WACHEMO UNIVERSITY

COLLEGE OF MEDICINE AND HEALTH SCIENCE

ASSESSMENT, PRIORITIZATION AND INTERVENTION OF HEALTH AND HEALTH RELATED PROBLEMS IN

HALABA KULITO HEALTH CENTER CATCHMENT AREA, HALABA TOWN ADIMINSTRATION, KULITO
WEREDA HALABAZONE, SNNPR, ETHIOPIA, 2023.

PREPARED BY: HALABA TEAM

ADVISORS: - 1. YOHANNIS (BSc, MPH)

2. TEMESGEN (BSC, MSc)

July, 2023

HALABA, ETHIOPIA
 WACHEMO UNIVRSITY

COLLEGE OF MEDICINE AND HEALTH SCIENCE

ASSESSMENT, PRIORITIZATION AND INTERVENTION OF HEALTH AND
HEALTH RELATED PROBLEMS IN HALABA KULITO HEALTH CENTER
CATCHMENT AREA, HALABA TOWN ADIMINSTRATION, KULITO
WEREDA HALABAZONE, SNNPR, ETHIOPIA, 2023.

1.YOHANNIS (BSc, MPH)

2.TEMESGEN (BSC, MSc)

LIST OF HALABA KULITO SITE TEAM MEMBERS

NO NAME OF STUDENT DEPARTEMENT DUTY

1 Abdisa Gemedo PHO MEMBER

2 Bisrat Asefa MIDWIFERY MEMBER

3 Chaltu Aman S.NURSING LOGISTICS

4 Dawit Kaltamo PHO MEMBER

5 Debora Abrham MEDICINE(MI) MEMBER

6 Deme Abdisa ANESTHESIA MEMBER

7 Daselagn Tessema C.NURSING MEMBER

8 Emebet Ayanew M.LABORATORY MEMBER

9 Endres Ali C.NURSING MEMBER

10 Ermias Gelalcha PHO RAPORTER

11 Esayas Ersino MEDICINE(MI) MEMBER

12 Esuendale Anteneh MEDICINE(MI) LEADER

13 Feven Mello S.NURSING MEMBER

14 Fraol Getachew MEDICINE(MI) MEMBER

15 Fraol Solomon ANESTHESIA MEMBER

16 Getnet Kassahun MEDICINE MEMBER

17 Gosaye Abule M.LABORATORY MEMBER

18 G/Hiwot Mihret S.NURSING MEMBER

19 Habtamu Teshale M.LABORATORY MEMBER

20 Mistre Samuel PHO MEMBER

21 Nejat Bilal PEDIATRICS MEMBER

22 Ruhama Ashenafi ANESTHESIA MEMBER

Acknowledgment
We would like to express the deepest appreciation and gratitude to wachemo University CBE office for
their support in giving us a special moment for interaction with the community and all staffs of different
sectors who provided us information.

We would also express our heartfelt gratitude to our respected Advisors and supervisors for their
supervision and advice to develop this action plan.

Last but not least, we would like to extend our special thanks to different staff members of the Health
center and other office and also community as a whole for their cooperation in providing the necessary
information’s.

Table of content
Table of contents........................................................................................................................................III
List of tables................................................................................................................................................V
List of figures..............................................................................................................................................V
Acronyms and abbreviation.......................................................................................................................VII
Abstract......................................................................................................................................................IX
CHAPTER ONE: INTRODUCTION..........................................................................................................1
1.1. Background................................................................................................................................2
1.2. Statement of problem.....................................................................................................................3
1.3 Significance of the study..................................................................................................................4
CHAPTER TWO: LITERATURE REVIEW............................................................................................14
2.1 Socio-Demographic Characteristics.............................................................................................14
2.2 Environmental conditions.............................................................................................................14
2.2.1 Housing Conditions................................................................................................................14
2.2.2 Latrine Utilization.................................................................................................................15
2.2.3 Water Supply..........................................................................................................................15
2.3. Vital statistics……………………………………………………… ………………………………………………………………. 15
2.4 Maternal and Child health........................................................................................................16
2.4.1Family Planning.....................................................................................................................16
2.4.2 Antenatal care.........................................................................................................................16
2.2.3 Child Immunization................................................................................................................16
2.4.4 Institutional and non-institutional delivery………………………………....……………………………….…….17
2.4.5 Under five Mortality...............................................................................................................17
2.5 Communicable Diseases ...........................................................................................................17
CHAPTER THREE: Objectives................................................................................................................18
3.1 General Objective..........................................................................................................................18
3.2 Specific objectives..........................................................................................................................18
CHAPTER FOUR: Methods and materials..........................................................................................19
4.1 Study area......................................................................................................................................20
4.2 Study period...................................................................................................................................21
4.3 Study Design...................................................................................................................................21
4.4 .1Source population.......................................................................................................................21
4.4.2. Study population........................................................................................................................21
 4.5. Sampling unit................................................................................................................................21
4.6. Study unit......................................................................................................................................21
4.7 Inclusion and exclusion...........................................................................................................21
4.7.1 Inclusion criteria..............................................................................................................21
4.7.2 Exclusion criteria....................................................................................................................21
4.8 Sample size determination method...............................................................................................21
4.8.1. Sampling Technique and procedures.......................................................................................23
4.9. Study variables..............................................................................................................................23
4.10 Operational definitions and definitions of term........................................................................23
4.11 Data collection methods...............................................................................................................25
4.12 Data Quality Assurance...............................................................................................................25
4.13Data Processing and Analysis s....................................................................................................25
4.14 Ethical consideration...................................................................................................................25
4.15 Dissemination of results...............................................................................................................25
4.16WORKPLAN…………………………………………………………………………………………………………………………….26
4.17 BUGDET…………………………………………………………………………………………………………………………………26
Clinical action plan....................................................................................................................................28
References.................................................................................................................................................33

Abrevation and Acronyms

AFI Acute febrile illness

ANC Antenatal Care
CBE Community Based Education
CDI Community Direct Intervention
CEO Chief Executive Officer
EDHS Ethiopian Demographic Health Survey
EPI Expanded Program of Immunization
FP Family Planning
 G.C Gregorian Calendar
HIV/AIDS Human immunodeficiency virus/Acquired immune
deficiency syndrome
HEW Health Extension Workers
SNNPR Southern Nation Nationality and Peoples Region
T Tetanus Toxoid
THH Total house hold
TB Tuberculosis

OBS/GYN Obstetric gynecology

UNICEF United Nation international children emergency fund

WCU Wachemo University

WHO World Health Organization

LIST OF TABLES
Table 1. Gaunt chart showing work schedule, WACHEMO, July and august, 2015
Table 2 budget
Table 3Adult top 10 diseases in halaba kulito health center catchment area
Table 4The five top disease of under five children in halaba kulito health center catchment area
Table 5. Weekly Stat ic activity action plan in Kulito HC, July2023
LIST OF FIGURES
Figure 1 Map of Halaba Kulito Health Center Catchment Area.............................................................................7
Figure 2 Kebeles in Halaba Kulito Health Care Catchment Area ,number of household and proportionally selected
sample........................................................................................................................................................ 7

Abstract
Introduction: Community based Education is a means of achieving educational relevance to community needs and
consists of learning activates that use the community -oriented education program. It strengthens the link
between theoretical knowledge and practical field experience and helps students to gain sense of social
responsibility and deeper understanding of the problems facing the community. The epidemic raised by
communicable disease is serious threat to Ethiopia’s social and economic development. Nearly one out of 10
babies born in Ethiopia does not survive their first year. Drinking unsafe water, unsafe sanitation and lack of
hygiene also remain important causes of death, with an estimated 871, 000 associated deaths occurring in 2012.
Such deaths disproportionately occur in low-income communities and among children under 5 years of age.

Objective: To assess. Prioritize and intervene health and health related problems in the Halaba Kulito HC
catchment area, SNNPR Ethiopia, 2023.

Methods: A community based cross sectional study was conducted conduct starting from JULY 02-, 2023. Sample
size was calculated using single population proportion and was proportionally allocated to the two kebele
accordingly which are selected by random sampling method for a total of 9 kebeles. Then systematic random
sampling will be used to select households for interview from the kebele. A total of 422 Households was expected
to be representative samples for all 12,567 households of 9 kebele in kulito town. All data collected, edited, coded
and analyzed digitally by SPSS and result was presented by appropriate table and graphs.
Chapter One:

Introduction
1.1. Background of the study
Community Based Education (CBE) is a means of achieving educational relevance to community needs
and consequently of implementing a community oriented education. CBE, as an educational philosophy
aims at developing professionals with problem identification and solving skills and positive attitudes to
serve the society. CBTP (community based training program), TTP (team training program) and SRP
(surveillance research program) are strategies to realize the philosophy of CBE(1).

TTP is team training program and a community based learning activity that focus on problem solving
approach and covers tasks such as site selection ,mapping, developing investigation tools, gathering
data, processing and analyzing information ,listing and prioritizing problems , drawing a plan of action,
caring out interventions and conducting follow up and evaluation work involving all stake holders. TTP
provides a practical and significant development in the fields of health professional training for
developing countries. (2)

The main objectives of utilizing TTP to enable trainers to develop positive attitude towards rural
practices, to appreciate community health activities and challenges to establish community links with
other sectors and promote inter sect oral collaboration to develop team work skills, to appreciate the
interdisciplinary nature of health care provision.(2)

Community Health and health related problems are the major problems in the world even though the
problems are easily preventable. The community is suffering from the problems resulted from the
environmental health conditions such as improper latrine utilization or absence of latrine, absence of
drink water or improper utilization and improper waste disposal system (3).

There are many health and health related problems affecting people over all over the world. Among
those problems some of them are:-over half million mothers die every year as a result of complications
arising from pregnancy and child birth, Since the beginning of the epidemic, more than 70 million people
have been infected with HIV virus and about 35 million people have died of HIV and Globally 36.7 million
people were living with HIV at the end of 2015[4].

Worldwide 25% of all deaths and the total disease burden can be attributed to environmental factors
(2). A total of 216 million estimated malaria cases occurred in 2010, 81% of which were reported in the
African region. The total number of malaria deaths was estimated to be 655,000 in 2010: 91% of who
occurred in the African region (5).

Sub-Saharan Africa is the most severely affected region by HIV/AIDS, nearly 1 in every 25 adults (4.4%)
living with HIV and accounting for nearly 70% of the people living with HIV worldwide [4].

In Ethiopia health related problems are major concerning area by government and other organizations
and the government makes different policies and strategies to improve ,so community health
attachment program works systematically collect, analyze and intervene health problems in
collaboration with the community (6).

Women in Ethiopia have a one in 52 chance of dying from childbirth related causes each year. Every
year, more than 257,000 children under the age of five die and 120,000 die in the neonatal period. More
than 60% of infant and 40% of under-five deaths in Ethiopia are neonatal deaths (7).

In Ethiopia, acute watery diarrhea has been identified as major Public health emergency outbreak
affecting almost all parts of the country that results in many cases in deaths in which poor hygiene and
sanitation practice have been stated as underlying cause. Access to safe drinking water, latrine, and the
provision of personal hygiene in Ethiopia is very low (8).

1.2. Statement of problem

Health and health related problems are pronounced in country with low socio economic status like
Ethiopia. As Kulito is one of a woredas in Halaba zone it will share the same burden. These problems are
more rampant in developing nations as compared to those in the developed world, Ethiopia as being
one of the countries in the developing nations, have been encountering much of their burdens which
aggravated the health problem. Those problems could have been minimized by good health services
management and strong political commitment as well as community participation.[7] According to WHO
survey 80% of all illness in developing countries is water and environmental condition associated (9).

Worldwide, there are 884 million people without access to a safe water supply and 1100 million people
do not have access to latrines, 4 billion cases of diarrhea occur every year(5).. Child deaths are
concentrated in developing countries and in the first month of life and still need more rapid progress to
meet the 2015 targets of reduction by two-third. Nearly 50 million babies worldwide are delivered
without skilled care. Worldwide, only 9 in 10 women of reproductive age who are married or in union
and using contraceptive rely on modern method.(4)

Every year 287,000 women die of complications during pregnancy or childbirth. There is about 800
maternal deaths per single day or 1 maternal death per 2 minutes. Developing countries account for
99% (284000) of the global maternal deaths, in sub-Saharan Africa (162000) and Southern Asia (83000).
(10)

Africa had made a good progress in reducing child and maternal mortality in recent years. Under- five
mortality rate reduced from 146 deaths per 1,000 live births in 1990, to 91 deaths per 1000 in 2011.This
implies 47% (1990-2011) reduction of under-five mortality in the continent. Maternal death reduced
from 745 deaths per 100,000 live births to 429 deaths per 100,000 live births in 2010. Generally,
maternal mortality fails 42% (1990-2010). But so far too many children and pregnant women die each
year from preventable diseases. (10)

In Ethiopia 35% of house-holds get drinking water from unimproved source in average it is from 3% in
urban and 43% in rural. More than half of rural house-holds (53%) travel greater than or equal to 30
minutes round the trip to fetch the drinking water. (2)The current growth and transformation plan “GTP-
II” clearly articulates, based on new water supply standard, to reach 85% from current 59% in rural areas
and 75% from current 58% in urban areas by 2020(2).

According to EDHS 2016 in Ethiopia the contraceptive prevalence rate for currently married women age
15-49 in Ethiopia is 36% and 58% in sexually active unmarried women. Total fertility rate 4.6 children per
woman. 38 % of women who gave birth were not received antenatal care for their last birth. Deliveries
assisted by skilled HP 28%. 49 % of women received sufficient doses of tetanus toxoid to protect their
last birth against neonatal tetanus.39 % of children aged from 12 to 23 months have received all basic
vaccinations. 16% of children in this age group have not received any vaccinations.(3)

About four in every ten Ethiopian women (41 %) did not receive any antenatal care for their last birth in
the five years preceding the survey. This represents a marked decline from fifteen years ago when
almost three in four (73%) pregnant women did not receive any antenatal care [14]. Sixteen percent of
births in Ethiopia are delivered at a health facility 15 percent in a public facility and 1 percent in a private
facility (11).

Estimated life expectancy in Ethiopia is 57 years for male and 60 years for females (14). The burden of
disease measured in terms of premature death is estimated at 350 disabling adjusted life years lost per
1000 population which is highest in sub-Saharan Africa. (12)

The disease burden responsible for 74% of deaths and 81% of disability adjusted years lost per year is
dominated by malaria, prenatal and maternal death, ARTI, Nutritional deficiency (malnutrition),
diarrheal and HIV/AIDS. Based on single point estimate there are nearly 1.2 million people living with
HIV/AIDS in Ethiopia. The adult prevalence rate is estimated at 2.4 % and incidence rate is 0.29% 3rd in
Africa and 8th among the highest TB burdened countries in the world. (12)

1.3. Significance of the study

TTP is a program designed to enable students to identify the actual community problem to
prioritize the problems and to intervene them It is important to assess health and health
related conditions as well as different factors and circumstances that have a great influence to
the health of the community. This study will provide us an insight to dig out health and health
related problems that have major effect on the health of the community. At large, the result of
this study possibly creates awareness to the community to solve health and health related
problems by themselves or with the concerned bodies. In addition to these working with the
community improves the credibility of the University the result also will open way for
concerned bodies to intervene in major health problems and provide support of starting point
for further detailed investigation required by anybody for complete solution. Finally, the finding
might be used as baseline those who in need.
CHAPTER TWO

LITERATURE REVIEW
2.1 Socio-Demographic Characteristics
Despite Ethiopia`s long history, there were no estimates of the total population of Ethiopia prior to
1900.avaliable estimated indicated that the population increased fourth fold between 1900 and 1988.
The total population of the country in 1900 was estimated 11.8 million and this doubled to 23.6 million
in 1960 years later data from 1984 and 1994 population to housing census show that overall population
of the country increased at annual of rate of about 2.3% between 1960 and 1970, 2.5% between 1970
and 1980, 2.8% between 1980 and 1990, 29% between 1990 and 1995.Between 1984 and 1994, there
was 26% increase in the overall population of Ethiopia from 43million to 54 million, the central statically
agency (CSA) projects that Ethiopia population could range anywhere from 104 million to 115 million by
the year 2016 [7].

2.2 Environmental Health Condition

2.2.1 Housing condition

Housing conditions are one of the most important factors which influence the health conditions of
individuals and community at large. Health effects can be directly triggered by inadequate housing
conditions [21].Since urbanization and increment of population size are directly related with the
demand of housing it is expected that the more the country is urbanized the more houses needed to
accommodate the large population in urban centers [9].

According to community based cross sectional study done in Boditi health center catchment area,
SNNPR, Ethiopia about 5(8%) of houses have 1 class, 17.7% 0f houses have 2 classes, 59.4% houses have
3 classes, 20% houses have 4 classes and rest of our respondents’ houses have 5 and more classes. Out
of 271 households 79.7% are cement floor and the rest 20.3% are soil floor. Majority of our study
households have adequate ventilation 77.1%. Those households with moderate ventilation are 20.3%
and 2.6% having poor ventilation n out of 271 houses. Out of 271 households 76.8% are clean, 18% are
moderately clean and 5.2%) are poor in cleanness [23].

Community based cross sectional study done on Hulbareg health center catchment area from May 01 –
03, 2018 showed that Majority of HHs housing condition 86.47% were not attached to their neighbor’s
house or fence. Among 377 households, majority 78.25% HHs had separate kitchen while the rest
21.75% were not separated from the house. (24).
2.2.2 Latrine Utilization
According to 2016 EDHS Six percent of households in Ethiopia use an improved and not shared toilet or
latrine facility. Another 9% of households (35% in urban areas and 2 percent in rural areas) use facilities
that would be considered improved if they were not shared by two or more households. Half of
households in urban areas (50%) use an unimproved toilet facility, compared with more than 9 in 10
(94%) of households in rural areas. The most common type of toilet facility in both urban and rural
households is a pit latrine without a slab or open pit (41% in urban areas and 55% in rural areas).
Overall, 32% of households have no toilet facility at all; they are almost exclusively rural, accounting for
39% of rural households. There has been an improvement since the 2011 EDHS, when 45% of all
households in rural areas did not have a toilet facility [9].

According to research finding in Lera health center catchment area among total of 393 households 4.6%
HHs had no latrine, 95.4% had latrine and of which 96.5% is traditional pit latrine, 2% was shared, were
98% owned by the family (private).Among the total of HHs 88% HHs had no associated hand washing
material after toilet, 78.4% had no cover over their toilet. Majority of HHs 68% had poor toilet utilization
and 92% were unclean [16].

2.2.3 Water Supply

According to EDHS 2016, about two-thirds of households in Ethiopia (65%) obtain their drinking water
from an improved source. This is an improvement since the 2011 EDHS, when 54% of households
obtained drinking water from an improved source. Use of improved drinking water sources is more
common among households in urban areas (97%) than among those in rural areas (57%) [9].

The most common source of drinking water in urban areas is water piped into the dwelling, yard, or plot
(63%), to a neighbor (12%) or to a public tap or standpipe (13%), resulting in about 9 in 10 urban
households (88%) using piped water. In rural areas, the most common sources of drinking water are
public tap or standpipe (19%), a tube well or borehole (13%) and a protected spring (14%) [9].

2.3. Vital statistics

Community based cross sectional study done on Hulbareg health center catchment area showed that
Among 377 households the total number of deaths in the last 12 month is 13, so among those 1 dead
persons were from each 7 households, 2 were from each 3 households but no death is present in 367
total households (24).

A Cross sectional study conducted in Masbira kebele, Lemo woreda, Hadiya zone by public Health
students showed that, Among 251 households 11.6% of them, had mothers who have given birth to a
child in the last 12 months. Out of these mothers 58.6% were between the age of 26&36. Among 29
deliveries within the last 12 months, 14% were delivered at home and 86% were delivered in heath
institution. And the majority of the deliveries are attended by health professionals (26).

According to research finding from worabe health center catchment area Among 380 total households,
Majority of households 58% were include family number of 6-10. According to our survey the total
number of deaths in the last 12 month is 1.9%, among those all were 1 person from different 7
households. Among them majority or 57% were males and rest were females, in which most of them or
71.4% were dead in case of disease [25].

2.4. Maternal and Child health care

2.4.1 Family planning

According to EDHS 2016, 36 percent of currently married women are using a method of family planning:
35 percent are using a modern method, and 1 percent is using a traditional method. Among currently
married women, the most popular methods are injectable (23 percent), implants (8 percent), IUD, and
the pill (2 percent each). The contraceptive prevalence rate (CPR) among married women increases with
age, peaking at age 25-29 (41 percent) before declining steadily to 19 percent among women age 45-49.
Urban women are much more likely than their rural counterparts to use any method of contraception
(52 percent versus 33 percent). By region, contraceptive prevalence rate ranges from 2 percent in
Somali to 56 percent in Addis Ababa. Contraceptive use increases with women’s education and
household wealth. For instance, 31 percent of women with no education are using a contraceptive
method compared with 55 percent of women with more than a secondary education. Women with no
living children (30 percent) and those with five or more children (28 percent) are the least likely to use
any method of contraception. Among sexually active unmarried women, 58 percent are currently using a
contraceptive method: 55 percent are using a modern method and 3 percent are using a traditional
method. The most commonly used methods among sexually active unmarried women are injectable (35
percent), implants (11 percent), the male condom, and emergency contraception (4 percent each) [11].

2.4.2 Antenatal care

The 2016 EDHS results showed that 62 percent of women who gave birth in the five years preceding the
survey received antenatal care from a skilled provider at least once for their last birth. Three in 10
women (32 percent) had four or more ANC visits for their most recent live birth. Urban women were
more likely than rural women to have received ANC from a skilled provider (90 percent and 58 percent,
respectively) and to have had four or more ANC visits (63 percent and 27 percent, respectively) (11).

2.4.3 Immunization
The 2016 EDHS collected information on the coverage of all of these vaccines among children born in
the 3 years preceding the survey. It was founded that full vaccination coverage is much higher in urban
areas (65%) than rural areas (35%). Full vaccination coverage is highest in Addis Ababa (89 percent) and
lowest in Afar (15 percent).Vaccination coverage increases with mother’s education. About 3 in 10 (31
percent) of children whose mothers have no education are fully vaccinated compared with more than 7
in 10 (72 percent) of children whose mothers have more than a secondary education. Similar patterns
are observed by household wealth. [11].
2.4.4 Institutional and non-institutional delivery
Community based cross sectional survey conducted in urban population Keble 05 Debiremarkos town
and shows that, Among 47 couples, 6.47% and 14.41% of them married in the age less than 18 and
greater than 18 years respectively. Among couples, 25.54% of women gave birth in the age of less than
18 years old while 48.94% of them gave birth between the ages of 18-35 years old. No abortion case
(legal and illegal) was found in the last 12 month (27).

2.4. 5 under five Mortality

According to the 2016 EDHS, the under-five mortality among the poorest 20% the population
(137/1000) was 1.6 times that of the wealthiest 20% of the population (86/1000). For children of
mothers with at least secondary education it was 46/1000, but for children of mothers with no
education it was 121/1000, 2.6 times as high as with that of children of mothers with at least secondary
education and more than 5 times as high as that of mothers with more than a secondary education (24
per 1,000 live births). Likewise, for children who live in urban areas the mortality rate was 83/1000,
whereas the rate for rural children was 114/1000, 1.4 times as high as that of the mortality rate for
urban children. There was also wide regional variation in mortality with U5MRs ranging from as low as
53 in the capital city of Addis Ababa to as high as 169 in Benishangul-Gumuz and 127 in Afar, the two
developing regional states of the country [11].

2.5 Communicable Diseases

The major proportion of morbidity and mortality in most developing countries including Ethiopia is
attributed to communicable diseases which could be prevented through simple interventions. According
to the CDC factsheet published in 2013, a death due to communicable diseases accounts about 34% of
the total deaths [32]. There were an estimated 429 000 malaria deaths globally, with the heaviest
burden borne by the WHO African Region –where an estimated 92% of all deaths occurred and by
children under 5 years of age, who accounted for more than 70% of all deaths [30].

Tuberculosis (TB) remains a major global health problem, despite being a treatable and curable disease.
In 2015, there were an estimated 10.4 million new TB cases and 1.4 million TB deaths, with an additional
0.4 million deaths resulting from TB among HIV-positive people. In 2015, the TB case fatality rate
(calculated as mortality divided by incidence) varied widely –from under 5% in some countries to more
than 20% in most countries in the WHO African Region. [30, 31]

In 2015, a reported 1.6 billion people required mass or individual treatment and care for neglected
tropical diseases (NTDs) down from 2.0 billion people in 2010. Most of these people required mass
treatment for lymphatic flariasis, soil-transmitted helminthiases, and schistosomiasis [30, 31].

Chapter 3 Objective
3.1 General objective
To assess, prioritize and intervene health and health related problems of Halaba kulito Health center
catchment Community, Halaba Zone, SNNPR, Ethiopia from july 20-august 4.
 3.2 specific objectives
To identify health and health related problems of the catchment community.

To prioritize major identified health and health related problems of the catchment community.

To intervene on major prioritized health and health related problems of the catchment community.

Chapter 4:-Method and Material

4.1 study area
The study was conducted in Halaba Kulito Health center catchment area community, which is found in
halaba Zone, SNNPR, Ethiopia. Halaba Zone is one of 13 Zones in the SNNPR Ethiopia

Based on the 2007 Census conducted by the Central Statistical Agency of Ethiopia (CSA), this Zone has a
total population of 232,325, of whom 117,291 are men and 115,034 women. With an area of 994.66
square kilometers, Halaba has a population density of 233.57; 26,867 or 11.56% are urban inhabitants. A
total of 49,028 households were counted in this Zone, which results in an average of 4.74 persons to a
household, and 47,205 housing units. The largest ethnic groups reported in Halaba Zone are the name
sake Halaba (79.08%), the Kambaata (7.95%), the Silte (3.19%), the Ari (2.58%), the Amhara (1.76%) and
the Hadiya (1.6%). Alaba is spoken as a first language by 77.23%, 7.7% speak Kambaata and 5.91% speak
Amharic. 90.9% of the population said they are Muslim, 5.02% are Protestant and 3.79% practice
Ethiopian Orthodox Christianity. [29]

Halaba Kulito health center is the only health center found in the woreda. Which is located in the
administrative center town called Kulito. The catchment area have 9 urban and no rural kebeles. The
catchment area has a total population of 61,583 of whom are 29 610 men and are 31,973women. The
total number of house hold in the catchments area is 12,563.

From the 9 urban kebeles in kulito town Denbebe fame has the largest population 11676 then Murrassa
ber 11289, Lenda ber 10554, Wanja Ber 6932, Mehal Arada, Hologeba Kuke 4973, Chanabula 4085
Huletegna Choroqo 3785, Andegna Choroqo 3686.

There are 4 High schools, 6 Elementary schools, 9 Mosque 3 churches and 1 Prison were found in the
catchment. There were 5 clinics, 4 Health post 5 Drug store and there was 1 general Hospital. There is 2
main road that crosses the catchment.
Figure 1 MAP OF HALABA KULITO HEALTH CENTER CATCHMENT AREA
 4.2 study period
The study was conducted from July 11 2023 – July 14 2023.

4.3 study design

Community based cross sectional study was conducted.

4.4. Population

4.4.1. Source population

All HHs in the two randomly selected kebeles.

4.4.2. Study population area

All selected HHs in the two randomly selected kebeles.

4.5. Sample unit

Each Selected HH

4.6. Study unit

Respondent in the selected HH

4.7. Eligibility Criteria

4.7.1. Inclusion Criteria

HHs who lived for at least for six months

4.7.2. Exclusion Criteria

 Respondents age less than 18 year old
 Persons who is mentally or critically ill

4.8. Sample Size Determination

The sample size for this particular study was calculated by using a single population proportion formula
considering the following assumptions:-

1. A single population proportion formula, n= was used to estimate the sample size with the
following assumptions:- n=(z a/2)2pq/d

n= n =z2 p (1-p) / d2 =1.962 *0.05(1-0.05)

(0.05)²

n=384

Since our population size is less than 10,000 (4456(35.5%)) we use reduction formula
nf=no(1+no/N)

384/ (1+384/4456)

=349 household then with 10% non-respond rate is 384

4.8.1. Sampling Technique

Study units were selected from both 2 kebeles,which are selected from all 9 kebeles which all are urban,
by using lottery method, proportional to population size of the kebele.from these both kebeles study
participants was selected by using systematic random sampling by using determined kth value.after first
household was selected by using lottery method from each kebele and then by using kth value, the
digital questionnaire was administered until the intented sample size was fulfilled using odk application.

Kth value=N/n

Where N stands for total number of house hold and

n stands sample size

Kth value =4456 /384= 12

4.8.2. Sampling procedure
Sample unit will be selected from all kebeles proportional to their population size

Halaba Kulito health center catchment area

(All are urban kebeles)

Andegna Huletegn Holegeba chanabula Murassa Denbebe Lenda Wanja Mahal

choroqo a kuke ber fame ber ber arada
choroqo

Using lottery method →

Murassa ber Lenda ber

←Using systematic sampling method →

THH= 2303 THH= 2153

n=199 n=185
K=12 K=12

Total n=384

Figure 2kebeles in Halaba Kulito health care catchment area, number house hold and proportionally
selected sample
 4.9. Variable of the study

4.9.1. Dependent variable

Health and health related problems

4.9.2. Independent variable

Socio demographic factors: - sex, age, family size, religion, marital status and educational status.

Vital statistics: - Birth, mortality, morbidity and migration

Environmental health: - housing condition, latrine utilization, source of water, water consumption,
waste disposal, presence of rodents and insects…etc.

Maternal and child health: - ANC coverage, family planning usage, immunization coverage, nutritional
status, skilled delivery….etc.

4.10. Operational definition

Monthly income-.( operationalized by group member according to context)

Daily water consumption (WHO 2016)

Inadequate - <20L/individual/day

Adequate - ≥20L/individual/day

Distance from home to water source (EDHS 2016)

Near - <30 minutes

Far -≥30 minutes

→ Ventilation

Good ventilation=house which have one or more windows for a room which are functional

Fair ventilation= a house which has one window but function partially

Bad ventilation= no windows or closed all the time/non functional

→ Illumination

Good illumination = A house in which lead/pencil written material can be read by natural light

Fair illumination= A house in which ink written material can be read by natural light
Bad illumination= ink written material is illegible

Poor latrine utilization-a latrine with no hand washing material after toilet and without target use of the
hole. (Operationalized by group member according to context)

Stakeholders: are individuals who are accepted as well as respected in the community like religious
leaders, administrative bodies, and elders and concerned about health related activities.
(Operationalized by group member according to context)

Respondent: is a person who respond for the interview question by representing the household.
(Operationalized by group member according to context)

Family size:- is number of people who live in one house hold.( operationalized by group member
according to context)

Health status:- the health condition of the community assessed on morbidity, mortality, disability and
utilization of health services.( operationalized by group member according to context)

Head of household: - is a person who is considered as a head of house by other members.

(Operationalized by group member according to context)

4.11. Data collection tools and quality control

Structured questioner which was already prepared by Wachemo University College of medicine and
health science from community based education department by using ODK software on mobile
application. It is given for students to collect information on the households’ socio-demographic
characteristic, sanitation service, housing condition and mortality and morbidity & other aspects of
health. Data was collected from respondents who were included in the sample. If the respondent is not
available during the time of survey we made another visit for those house hold on the next day. To
ensure quality of data, all data collected from respondents was checked for completeness, clarity and
consistency. Any misunderstanding or ambiguity was solved before data analysis by data editing and
checking, during data collection by supervision and feedback giving was cleared. The overall data
collection process was coordinated by the leader of the group & all of the group members actively
participating having a specific task.

4.12. Data processing and analysis

The data was sorted out, cleaned, edited and processed by SPSS and results of the study are presented
in the form of tables, charts, graphs and conclusions

4.13. Ethical consideration

The study was conducted after obtaining formal letter from WCU. We asked Permission from Halaba
administrative office and Health center officials. Verbal consent was obtained from the respondents
after through explanation of the purpose of the study. Data was kept to be confidential and culture,
norms and life style of the society was respected throughout the study process.

4.14. Dissemination and utilization of result

The finding of the study was disseminated through presentation and finally written document will be
submitted to WCU College of medicine and health science, to each department and, Halaba kulito town
health office and concerned bodies to design coordinated interventions

Chapter Five

RESULT AND DISCUSSION

Socio demographic characterstic

A total of 384 selected households took part in the study and yielded a response rate of 100%.
The mean (±SD). More than half (51%) of the respondents were heads and males. Regarding the
religion, the majority, 152 (39.6%) of respondents were Muslim and most of them are merchants
114 (29.7%) and regarding to ethnicity 126 (26.8%) were Kambata .and around 45.1% of the
respondent can write and read.

Table1: Socio-demoraphic characteristics of the respondents in Halaba zone, Murasa and Lenda
Ber Ethiopia, 2023

Variables Categories Frequency Percent

Relationship to HH Head 196 51.0

Spouse 127 33.1

son/daughter 50 13.0

other relative 11 2.9

Total 384 100.0

Sex of head of Household Male 179 46.6

Female 205 53.4

Total 384 100.0

Ethnicity Hadiya 62 16.1

Kembata 126 32.8

 Silte 53 13.8

Gurage 30 7.8

Other 113 29.4

Total 384 100.0

Religion Protestant 149 38.8

Muslim 152 39.6

Orthodox 78 20.3

Catholic 4 1.0

Others 1 .3

Total 384 100.0

Educational status of cannot read and write 37 9.6

respondent
Read only 15 3.9

read and write 173 45.1

Primary 73 19.0

Secondary and above 86 22.4

Total 384 100.0

Marital status of respondent Married 295 76.8

Single 65 16.9

Divorced 11 2.9

Separated 3 .8

Widowed 10 2.6

Total 384 100.0

tOccupational status of Farmer 20 5.2

respondent
government employer 88 22.9

Student 40 10.4
 Merchant 114 29.7

Unemployed 17 4.4

Tella seller 5 1.3

house wife 78 20.3

Wood carver carpenter 7 1.8

Others 15 3.9

Total 384 100.0

5.1.1 Means of communication

Among 384 HH, 278HH(72.4%) respondent do have radio set ,347HH(90.4%)of respondent
have TV set and they have cellphones 86.7%.around 63.5% or 244 HH couldn’t get news papers

Table3: Family Income of HH in Halaba town ,kebele Murasa and Lenda Ber ,Ethiopia2023.

Variables Categories Frequency Percent

Yes 278 72.4

Do you have radio set No 106 27.6

Total 384 100.0

Do you have private TV set Yes 347 90.4

No 37 9.6

Total 384 100.0

Yes 333 86.7

Do you have telephone No 51 13.3

Total 384 100.0

Have access to public phone Yes 338 11

No 46 8

Total 384 100

 Do you get newspaper fairly Yes 140 36.5
in time
No 244 63.5

Total 384 100.0

5.1.2 Family income of HH

Among 384HH 72.7%6R 279 HH Doesn’t have additional source of income such as house rent,
ranching..etc and around 44.3% 170hh of respondent monthly income ranging b/n 50-5000.

Variables Categories Frequency Percent

Do you have additional Yes 105 27.3

source of income
No 279 72.7

Total 384 100.0

Monthly ≤500 18 5.3

income(trading and gov.t) 1000-5000 173 54.2

6000-10000 141 38.2

11000-20000 51 13.8

>20000 2 .5

total 385 100.0

Vital statistics

There were 104(22.7%) birth in Halaba zone Murasa and Lenda Ber kebele in the last 12 month.
which 55 were males and 49 were females. among 104 births 93 were delivered in health facility
with professional attendant.
From 384 HH 128HH (31.8%) were experienced different disease in the last two among them 88
persons seeks help in health institution.

The common illness was fever it took 77% of the causes.

There were 15 death in the last 12 month 38 HH (9.9%) due to medical disease .among 384 HH
54(13.4%) were migrated and 50 6f them were males.

Table 4: Birth, morbidity ,mortality status with in last 12 month of households and migration
status in Halaba town ,kebele Murasa and Lenda Ber ,Ethiopia2023

Variables Categories Frequency Percent

Yes 104 22.7

Birth in the last 12 month No 280 77.3

Total 384 100.0

Age of the mother ≤20 299 78.1

21-30 41 10.7

31-40 38 9.9

≥41 5 1.3

Status of the baby live birth 109 28.4

still birth 7 2.6

NA 268 69

Total 384 100.0

Sex of newborn male 55 14.3

female 49 12.8

Total 104 72.7

Place of delivery Home 11 4.7

Health 93 24.2

NA 283 70.8

Total 384 100.0

 Attendant of delivery TBA 29 7.6

professional 85 22.9

NA 270 70.3

Total 384 100.0

Sick among member of the Yes 122 31.8

family
No 262 68.2

Total 384 100.0

Age of sick family 15-20 94 77.0

member
21-30 28 23.0

Total 122 100.0

Common disease(ailment) Fever 77 20.1

diarrhea 27 7.0

Cough 16 4.2

other specify 17 4.4

NA 247 64.3

Total 384 100.0

Days lost due to illness 1-10days 37 9.6

11-20days 39 10.2

Above 30 days 308 80.2

Total 384 100.0

Did the person seek help Yes 113 29.4

No 271 70.6

Total 384 100.0

Place where to seek help health institution 88 77.9

 traditional health 3 2.7

home level of 22 19.5

treatment

Total 113 100.0

Death in the last 12 month Yes 38 9.9

No 346 90.1

Total 384 100.0

Sex of the dead male 28 7.3

female 10 2.6

total 38 9.9

Age of dead family 20-40 10 2.6

member
41-60 10 2.6

other 18 94.8

Total 38 100.0

Perceived cause of death medical disease 30

accident 4

other 4

Total 38

Migrated from the house Yes 54 13.8

No 330 86.2

Total 383 100.0

Sex of migrant male 50 13.1

female 4 .8

Total 54 100.0
 Age of migrant 15-20 16 4.2

21-30 28 7.3

31-40 11 2.9

41-50 4 1.0

other 325 84.6

total 384 100.0

Perceived cause Work 35 68

Education 3 5

Marriage 6 11

Bussiness 3 5

other 4 7

Country of migration South Africa 17 33.3

Dubai 7 13.7

Saud Arabia 20 39.2

Canada 7 13.7

Current status of migrant Alive 43 84.3

Dead 2 3.9

Unknown 7 13

NA 317
5.3 Environmental Health Survey

5.3.1 WASTE DISPOSAL

In Halaba zone,kebele Murasa and Lenda Ber 325 HH (84.6%) have highly residential/domestic
waste and 83.6% of them have schedule to collect the waste.

The majority of the population uses the Pit type of latrine facility 326HH(84.4%).even if there is
adequate spaces for construction of latrine ,around 50.8% not affordable.

Table 5: Waste disposal system in Halaba town,kebele Murasa and Lenda Ber ,Ethiopia2023

Variables Categories Frequency Percent

Waste disposal system of 319 83.1

Closed
latrine
drained to pipes and then 13 3.4
to river

clearing the septic tank 18 4.7

Other 34 8.9

Total 384 100.0

Source of waste residential/domestic 325 84.6

Commercial 44 11.5
Industrial 1 .3
Other 14 3.6
Total 384 100.0

Schedule program to collect Yes 321 83.6

waste
No 63 16.4

Total 384 100.0

Final disposal method for sanitary land field 135 35.2

disposing collected waste
dumping in the river 21 5.5

open dumping 31 8.1

Burning 95 24.7

Composing 80 20.8
 Other 22 5.7

Total 384 100.0

Latrine facility Yes 367 95.6

No 17 4.4

Total 384 100.0

Pit 326 84.9

VIP 23 6.0

Type Flush 15 3.9

Other 1 .3

Total 384 100.0

How far is it from home?9in ≤1min 159 41.4

meter)
2-5min 97 25.3

6-10min 81 21.1

11-20 23 6.0

≥21 24 6.3

Yes 367 95.6

Do you have latrine facility No 17 4.4

Total 384 100.0

Ownership owned by family 296 77.1

shared or communal 84 21.9

other 4 1.0

Total 384 100.0

Adequate space for Yes 189 49.2

 construction of latrine No 195 50.8

Total 384 100.0

Construction affordable Yes 213 55.5

No 171 44.5

Total 384 100.0

5.3.2 Water Supply

From the selected 384 household 365 population (95.6%) uses water from Tap.The other 8HH
(2.1%) peoples uses water from Well and uses and purified method of boiling 31.4%
The Majority of population consume above 60-80 litter of water(29.1%) per day.

Table 7: Water Supply in Halaba town,kebele Murasa and Lenda Ber ,Ethiopia2023

Variables Categories Frequency Percent

Source of water supply Tap 367 95.6

Well 8 2.1

Spring 3 .8

Other 6 1.6

Total 384 100.0

Protected or not (well) Yes 158 41.1

No 25 6.5

NA 201 52.3

Total 384 100.0

≤2 184 47.9

Distance from the toilet 3-10 153 39.8

11-20 23 6.0

21-50 20 5.2

≥51 4 1.0

Downhill from the toilet Yes 164 42.7

 No 220 57.3

Total 384 100.0

Employ method of Yes 185 48.1

water purification
No 199 51.7

Total 384 100.0

Which method Boiling 119 31.0

traditional filtration 18 4.7

standard filtration 23 6.0

chemical tretment 23 6.0

2 .5
Other

Total 384 100.0

Consumption of water 1-40 55 14.3

41-60 114 29.7

61-80 106 27.6

Above 109 28.4

Total 384 100.0

5.3.3 HOUSING CONDITION

In Halaba town , from selected 384 population 36.7% (141hh) have three rooms and most of the
home are well ventilated ,illuminated and clean house.

Around 50% the house have separated quarter and the kitchens are separated but detached to
the main house.

Table 6: house condition in Halaba town,kebele Murasa and Lenda Ber ,Ethiopia2023.

Variables Categories Frequency Percent

Number of rooms One room 44 11.4

Two rooms 178 46.3

 Three rooms 151 39.7

Total 384 100

Ventilation Good 284 74.0

Fair 98 25.5

Bad 2 .5

Total 384 100.0

Illumination Good 268 69.8

Fair 114 29.7

Bad 2 .5

Cleanses Good 289 75.3

Fair 92 24.0

Bad 3 .8

Type of floor Cement 312 81.3

Soil 63 16.4

Wood 5 1.3

Cracks on the floor Yes 119 31.0

No 265 69.0

Total 384 100.0

Frequency of house cleaning One time 89 23.2

two per days 170 44.3

three per days 107 27.9

above 13 3.4

Livestock in the house Yes 128 33.3

No 256 66.7
 Total 384 100.0

Are they living with your Yes 29 7.6

house No 99 25.8

Type of kitchen separate but attached 171 44.5

to main house

separate room but 195 50.8

detached

no kitchen at all 18 4.7

Total 384 100.0

5.3.4 FOOD SANITATION

Around 98% Halaba’s selected 384 people washes hand ,vegetable ,cooks adequately and clean
the material frequently.

Around223hh 56.1 % uses refrigerator for food preservation method around other 144hh
37.5% uses method of drying.

Table 8: Food Sanitation in Halaba town,kebele Murasa and Lenda Ber ,Ethiopia2023 .

Variables Categories Frequency Percent

washing hands 69 71.1

7 7.2
washing vegetables

proper and adequate 16 16.5

cooking
material cleaning 4 4.1
frequently
Method for preserve food Refrigerator 223 58.1

Drying 144 37.5

Other 17 4.4

Total 384 100.0

5.3.5 INSECT AND VECTOR CONTROL

Variables Categories Frequency Percent

Stagnant water Yes 156 40.6

No 228 59.4

Total 384 100.0

Is there any method use Yes 290 75.5

to control insect
No 94 24.5

Total 384 100.0

Insect control method Bed net 211 24.5

Insecticide 62 54.9

draining stagnant water 7 16.1

insect repellant 10 1.8

Total 384 2.6

Rodent infestation Yes 249 64.8

house
No 135 35.2

Total 384 100.0

Method for eradication Poison 101 26.3

mouse traps 52 13.5

Cats 83 21.6

Other 13 3.4

5.4 Maternal and child health

5.4.1 Maternal nutrition
In Halaba ,73 women those who breast feeding frequency during pregnancy was 19% feeds
three per day and also those who had taken diatary food like fatty and proteins during their
pregnancy were 120 ( 31.4%).
Table 10. Maternal Health in Halaba town,kebele Murasa and Lenda Ber ,Ethiopia2023

Variables Categories Frequency Percent

Frequency of feeding in a twice per day 10 2.6

day
three per day 73 19.0

four per day 22 5.7

NA 279 72.7

Total 384 100.0

Dietary food Yes 120 31.3

No 18 4.7

Total 246 64.1

Staple food during Enjera 143 37.2

pregnancy
Bread 11 2.9

Vegetables 31 8.1

Others 4 1.0

5.4.2 Child nutrition

In Halaba zone kebele among 384 house hold 136(35.4%) of children were feed breast and
37.8%%of children initiated complementary food after six(6) months.and other starts at 12
months of their age.

Table 11: Child Nutrition in Halaba town,kebele Murasa and Lenda Ber ,Ethiopia2023

Variables Catagories Frequency Pecent

Child exposed to sunlight Yes 134 34.9

or not
No 27 7.0

Breast fed Yes 136 35.4

 No 23 6.0

Currently breast feeding Yes 136 35.4

No 23 6.0

NA 225 58.6

Total 384 100.0

Complimentary food At 6 month 144 37.8

initiation
at 12 month 19 5.0

one up to six month 144 37.8

six up to twelve 19 5.0

Combination of food food made of cereals only 15 3.9

feeding child
food made of cereals and 43 11.2
legumes

milk alone 10 2.6

milk, cereals and legumes 100 26.0

combined

Frequency baby eating Once 4 1.0

other than liquids
yesterday during day and Twice 29 7.6
night
three times 35 9.1

four times 90 23.4

5.4.3 Child Immunization

In Halaba among 384 house hold 114HH (29.7%) less than2 years old and most of them have
vaccination card 122(31.8%) and only few of them doesn’t have vaccination card (8%)
Variables Categories Frequency Percent

Under 2 Yes 114 29.7

No 114 29.7

NA 156 40.6

other 384 100.0

Child vaccinated Yes 110 28.6

No 3 .8

NA 1 .3

Total 384 100.0

Vaccination card Yes 122 31.8

No 47 12.2

NA 215 56.0

Total 384 100.0

Does the baby vaccinated all Yes 49

types of vaccine such as
BGC,OPV,PENTA,MEASEALS. No 67

.
Total
 Maternal health
In Halaba town, among 384 house hold (13.8%), were pregnant women and among that 84
(21.9%) was visited in health care and ( 2%) received tetanus vaccination.

Table13: Antenatal Care Child Nutrition in Halaba town,kebele Murasa and Lenda
ber ,Ethiopia2023

Variables Catagories Frequency Percent

Is there pregnant mother in Yes 53 13.8

the family
No 331 86.2

Total 384 100.0

Term of pregnancy First trimester 13 24.5

Second trimester 8 15.1

Third trimester 32 60.4

Does she visit ANC service Yes 84 21.9

No 300 78.1

Total 384 100.0

How many times did she 1 16 4.2

visit health facility
2 12 3.1

3 22 5.7

4 21 5.5

5 6 1.6

6 6 1.6

Total 384 100.0

Is she tested for HIV/AIDS Yes 96 25.0

during ANC visit
No 288 75.0

Total 384 100.0

Do you know your HIV Yes 99 25.8
status
No 285 74.2

Total 384 100.0

Did you receive TT Yes 94 24.5

vaccination during ANC
service No 290 75.5

Total 384 100.0

How many doses did receive TT1 25 6.5

tetanus toxoid vaccination
TT2 25 6.5

TT3 20 5.2

TT4 13 3.4

TT5 11 2.9

pregnant women who took TT vaccine.

18.7% not
vaccinated

vaccinated
unvacinated

81.3% TT vac-
cinated

5.4.4.2 Family planning

Do you know any Yes 294 76.6
 information about No 90 23.4
contraceptive
Total 384 100.0

Do you know any Yes 288 75.0

contraceptive methods
No 96 25.0

Total 384 100.0

Methods Pill 25 6.5

condom 3 .8
injectable 31 8.1
norplant 5 1.3
IUCD 2 .5
Other 1 .3
Currently uses Yes 114 29.7
contraceptive method
No 270 70.3

Which type ,you are using Pill 15 3.9

Condom 63 16.4

Injectable 21 5.5

Nor plant 12 3.1

Other 2 .5

6 1.6
Geographical east

281 73.2
west

59 15.4
north

38 9.9
south

384 1.6
Total

99.0 99.0
urban
 1.0 1.0
Cathement rular

100.0 100.0
Total

Is there electrical supply? yes 100.0

384

no 0 0
32 8.4
Type of marriage polygamous

337 88.0
monogamous

14 3.7
other

383 100.0
Total

latrine shortage 41 10.6

What are the community problem
malaria 47 12.2
stagnant water 38 9.9

false labratory test 95 24.7

Cholera 43 11.2
vaccine shortage 20 5.2
33 8.6
muddy water
Male 77 20.1
Sex of child MUAC
Female 79 20.6
measure
NA 228 59.4
Total 384 100.0

1. PROBLEM PRIORITIZATION

1.1 Identified problem

 Low utilization of contraceptive

 Inadequate space for construction of latrine
 Poor water purification
  Rodent infestation
 Incomplete child vaccination
 Poor ANC follow up
 Unaware of HIV/AIDS status
 False laboratory result
 Poor dietary food consumtion during pregnancy
 Poor TT vaccination during prenancy.

Prioritizing criteria

1. Magnitude

5= It covers very high percentage of the identified problems

4= It covers high percentage of the identified problems.

3= It covers medium percentage of the identified problem.

2= It covers low percentage identified problem.

1=It covers very low percentage of the identified problem.

2. Severity

5= Very high consequent suffering and disability from the identified problem

4= High consequent suffering and disability from the identified problem.

3. Moderate consequent suffering and disability from the identified problem.

2= Low consequent suffering and disability from the identified problem.

1= Very low consequent suffering and disability from the identified problem.

3. Feasibility

5= highly feasible considering available resource

4= more feasible considering available resource.

3= feasible considering available resource.

2=Less feasible considering available resource.

1= Not feasible considering available resource.

 4. Community Concern

5= Very high in terms of political and social acceptability with consideration of equity from the identified
problem.

4= High in terms of political and social acceptability with consideration of equity from the identified
problem.

3= Moderate in terms of political and social acceptability with consideration of equity from the identified
problem.

2= Low in terms of political and social acceptability with consideration of equity from the identified
problem.

1= Very low in terms of political and social acceptability with consideration of equity from the identified
problem.

5. Government concern

5= Very high involvement of government is required.

4= High involvement of government is required

3= Moderate involvement of government is required.

2= Low involvement of government is required.

1= Very low involvement of government is required

Prioritization of problem
Table : Prioritized problems in Halabazone in 2022

List of problems to be magnitud Severity Feasibility Community Government Total Rank

prioritized e concern concern

4 4 4 3 5 20 3
Low utilization of
contraceptive
 5 4 5 5 4 23 1
Waste disposal

4 4 4 4 4 20 3
latrine

3 3 2 3 3 14 9
Rodent infestation

4 4 4 3 4 19 6
Incomplete child
vaccination

5 3 4 3 5 20 3
Poor ANC follow up

5 3 3 3 5 16 8
Unaware of
HIV/AIDS status

4 4 5 4 4 21 2
stagnant

4 3 4 3 4 18 7
Poor TT vaccination
during pregnancy.

Prioritized Problem

1. Poor waste disposal.

2. Stagnant water.

3. Shared and unimproved latrine usage.

4. Low utilization of Family planning method.

5. Poor ANC

Action Plan
Problem Base line objective Strategy Target Activity Responsibil Resource
ity

poor 27.8% To increase poor Working The Halaba Educating the The The kebel
waste waste disposal system with the Kulito HC community; kebele; Human
disposal from 27.8% to 35 kebele and catchment Providing community power;
properly Communi
%July in 23 – Aug 06 responsible area
programmed Voluntere
bodies
and organized
waste disposal
system

High 40.6% To drain and dry Working The area educating the The The
proportio stagnant water as with; health with in our community community Governme
n of much as possible in extension study about the ; ; NGO ;
Human
stagnant Halaba Kulito HC workers; catchment dangerousnes governmen
power
water catchment area from the area s of stagnant t body and
40.6%to 45% July 23 community water health
to 30 office of
kebele and
health
extension
workers

Shared 21.9% To increase the Working Educating the Health

and quality of latrine in together community extension
unimprov Halaba Kulito HC with the about latrine workers;
society ,gov …..
ed latrine catchment area from usage
ernment
facility 21.9 to 38% , from and health
July 23 to Aug 6 Supply &
extension
amount of
workers
 water.

Low 27.5% To increase utilization Working All Creating Governme Governme

utilization of contraceptive with health reproducti awareness nt ,NGO's and NGO
of family method from 27.5% extension ve age about the health and west
extension Halaba
planning to 50%; from July 23- workers ,ke group meaning type
workers health
methods 30 bele individuals and benefit of extension
administrat contraceptive workers.
or’s and HC method

Low ANC 72.6% To increase ANC Working All Media Health Governme
follow up follow up ; from with Halaba pregnant campaigns institution NGO’s
72.6% to 80% in July Kulito HC in women’s reaching the of the Human
collaboratio society, zone; power
23- 30 in Halaba
n with any Publishing and All group
Kulito HC
media & ….flyers, members
publisher at catchment Providing full
the zone area ANC service
using focused
approach,
Facilitating
transport for
high risk
pregnant
mothers
 5: WORK PLAN AND BUGDET BREAK DOWN

5.1 Work plan of the study

Table 1. Gaunt chart showing work schedule, WACHEMO, July and august, 2015

Work plan JULY-AUG

JULY11-14 JULY JULY12- JULY AUG

15 14 14- 13
AUG
12

Proposal development

Proposal presentation to
resident supervisor

Data collection,
analysis& interpretation

Intervention and mini

projects
 Final report submission

5.1 BUGDET

No   Unit Qty. Unit price Total

cost

1 Marker Pcs 6 45 270

2 A4 size paper BOX 1 375 375

3 Internet data 150 150

Sub 795B
Total irr

Personnel

  Personnel Number Cost/day Number of Total

days
 2.1 Principal 23 65 3 4485
investigator

4485
Sub total

5130

GRAND TOTAL
Table 2 total budget

6. CLINICAL ACTION PLAN

Key activities of the Departments

Adult OPDs
It is organized and concerned with serving clients of age greater than 5years old. . This OPD
provides medical service for all patients those presenting with different health problems, in
addition they provide medical certificate for medico legal and other cases when requested
formally. In average 20 patients visit in each OPD per day.

Table 3 Adult top 10 diseases in Halaby kiloton health center catchment area from 2009-
2010EC

NO DISEASE FREQUENCY
1 AFI 6843
2 Helminthiasis 2824
3 UTI 2003
4 All respiratory diseases 1502
5 Infection of skin 1430
6 Dyspepsia 1473
7 Trauma 690
8 MALARIA all type 333
9 Otitis 247
10 Other new diagnosed 1819
 Total new diagnose 22386

Under 5 OPD
They provide the service for < 5ys of age clients. The services being provided are treating
different medical problems, screening children for malnutrition and management of MAM and
uncomplicated SAM and complicated SAM.It serves 15 patients daily on average.

Table 4the five top disease of under five children in the Kulito health center catchment area
of 2009 EC

NO DISEASE FREQUENCY
1 AFI 3705
2 PNEUMONIA 2069
3 Diarrhea 1902
4 All resp. disease 469
5 Otitis 409

Stakeholder Analysis
- is the technique used to identify the key people who have to be won over.
Top stake holders
HEWs
Keble administrator
Health facility administrators and professionals
Police office
Town municipality
Wachemo University
Coordinators
Community
School directors

Table 5. Weekly Static activity action plan in Kulito HC,July2023

  Timeline in a Week

  Total 2nd&3rd Week 4th Week

Static activities and sub

Achieve

Achieve
Total %

activities
Plan

Plan

Plan
%

%
Adult OPD 300 200 100

<5 OPD 225 150 75

Emergency OPD 80 40 40

MCH Service

Family Short term

planning
10

30 20
 Long term

15 10
25

ANC ANC 1 50 25 25

ANC 2 30 15 15

ANC 3 30 15 15

ANC 4 50 25 25

TT1 90 45 45

TT2 90 45 45

TT3

TT4

TT5

Delivery 40 20 20

PNC 40 20 20

EPI BCG 60 30 30

OPV0 60 30 30

Penta1 60 30 30

PCV1 60 30 30

OPV1 60 30 30
 Rota1 60 30 30

Penta2 60 30 30

PCV2 60 30 30

Rota2 60 30 30

Penta3 60 30 30

OPV3 60 30 30

PCV3 60 30 30

Measles 55 30 30

Vitamin A 50 25 25

Laboratory Service

Serology Widal test 90 45 45

H.pylori 50 25 25

Urine HCG 40 40 40

VDRL 40 40 40

Parasitology Stool 100 45 50

examination

BF 100 50 50

Urinalysis Urine 40 20 20
microscope

Urine 80 35 45
dipstick

Bacteriology AFB 20 7 8

Immune Blood 50 25 25
hematology grouping

Clinical RBS 40 20 20
chemistry
FBS 40 20 20

Hematological WBC 60 25 35
test differential
 SWOT analysis
Strength
Wise use of resources by group members.
Active participation of group members.
Close supervision of our advisor and providing us the
right comment at the right time
Punctuality of group members
Coordination and collaboration of members
Ethics of members
Weakness
Unable to find the actual map of Halaba.
shortage of time.
shortage of data collection tool (smart phone)
skill gap toward ODK app
Lack of common Understanding on ODK questionnaire
Opportunity
Willingness of community and kebele leaders to provide
information
Willingness of respondents during data collection period
Preparation of advanced data collection technology by the
university
Community smooth relationship
Threats
Unfavorable weather condition
REFERENCE

1,Department of Community Health (2010) Manual for Student Research Project. Jimma: Jimma
Institute of Health Sciences 1-71.

2.National Center for Health Statistics (2006) Health, United States, with chart Book on trends on the
health of Americans. Hyattsville, MD.

3, Ethiopian demographic health survey; published in 2016

4. HIV available at https://en.m.www.who.int.gho.HIV (accessed on May 17, 2017)

5.Beatrice A, et al, Epidemiology of malaria in endemic areas, Mediterranean journal of hematology and
infectious diseases. 2012;4(1))

6.(AtekurDefar and BilutkenawTamiru , 2012, first edition,Basic concept of research methods for
health and health related problems)

7. Central Statistical Agency (CSA) [Ethiopia] and ICF. 2014. Ethiopia Demographic and Health Survey
2014: Key Indicators Report. Addis Ababa, Ethiopia, and Rockville, Maryland, USA.CSA and ICF.

8 The world health report 2001-Mental Health: new understanding, new hope, May, 2017)

9. Ethiopia health care demography survey 2011.

10. United Nations ,Millenium Development Goals Report 2013.

11 Maternal and child health and nutrition, Ministry of health, Ethiopia, 2016)

12. Cross sectional community study on South Africa, 2014

13.Wachemo university college of medicine and health science health and health related problems in
Areka health center catchments SNNPRS, Ethiopia

14.

15.Maternal and child health and nutrition, Ministry of health, Ethiopia, 2016)

16.Cross sectional community study on South Africa, 2014

17.Wachemo University College of Medicine and Health science, assessment of student’s health and
health related problems hulbareg SNNPR ETHIOPIA, 2017.

18.Wolaita sodo University College of medicine and health science student, assessment of student’s
health and health related problems bodity SNNPR Ethiopia 2016.

19.Wachemo University College of Medicine and Health science, assessment of student’s health and
health related problems, lera SNNPR, Ethiopia 2017.

20.National Center for Health Statistics (2006) Health, United States, with chart book on trends on the
health of Americans. Hyattsville, MD.

21.Wachemo University College of Medicine and Health science, assessment of student’s health and
health related problems, mesbira SNNPR, Ethiopia June 2017.

22.Wachemo University College of Medicine and Health science, assessment of student’s health and
health related problems, worabe SNNPR, Ethiopia June.

23.Debere markos University College of Medicine and Health science, assessment of student’s health
and health related problems, Debre Markos Amhara, Ethiopia 2017.

24. Community based cross sectional study Hulbareg health center 2021

25.Arbaminch university collage of medicine and health science assessment of community health and
health related problems in chencha , SNNPRS, Ethiopia June

26.Bolohora university college of medicine and health science assessment of health and health related
problems in

27.Wachemo University College of medicine and health science. on health and health related problems
in butajirra mesken woreda

28.Wachemo umiversity collage of medicine and health science, on health and health related problems
in Angancha woreda SNNPRS. Ethiopia august

29.wikipedia

30. Adapted from: Kieny MP, Bekedam H, Dovlo D, Fitzgerald J, Habicht J, Harrison G, et al.
Strengthening health systems for universal health coverage and sustainable development. Bull World
Health Organ. 2017
31. Central Statistical Agency (CSA) [Ethiopia] and ICF. 2016. Ethiopia Demographic and Health Survey
2016: Key Indicators Report. Addis Ababa, Ethiopia, and Rockville, Maryland, USA.CSA and ICF.

32. Global database on child growth and malnutrition [online database]. Geneva: World Health
Organization; 2017 (http:// www.who.int/nutgrowthdb/database/en).