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PHASE IV CBTP Finale.
PHASE IV CBTP Finale.
Institute Of Health
1
List of team members
1 Bethelhem kifle 9 Desalegn Yimam
2 Ibsa Desalegn 10 Bethelhem Gezahegn
3 Bayush Aklilu 11 Mahider Ayana
4 Alamudin Ali 12 Mihiret Sisay
5 Rediet Samuel 13 Lalise Tujuba
6 Birhan Gedion 14 Rediet Kassahun
7 Rediet Tewodros 15 Mahlet Nigusse
8 Bayisa Merga 16 Abel Teshome
2
Outline
Introduction
Background of the study area
Significance of the study
Objective
Method and material use
Result and discussion
Problem encountered during the data collection
Conclusion and recommendation
List of prioritized problem and action plan
Acknowledgement
Reference
3
List of Abbreviations
CBE: Community Based Education
CBTP: Community Based Training Program
DTTP: Developmental Team Training Program
FIG: Figure
HI: Health Institution
JU: Jimma University
SRP: Student Research Program
OTC: Over The Counter
POM: Prescription Only Medication
4
Key Terms
Modern medicine: Also known as Allopathic or western medicine, modern
medicine is the most advanced, scientifically based, and statistically approved
therapeutic system and diagnostic methodology.
Complementary medicine :is a term used to describe types of treatments
you may receive along with traditional Western medicine.
Rational drug use (RDU): is the process of appropriate prescribing,
dispensing, and patient use of drugs for diagnosis, prevention, and treatment
of diseases.
Self Medication: The act or process of medicating oneself especially without
the advice of a physician
5
Cont..
Social drug: kchat, tobacco, alcohol, Coffee, tea
Chewing kchat: more than 15 days per month
Kitchen room: putting medication around the place where they Cooke, bake.
Visiting health institution: visit less than 1 yrs ago
woina Dega :a climate with average temperature is 22 °C, the annual rainfall is
between 800 and 1200 mm, and the average elevation ranges between 1500 to
2500 m
6
Introduction
CBE is a means of achieving educational relevance to community
needs.
It consists of learning activities that uses the community extensively as
a learning environment.
The learning takes place within the community rather than in class
room setup.
Phase IV CBTP is the last phase of CBTP which all the phases are discussed
together and changes secondary to students involvement in the community
are measured.
It is an evaluation phase.
7
Strategies Of CBE
In order to realize the philosophy, the college uses the following
strategies:
Based Training Program (CBTP)
Team Training Program (TTP) or (Developmental Team Training
Program DTTP)
Student Research Program (SRP)
8
Significance of the study
9
The Background of study
Buyo kechema is one of the kebele found in ,Seka Chekorsa Woreda, Jimma
zone, Oromia region, south-west Ethiopia, located about 15km away from
main campus of Jimma University in North West .
Have a total population of 8321 (Male 4189 Female 4132) and Households are
1045.Climatic condition is Woina-dega.
It is bounded by four kebele It has the boundaries East: kusaroo, qofe, West:
G/Boosee, south: D/Gibee, north: Allagaa, yabbu woreda
10
Objective
General objective
To measure the quantitative effect of changes due to intervention made on use
of social drugs, self-medication, drug sharing, stocking of drugs, taking more
doses, and drug storage.
Specific objective
To measure the quantitative changes due to intervention made on social drug
use and self medication.
To observe the quantitative changes due to intervention made on sharing of
drugs and stocking of drug.
To measure the quantitative changes due to intervention made on drug storage
and taking more dose.
11
Study Method and Design
Study area – Buyo Kechema Kebele, Seka Chekorsa Woreda, Jimma
Zone, Oromia Region, South West Ethiopia
Study period _August 24-26, 2022 GC
Study design _cross-sectional study
Target population_ all residents of Buyo Kechema(8321)
Study population_ house hold in Buyo kechema kebele(1045)
Sample size_281 households (Buyo kechema Kebele)
Frame of reference_4
Sampling technique_ systematic random sampling
12
Sample size determination
n=
Correction formula
nf =n/1+n/N since our total population is less than 10,000
K =N/nf
Where N, total house hold (1045)
n, sample size(384)
nf, final sample size(281)
P, proportion rare and q, is 1-p, (p= 0.5)
d, Margin of error(5%)
z, Critical value of the normal distribution at the required confidence level,(1.96)
13
Materials used
Questionnaire
Computer
Chalk
Pen
Calculator
Mobile phone
Data collection and analysis
15
Quality assurance
16
Ethical Consideration
Permission letter was sent from Jimma University to the Buyo Kechema
kebele administration and approved by the head.
The students surveyed throughout the kebele in a polite manner respecting the
culture, custom and belief of the society
17
Summary of previous phases of CBTP( I, II, III)
CBTP phase I
The general objective of phase-1 CBTP was:
19
Major findings of phase I
The major findings were;
majority of the study community were Oromo ethnic group.
majority of the study community were illiterate.
majority of the study community were married.
There means of communication were radio.
Problems like fever, safe water supply, and diarrhea was identified and
prioritized based on the severity, feasibility government concern and
magnitude and community concerns.
20
The problems identified and prioritized from phase I
I. Home delivery
II. TTBA
III. Febrile illness
IV. Lack of access to postal and Telephone service
V. Poor hygiene
21
CBTP phase II
The general objective of this phase was: -
To assess type, availability and distribution of health facilities, social drug,
rational drug use as well as complementary medicine practice in Buyo Kechema
kebele.
The specific objectives were:-
To collect on the type, availability and distribution of health facility in the study
community.
To identify the common complementary medicine practice and the community
attitude towards them.
To know the understanding of community on some local drugs (alcohol, khat,
tobacco….)
22
Cont.…
To identify some common problems in setting the drugs community.
To identify and prioritize some of the common problem related drugs.
To use appropriate technique to asses drug using status of the
community
To organize, analyze, interprets and draw interference on the drug
information, self-medication, rational drug use, complementary
medicine and some social drugs using pattern.
To draw an action plan for some of the drug related problems they
identified in the community.
23
Major findings of phase II
The major findings were;
There is one health center in buyo kechema kebele
The study concluded that most of the study community who visited the health
center were unsatisfied because of insufficient survice.
Majority of the community use modern medicine for their day to day illness.
Most frequently used social drug were kchat and coffee especially by young
age male and middle age male.
Most of the community prefer health center pharmacy as a source of
medicine because it is nearer.
The community also use complementary medicine practice like that of bone
sitting, herbs religious and quaternization. They choose this kind of practice
because of effective and accessibility.
24
Identified and prioritized in phase II
25
CBTP phase III
In this phase students are supposed to make interventions based on the already
developed action plans in the previous CBTP phases (phase one and two).
General objective
To perform an intervention on problems that are identified from phase II in
collaboration with the community members and governmental institution.
Specific objective
The students here are expected to :–
Reconsider the previously identified and prioritized problems for possible
changes.
26
Cont.…
Refine the action plans developed to make adjustments and corrections where
needed.
Make interventions in the collaboration with the community members
governmental and non-governmental health institutions etc…..
To educate the community about the rational drug use
To aware the community on the dangers of self medication and non
adherence.
To create awareness in the community about effects of sharing drug.
To aware the community on the ways of transmission and prevention of Covid-19
27
Problem intervened
Problems reprioritized after merging the problems in the two phases where:
Social drug
Sharing drug
Self medication
Drug storage
Covid-19
Inappropriate drug use i.e unable to take medication
accordingly, taking more dose of medication than
recommended.
28
Result And Discussion Of CBTP Phase IV
29
Evaluation of phase I against phase IV
Other 33(2.23) -
30
EDUCATIONAL STATUS
80 76 68
60
40 32 phase I
24
Phase IV
20
0
litrate illitrate
Fig 1. Comparison of educational status of Buyo kechema community between phase I and
IV Jimma zone, August 24-26 2022 G.C.
31
PHASE I AND PHASE IV COMPARISSION BASED ON PRIORITIZED PROBLEM
32
Evaluation of phase II against
phase IV
33
A, Availability, Type and Distribution of Health Facilities
In Buyo kechema kebele there is only one health center available and there are no
hospital and health post in this kebele.
This health center located around kebele bureau and Buyo kechema primary
school on the side of main road of Jimma to seka chekorsa.
34
Table 3. The distance of households in terms of minutes from health
institution in Buyo kechema Aug 24-26 2022 G.C.
Distance <15 15-30 31-45 46-1hr Min. Max. Range Mean Std.De
in minute vaition
Have F % F % Do you F % F %
you ever satisfied
visited with the
HI service
TOTAL 281 100 281 100 TOTAL 281 100 281 100
36
Table 5. Reason for un-satisfaction by health service in Buyo Kechema Kebele,
jimma zone Aug 24-26 2022 G.C.
38
The source and preference of modern drugs in Buyo Kechema
Kebele, Jimma zone Aug 24-26 2022 G.C
Most of the community in Buyo Kechema prefer The health center pharmacy
both on CBTP phase II (90%) and IV (98%)than the Hospital and Red cross
pharmacy.
The reason they reported for choosing health center pharmacy is that because
it’s nearer and cost effective.
Some of them (5.4%) in CBTP phase II and (0.7%) on CBTP phase IV
chooses the hospital pharmacy because it have high quality drugs.
39
COMPLIMENTARY MEDCINE IN BUYO KECHEMA KEBELE, JIMMA ZONE
60
52.5%
50
39.5
40
30
20
10 5.1% 3%
0
Bone setting Herb Religious Quaternazation
41
The perception of community towards complementary medicine
practice in Buyo Kechema kebele, Jimma zone August 24-26 2022 G.C.
42
Table 6. Showing some of the plants used for the treatment of different diseases
in Buyo Kechema kebele, jimma zone in Aug 24-26 2022GC.
no. Traditional Name Scientific name Used plant part Medicinal Use
1 Damakese Ocimum spp leaf Common cold and anti-
inflammatory
2 Togo leaf Eye inflammation
3 Tenadam Ruta graveolense Leaf Headache, evil eye and
abdominal pain
4 Qoricha Adi Steam Evil eye
5 Aramiro leaf abdominal pain
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
Buda(Evil eye) Mitch(sun stroke) Cold Hepatitis Almaz Balechra Bone setting
Disease cured only by complimentary medicine
40
20
0
Alcohol Khat Tobacco Coffee Tea
Before intervention After intervention
Fig 4 .The most commonly used Social drugs in Buyo Kechema Kebele, jimma
zone before and after the intervention, Aug 24-26 2022 G.C.
45
elder female
Most frequent community that uses social Drug
elder male
0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00% 45.00%
Fig 5.The most frequent groups of community which use social drugs before and
after the intervention in Buyo Kechema Kebele, jimma zone Aug 24-26 2022G.C.
46
Cont.…
The most commonly used social drug in Buyo Kechema Kebele is Kchat
(52.6%) followed by Coffee, Tobacco ,Tea and Alcohol both before and after
intervention.
Before the intervention the most frequent community that use social drugs
were young age male(36.6%) and middle age male(21.3%)
Despite the intervention it has increased however by 2.1 and 1.2%.
The reason for this might be the political situation of the country (schools
were closed most of the time) and because of the COVID 19 lockdown (since
there is nothing they can do)
47
Chewing khat status
32.4%
67.6%
YES NO
Fig 6. number of people chewing khat in Buyo kechema kebele, Jimma zone
August24-26 2022GC
Study conducted in Buyo Kechema 2021 before intervention shows 40% of respondent
are khat chewing and 7% alcohol consumption.
Despite The intervention the khat chewing has increased by 27.6%
48
C. Rational drug use
90.60%
83.30%
16.70%
9.40%
YES NO
Before intervention After intervention
Fig 7.Status of the community for taking drugs according to the information given by the
health workers before and after the intervention Buyo Kechema Kebele , Jimma zone
Aug 24-26 2022GC.
49
Table 7. Reasons for not taking the drugs according to the information given
by health workers in Buyo Kechema Kebele, Aug 24-26 ,2022 G.C
Probable reasons for not taking drugs according to info given Frequency %
Total 16 100
50
Do you take more doses during medication?
92%
92%
8.20%
8%
YES NO
BEFORE INTERVENTION AFTER INTERVENTION
Fig 8. The percentage of community taking more doses before and after the
intervention in Buyo Kechema kebele, Jimma zone Aug 24-26,2022 G.C
As we can see from this figure most of the community don’t take more drugs
before and also after the intervention.
51
Reasons for taking more doses during medication
Fig 9. The probable reason for taking more dose by the community of Buyo
Kechema Kebele, Jimma zone in Aug 24-26,2022 G.C
52
Drug sharing status
90.00% 81.90%
80.00% 76.80%
70.00%
60.00%
50.00%
40.00%
30.00% 23.20%
18.10%
20.00%
10.00%
0.00%
YES NO
Before Intervention after intervention
Fig10.The percentage of the community sharing drugs before and after the
intervention in Buyo Kechema Kebele, Jimma zone Aug 24-26 2022 G.C
53
In the figure above, it is clear to see that most of population do not share drug
with their family and neighbors both before and after intervention. Although,
majority of the community doesn’t share drugs, there is still some part of
population sharing drugs. But after the intervention, the habit of sharing
drugs has shown decrement by 10.2%.
54
Table 8.The reasons for sharing drug in Buyo Kechema Kebele , Jimma zone Aug 24-26,2022G.C
From the previous figure we have seen that 18.1% of the population share drugs and here we can
understand that some of the community share drugs with others for the reason of relieving common
symptom and also for patient who are unable to afford.
55
Fig 11. The place where the community keeps the drugs in households before and after the intervention of
Buyo kechema Kebele, Jimma zone Aug 24-26 2022 G.C.
56
Cont..
The above figure shows some of the places where the community stores drugs.
Locked cabinet are the place where most of the community uses to store drugs
followed by bed room ,open area and Kitchen.
After the intervention, there was some change that the community tried to
store their drug in locked cabinet and there were an increment which is around
25.9%.
57
Table 9. showing most commonly stocked drugs in the household medicine
cabinet in Buyo Kechema Kebele, Jimma zone August 24-26 2022 G.C
% %
NSAIDS 58.8 51.2
Fig 12. Reasons for stocking Drugs in Buyo Kechema Kebele, Jimma zone
August 24-26 2022 G.C
59
Having Drug information
23.80%
No
24.20%
76.20%
Yes
75.80%
0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00%
After intervention
Before intervention
Fig 13. The amount of community having information about drugs before and
After Intervention in Buyo Kechema Kebele, Jimma zone Aug 24-26 2022G.C.
60
Table 10: the information that the community have about drugs in Buyo Kechema,
Jimma zone before and after intervention.
The information they Before intervention After intervention
have % %
About drug storage 63.8 66.4
61
Before intervention After intervention
31.60
%
35.30
64.7 % 69.40
0% %
YES NO YES NO
From the above pie chart we conclude that before our intervention majority
of the community (64.7% ) were not practice self- medication.
Fortunately after we intervened we slightly increased the number of the
community that don’t practice self medication around by 4.9%.
63
Kind of illness for which the community uses self
Medication
120.00%
100.00%
80.00%
60.00%
40.00%
20.00%
0.00%
minor pain cough wound Helmentiasis
Before intervention After intervention
Fig 15. Kinds of illnesses for which the community use self-medication before
and after intervention in Buyo Kechema kebele, Jimma zone August 24-26
2022 G.C
64
Cont..
From the data above, minor pain are the most self-medicated
followed by cough, wounds, helimentisis, malaria.
Compared to data before intervention there is slight decline in self
medication practice.
65
Table 11. shows the most commonly used drugs for self-medication in the community Before
and After intervention Buyo Kechema Kebele, Jimma zone August 24-26 2022 G.C.
66
Problem and limitation encountered
Problem we encountered
Language barrier
The respondents were unable to calculate there annual income.
Some of the residents house were closed for 1st day.
Most of the respondents lacked interest due to repetitive interview carried
out by different department of Jimma University.
Rainy days
Limitation
We faced a problem of getting all needed information from the kebele.
Scattered house in the community.
67
Solutions
68
Conclusion
When compared with previous results some good results were obtained on
intervened problems.
Most of community members are satisfied by the service given in health
institution.
khat is the most commonly used social drug followed by Coffee and Tobacco and
some of the community chew Khat and their number is Increased after the
intervention by more than a quarter.
Cont.…
Most of the community takes drug according to the information given by the
health worker both before and after the intervention.
NSAIDS are the most frequently stocked drugs followed by Antibiotics for the
treatment of emergency cases and for relapse cases.
Most of the community don’t take more drugs before and also after the
intervention.
It has been seen slight increment in the number of the community that don’t
practice self medication.
70
Recommendation
1. The Buyo Kechema Kebele Health Institution & the Kebele Administrators
Should work on creation of awareness about impact of social drugs, sharing of
drugs & provision of information related to stocking of drugs as well clearly
identify reasons for community un-satisfaction helps to solve problems easily.
2. The literate individual of the kebele such as health center workers, as well as
other people those know about the effect of chewing khat on social, economy &
health of the community should inform the community.
71
Conti…
3. Health extension workers should warn Buyo kechema kebele community on
drawbacks of sharing drugs so as to avoid possible accidents.
4. School of Pharmacy has to involve in studying medicinal plants that are found
in the community.
5. CBE office and Buyo kechema health institution workers should work in
cooperation with the kebele administrators on educating the community about
impact and benefit of complementary medicine together with modern
medicine
72
Table 12.Problem prioritization based on criteria in Buyo Kechema, Jimma Zone
August 24-26,2022G.C
1 Drug overdose 4 3 4 4 3
2 Sharing of drug 4 4 4 4 2
3 Chewing chat 3 5 4 2 4
4 Self-medication 5 3 2 1 4
5 Inappropriate 3 3 3 3 3
storage of drug
73
Table 13. Action plan on identified problem in Buyo kechema, Jimma Zone August 24-
26,2022G.C
Identified Objectives Target Strategies Activities Resource Responsibility
No problem
1
Drug To minimize usage of Buyo kechema Increasing the Teaching the impact Knowledge Next pharmacy
overdose overdose 90% kebele community awareness of taking of drug overdose of team student of CBTP
appropriate dose through drama and member member and CBE
using poster office
2
Sharing of To minimize drug sharing Buyo kechema Creating awareness Teaching the impact Knowledge Next pharmacy
drug habits in the community kebele community on the impact of of drug sharing of team student of CBTP
by 80% sharing drug through drama ,and members member and CBE
using poster office
3
Chewing To reduce the number of Buyo kechema Creating awareness Teaching the impact Knowledge Next pharmacy
chat chat chewer kebele community on the impact of of chewing chat by of team student of CBTP
chewing chat different technique members member and CBE
office
Practice of To minimize usage the Buyo kechema Educate the Teaching the impact Knowledge Next pharmacy
4 self- level of self-medication by kebele community community about of self-medication by of team student of CBTP
medication 50% self-medication using posters, and members member and CBE
public talk office
5
Inappropri To minimize usage the Buyo kechema Educate the Teaching the Knowledge Next pharmacy
ate storage level of inappropriate kebele community inappropriate storage inappropriate storage of team student of CBTP
of drug storage of drugs of drug of drug by members member and CBE
74 office
Reference
1. CBTP phase1, 2 and 3 documents
2. Asefa M., Community-based education: Concept and practice Ethiop. J. Health
Dev.2000; 14: 227-237.
3. Central Statistical Agency [Ethiopia] and ORC Macro. 2001. Ethiopia Demographic
and Health Survey 2000. Addis Ababa, Ethiopia, and Calverton, Maryland, USA: Central
Statistical Agency and ORC Macro.
4. Kandari et al. Springer Plus 2014,3:579(http://www.springerplus.com/content/3/1/579)
5. HEALTH SERVICES UTILIZATION AND ASSOCIATED FACTORS IN JIMMA
75
Acknowledgement
We would like to express our huge gratitude of thanks to;
our study community
Kebele Administrative
CBE coordinative office
Our supervisors
Finally we would like to appreciate the unity and active participation of our
group members in intervening the problems of society.
76
Thank you!
we are in the community
77