................................................................................................................10

List of Table
Table 1: Work plan......................................................................................................................................9
Table 2: Budget..........................................................................................................................................10

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Cover Letter
This project proposal cover Letter states a short description on the effective means of reducing
prevalence of diarrhea among under five children and we require any funding agency on the
project to prevent and control the disease. This project proposal estimates or tries to save the
effect of diarrhea on public health.

III
Executive Summary
Diarrheal disease represents a serious global health concern, particularly in low-resource
settings throughout the developing world. Morbidity and mortality rates are highest globally
among children under the age of 5, with millions of preventable deaths occurring each year as a
result. As nearly most of all childhood diarrheal deaths occur in developing countries, there
exists great demand for programs and interventions to combat this pressing public health
challenge. Despite the widespread availability of effective treatment and infrastructure that
prevent the transmission of the disease throughout much of the developed world, low-
income countries such as Ethiopia have not yet benefited from such development.
prevention of childhood morbidity and mortality related to diarrheal disease will be
addressed through improvements in both water quality and increased knowledge regarding
access to appropriate treatment. This project intervention proposal has been designed for harar
town, eastern Ethiopia to decrease prevalence of diarrhea among under five children. The two
components of the intervention are: providing access to clean drinking water at the level of
the water tap (mid-source or point-of-access) and education for mothers with children under
the age of 5 about proper treatment for diarrhea. Each component requires a series of
implementation strategies and activities, as well as rigorous evaluation, in order to ensure the
intervention is both deployed correctly and meets its goals. For the project to taken out it
costs 697,107 birr.

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V
Organizational Information (Introduction)
Haramaya University is the oldest University in Ethiopia. It is located at 510 km east from Addis
Ababa and 5 km from Alemaya town in the Eastern Hararghe Zone, 40 km from Dire Dawa and
16 km from Harar.

Haramaya University ,formerly known as Alemaya Unversity, was established with the intiative
of Emperor Haile Selassie in1954 based on the need for modernizing Ethiopian Agriculture in
particular and Education in general though the establishment of Agricultural college and
training . It is was based on the emperors wish that the colleges found at its current location

Up to the 1963 Oklahoma state university was given the mandate to establish and operate the
college. The university was founded with the help of (Oklahoma State of university), accepting
its first students in 1954 and the new campus was opened in January 1958 by Emperor Haile
selassie.

In the past few years the university has witnessed tremendous expansion in terms of fields of
study and faculties. Haramaya University was promoted from a college with in Addis Ababa
University. For many years the university had been limited to only an Agriculture curriculum,
but in 1996 the university was given permission to open other faculties and departments.

The university currently functioning in three campus premises has twelve (12) colleges three
institutes and 6(six) centers. It offers courses in regular, summer, distance and Continuing
Education .Haramaya University now runs 50 degrees, 50 masters, and 13PHD programs.

Vision: -Haramaya University strives to be one of the leading African universities with
international reputation by 2025.

Mission: - The mission of Haramaya University is to produce competent graduates in diverse

field of study, undertake rigorous, Problem solving and cutting edge researches, Disseminate
knowledge and technologies, and provide demand-driven and transformative community
services.

Motto
The motto of Haramaya University is “Building the Basis for Development”

Core Values
1.Excellence:- a commitment to offer the best education, research and community engagements
; promotion of quality and excellence in staff members through promotion of quality and
excellence in staff members through professional development activities ;promotion of the

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development and wellbeing of each members of the campus community ,which in turn fosters a
strong commitment to the institution.

2. Context Sensitivity:- A strong sense of response to the national and international dynamic
socio economic and biophysical changes preparing students for a technologically changing
world; being adaptive and responsive in developing and delivering programs and services; a
string future orientation and a willingness to make long-term commitment, when necessary, as
well as the flexibility to respond commitment, when necessary, as well as the flexibility to
respond quickly to meet regional and national needs.

3. Perseverance:- Respect for work as a means of existence and development ; a commitment to

perform assigned duties to the best of one’s knowledge a and abilities

4. Collaborative Spirit: Culture of working cooperatively within a group and with other
research groups; developing the ‘’we’’ sprit and joint responsibility.

5. Customers Care: A commitment to give first priority and due respect to customers

6. Effectiveness and Efficiency:- A strong belief in creating and utilizing knowledge, skills and
other resources for cost effective conversion into out puts.

7. Professional Ethics: - A Commitment to a high standard of integrity; being consistently

honest and trust worthy and behaving in an ethical manner, taking ownership for onesbehavior
and responsibilities.

8. Open mindedness:- Recognizing , understanding ,and appreciating the existence diversity

among human being ; listening to ideas and viewpoints although they may contradict, fairness
and judiciousness in assessing and evaluating ideas and viewpoints held by others; supporting
colleagues who stand up for what they believe is right , and allowing them to make mistakes
and take risks in pursuit of goals, which may push them outside their comfort zones.

9. Creativity (Innovativeness:- Constantly pushing one’s self to new frontiers of knowledge;

welcoming new perspectives and ways of looking at things; examining critically long –held
beliefs and habits ; appreciating the power of imagination in one self and in others; willingness to
change and to

10. Social Responsibility:- contributing towards the development of the nation participating in
community engagement; using expertise for the betterment of the community the nation;
respecting the wellbeing of the environment and its sustainability

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Background
This project will be conducted in Harar town that found in eastern part of Ethiopia which 526 km
away from Addis Ababa and 52km from Dire Dawa city. The geographical location of Harar
town is 90 19’N latitude and longitude of 420 15’E with the elevation 1885m above sea level.
Annual temperature of the region is 26.50c. The region accounts 90% woinadega and 10% kola.
The total area of the region is 334km2.
According to 2012 estimation Harar has total population of 151,977. From this population 74900
were male and 77077 were female. There are 4/four/ governmental hospitals and one non-
governmental hospital, 8 health centers, 22 health post, and 12 middle private clinic.

Statement of the problem

Childhood diarrhea is a leading cause of morbidity and mortality in developing countries. Inspite
of the ministry of public health and sanitation together with the other stakeholders in the
public health sector developing health education and awareness and other environmental
health programs to avert the situation, the disease continues to revenge many children below
the age of five(1).

In deed many childhood illnesses in developing countries are water related. Diarrhea remains
one of the most important childhood environmental health problems. However research has
indicated that diarrhea is a function of water, sanitation and hygiene. According to a report
from Water wiki, 2010 transmission of diarrhea and water-related diseases are directly
linked to inadequate access to water and hygiene practices(1).
According to WHO report 2003 diarrhea disease is the third leading cause of death among
developing countries (1). The World Health Organization (WHO) report in 2004 rated Ethiopia
as the 4th among the 15 countries with the highest child deaths due to diarrhea, which was
estimated to be 86,000 children (5). The annual report published in 2008 by the Federal Ministry
of Health of Ethiopia showed that diarrhea is the 4th leading cause of morbidity at the national
level; in the Benishangul-Gumuz Regional State, diarrheal disease was the 2nd leading cause in
all health institutions visited (6). As a result, both infant and under-five mortalities are the
highest in this region (101 and 169 per 1,000 live births respectively) compared to other regions
of Ethiopia (7).

The severity and magnitude of diarrhea disease is high among children than adults. In 2013, 6.8
million children under five age died in Africa near 17000 children bias every day. This condition
occurred in 2014 with the same magnitude (2).
In most part of Ethiopia including Harar town, children feces disposed to any place, open
defecation and over dumping of the garbage common in Harar city. These wastes attract flies and

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other insect. So, many children exposed to these flies and other insects when they are playing
(3).
According to UNICEF report unsafe drinking water, inadequate water provision for hygiene and
lack of access to sanitary facilities contribute 88% death for diarrhea disease (4).
Some studies show that about 12% of children whose household disposed of children factor
unsafely reported to have diarrheas compared among children whose household disposed of
children feces appropriately (4).

Project goal
Creating and maintaining healthy under five children in harar town.

General objective
Reducing prevalence of diarrhea among under five children through effective and sustainable
community-based health activities in harar town.

Specific Objectives
• To increase community awareness on under five children diarrheal disease prevention and
control

• To advocate for increased investment (human, technical, and financial resources) in prevention,
control and management of childhood diarrheal disease

• To improve healthy behaviors of parents and care givers to protect under five children from
diarrheal disease

Out put
-Giving health information dissemination (HID)

-Improved sanitation status

-Provision of safe water supply

-Good hand washing behavior

- Number of child treated

ACTIVITIES
The Pathways of Contamination

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Activities under taken for reducing prevalence of diarrhea among under five children mainly
focuses on identifying and breaking pathway which is the major sources of diarrhea in the
environment.

The direct and indirect means or “paths” by which people come in contact with feces in their
environment are well known. From the original causal agent—feces—the bacteria, viruses, and
protozoa that cause diarrhea can make their way to the host via five different but often
intersecting paths:

1. Fluids

2. Fomites

3. Food

4. Flies

5. Fingers

Major activities

1. Improvement of the sanitation status (safe disposal of feces) blocks the paths between feces
and fluids, between feces and fomites, and between feces and food. A simple latrine that is
minimally maintained can also block the pathway between feces and flies, either by keeping flies
away from feces or by keeping flies that have had contact with feces away from people.

2.Facilitating Improvement in water quality(through water supply improvements, small scale

water treatment, and safe storage of drinking water): makes water safe to drink and safe to use in
all aspects of food preparation but only if that water stays clean and is not contaminated via other
pathways.

3. Facilitating to Increase water supply: allows the family to wash food more thoroughly during
preparation, wash food preparation surfaces and utensils more thoroughly and frequently, and to
bathe and wash hands more thoroughly. These activities can block a number of the paths to
contamination, including most of those involving fingers and flies and most having to do with
food, but if the water thus made available remains contaminated, then merely having more of it is
not the answer.

4. Promoting hand washing behavior: if done correctly at critical times, blocks all the pathways
that directly or indirectly involve the fingers. All of these interventions—whether of the
“hardware” (sanitation facilities, community water systems) or “software” (hand washing, water
protection, and safe excreta disposal) variety—have been shown to considerably reduce the
prevalence of diarrhea. And while each of these approaches is effective on its own, in
combination they can deliver even greater results.

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5. The Hygiene Improvement Framework

The Framework has three core components:

• Improving Access to Water and Sanitation “Hardware”

• Promoting Hygiene

• Strengthening the Enabling Environment.

Increasing Access to Hardware

The first part of the Framework, the “hardware” component, contains three elements:

• Water Supply Systems

• Improved Sanitation Facilities

• Household Technologies and Materials

Promoting Hygiene

It begins with and is built on what local people know, do and want.”

Strengthening the Enabling Environment

Supporting the enabling environment typically takes the form of one or more of these activities:

• Policy improvement

•Institutional strengthening

• Community involvement

• Financing and cost-recovery activities

• Cross-sector and public-private partnerships

•Community participation

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•Advocacy.

Hygiene Improvement Framework include,

 proper hand washing,

 proper disposal of feces, and
 Storing and using safe water, at least for drinking and preparing food.

Input
-Man power

-Chemical (cl, ORS, agar,)

-Materials for training (module (book), paper, pen, pencil, hall, leaflet,

-Material for demonstration (gerican, soap (ash), water,

Monitoring and Evaluation

Relevance

The Project’s relevance will be high in light of the following indicators.

 Consistency with the needs of beneficiaries in the project target areas

 Consistency with national health policies (The project will be line with priority issues in
the National Health Strategic Plan.
Effectiveness

The Project’s effectiveness will be high in light of the following indicators.

 If the Project Purpose is more or less fully achieved.
 The Project will achieve the initially set targets in two indicators concerning
bloody diarrhea and malnutrition, and will succeed in falling steadily the
incidences of non-bloody diarrhea and measles.
Efficiency

Overall, level of efficiency of the Project will be relatively high in light of the following
indicators.

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  If, the quantity and the timing of the inputs (dispatch of experts, acceptance of trainees,
provision of equipment and supplies, and operational expenses) will appropriate as
planned.

Sustainability/ Phase out strategy of the Project

We must continually adapt our plan in response to the changing circumstances, but the winners
in the project are the most competent team with the best strategic plan who respond best to the
conditions actually encountered for the sustainability of the project.

In deciding whether or not the program should be continue, ongoing or repeated is not
questionable. B/C the project program must be sustainable. Since the problem of diarrhea in the
Harar town is continued, the project should not be stopped. The project programs sustainability is
achieved by those who are interested to sustain the program. The project designer should
motivate other who are interested to sustain the program with different techniques such as
advertising media, social marketing and etc. The organization that sustain the project should be
supported by resources such as Health professionals, municipality professional, and other man
powers, costs funding agencies, local contributors, and stake holders.

Finally, after the project winners complete their work the project should be submitted to Harar
health bureau for the seek of sustainability, B/C the project for collection and disposal of solid
waste by effective locating of haul container seeks monitoring and evaluation activities.

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Table 1: Work plan

No Activities Responsible Time

bodies

M1 M2 M3 M4 M5 M6
1 Project
proposal
development
2 Resource
preparation
3 Personnel
selection
4 Educating and
training
5 Demonstration
about proper
hand washing
facility
6 Treating water
to assure
quality
7 Treating
children
having
diarrhea( prov
iding ORS)
8 Monitoring
9 Evaluation

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Table 2: Budget
NO Resources unit NO Cost/m Total(birr)
needed or unit
Trainee NO 16 6000 96000
Trainer “ 200 1500 300000
1 Manpower Physician “ 10 7500 75000
Manager “ 1 15000 15000
Demonstrator “ 12 6000 72000
Agar 5000
2 Chemical ORS 7000
Module “ 20 910 18200
Note book “ 250 10 2500
Paper Pack 5 150 750
3 Material Pen “ 42 50 2100
Pencil “ 21 30 630
Hall NO 4 3000 12000
4 Total “ 606180
5 Contingency “ 90927
6 Ground total “ 697107

References
1. http://www.child info.org)(June20,2014).
2. Desalegn M, Kumia A. Tefera W. Prediction of under five child hood diarrhea, Mecha
District, West Gojjam , Ethiopia Ethio, J Health dav.2011:25 (3),192-200
3. WHO/UNICEF-Why children dye and what to be done 20 aveenue tupia, 2009,1211
Geneva “ 27,Switzarland : p12-29.
4. WHO, water sanitation and hygiene : public health and the environment incitement
Geneva : WHO ; 2003.
5. Boschi-Pinto C, Velebit L, Shibuya K. Estimating child mortality due to diarrhoea in
developing countries. Bull World Health Organ. 2008;86:710–7. [PMC free article]
[PubMed]
6. Ethiopia. Ministry of Health. Health and health related indicator. Addis Ababa: Ministry
of Health, Federal Democratic Republic of Ethiopia; 2007. p. 30.
7. Ethiopia. Central Statistical Agency. Ethiopia demographic and health survey 2011.
Addis Ababa: Central Statistical Agency; 2012. p. 430.

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