KNOWLEDGE AND ATTITUDE ABOUT COMMUNITY BASED

TRAINING PROGRAM(CBTP) AMONG REGULAR GRADUATING

CLASS STUDENTS UNDER INSTITUTE OF HEALTH SCIENCES,
IN JIMMA UNIVERSITY
JIMMA UNIVERSITY

BY: MUHAJER HUALIS (BSC NURSE STUDENT)

A RESEARCH PAPER SUBMITTED TO JIMMA UNIVERSITY, INSTITUTE OF

HEALTH, FACULITY OF HEALTH SCINCES, SCHOOL OF NURSING, IN
PARTIAL FULFILLMENT OF BACHELORS DEGREE IN NURSING

AUGUST, 2021
JIMMA, ETHIOPIA
 JIMMA UNIVERSITY

INSTITUTE OF HEALTH
FACULITY OF HEALTH SCIENCES
SCHOOL OF NURSING

KNOWLEDGE AND ATTITUDE ABOUT COMMUNITY BASED

TRAINING PROGRAM(CBTP) AMONG GRADUATING CLASS
STUDENTS UNDER INSTITUTE OF HEALTH SCIENCES,
JIMMA UNIVERSITY

BY: MUHAJER HUALIS (BSC NURSE STUDENT)

ADVISOR: DESTA WORKNEH (ASST. PROFESSOR)

AUGUST, 2021
JIMMA, ETHIOPIA
ABSTRACT
Background: Jimma University started Community Based Education science since its
inception as Jimma Institute of Health Sciences. Community Based Education is a means
of achieving educational relevance to community needs. It consists of learning activities
that uses the community extensively as a learning environment. All students in Jimma
University is required to undertake Community Based Education courses in which they
are deployed in community diagnosis, data collection, implementation and evaluation
regarding to matters related to their field of study. To this end study on Community
Based Training Program is scarce calling for this study.
Methods: A cross sectional study was conducted from August 16 To August 20, 2021
GC. The source population for the study comprises all students enrolled in Institute of
health science during the academic year 2021. The study population was systematically
selected from the source population considering all departments in which the target
selected proportionally. Information collected comprises questioner on knowledge and
attitude towards Community Based Training Program. Data was collected by using self-
administered and pretested structured questioners by the principal investigator and two
trained data collectors facilitators. The collected information was analyzed; statistical
tests was computed manually using scientific calculators.
This study provides an insight in to knowledge and attitude of graduating class students
regarding community-based training program. In addition, it tries to suggest some
possible recommendations to improve the program and be a guide to further University
wide research activities and processes.
Result:
Conclusion and recommendation:

I
ACKNOWLEDGEMENT

I am grateful to my respected advisor DESTA WORKNEH (Asst. professor) for his

priceless guidance and support to go through the Conduct of this research. I would also
like to extend my thanks to the staff of health science library internet services and CBE
office staff for their endless efforts in providing the necessary support. Last but not least,
my deep gratitude goes to my study subjects who are graduating class students under
institute of health science.

II
TABLE OF CONTENTS

III
LIST OF TABLES

Table 1: Pattern and extent of response rates of students by Department, Jimma Zone,
south west Ethiopia, July 2021.
…………………………………………………………………..

Table 2: Socio demographic characteristics of respondent Jimma University, Jimma

Zone, South west Ethiopia July 2021.

Table 3: knowledge of students towards concept, principles & objectives of CBTP by

department among GC students of Institute of health sciences, Jimma University, July
2021.

Table 4: Frequency distribution of student’s attitude toward CBTP by Department Jimma

Zone south west Ethiopia July 2021.

Table 5: Problems in implementation of action plans during CBTP by department among

GC students of Institute of health sciences, Jimma University, July 2021.

IV
Table 6: Perceived short comings of CBTP for the perspective of GC students of Institute
of health sciences, Jimma University July 2021.

Table 7: Suggestion towards the future of CBTP activities by department among students
of institute of health sciences, Jimma University, July 2021

LIST OF ABBREVIATION

CBE- Community based education

CBTP- Community based training Programme
COEP- Community oriented education Programme
COE – Community oriented Education
HFA- Health for All
JU- Jimma University
GC- Graduating Class
PHC- Primary Health Care
SWE – South west Ethiopia
SRP- Students Research project
WHO- World Health Organization

V
VI
CHAPTER ONE: INTRODUCTION

1.1 Back ground

A popular demand arose regarding a new way of educational program which focused on
giving service to society in late 1970s. A serious of conferences and symposiums
regarding community oriented education took place along with the social movements of
the 1960&70’s which gave birth to the idea that higher learning institutions could
incorporate such teachings in their structure, academic plans & research to make their
activity relevant to community development & take part in society developmental change
(1).
Following this era Universities all over the world in addition to being responsible with
problems of knowledge, it’s expansion & transmission realized their success can’t be
separated from the society from whom much knowledge is derived & started to adopt
programs which take part in active involvement in solving urgent problems of society. (1)
Adoption of community based education in all countries of health professional training
institutions particularly in developing countries started in collaboration with the world
health organization. This notion implied learning activity should take place in the
community in collaboration with related sectors in problem identifying, prioritizing,
planning and implementation or solving approach using the community as source of
knowledge involving not only students but teachers, community members & other
stakeholders (1).
Jimma University (JU) is the national pioneer of community based higher education.
Even though the philosophy was adapted by health sciences at the beginning, all the
disciplines of the university are currently implementing it. In order to realize the
philosophy, JU uses its own strategies through CBTP, Team Training program and
students research project (1).
JU initially adopted CBE in 1990 in what was the called JIHS as it was the right strategy
to meet with the missions of the institute which involve production of a new generation
of health workers who were aware of the developing needs of the community (3).

7
Currently CBE as a strategy at JU have four components CBTP, TTP, DTTP and SRP.
Community based training program is one component of CBE which is initiated at the
very early educational exposure in the 1st year & continues up to the end of training in
consecutive phases taking 3-4 weeks every academic year throughout the surrounding
community(4).
It takes place in various rural & urban communities in 50 km radius around JU divided in
to six main districts which are further classified in to 65 Kebeles comprising of
population of 3000-10000 people.
Students enrolled in to the program are dispatched to the designated Kebeles & go
through data collection using structure questioner format , community diagnosis, activity
planning, implementation and finally evaluation Which gives them a chance to have an
insight in to the community problems & initiate possible intervention with local recourses
& give service to community(4).
At the end of each COMMUNITY BASED TRAINING PROGRAM attachment students
are expected to
 Define demographic, socio-economic & environmental aspects
 Make community diagnosis and draw health action plan suggesting appropriate
intervention
 Organize feasible intervention based on field of training and community need
 Plan and conduct problem oriented and community base research
During pre-graduation years, CBTP runs for 2,3,4 and 5 years, for academic years of
programs that take 3,4,5and 6 years respectively, with each phase having specifically
defined educational objectives related to class room teaching. Students are assigned to
urban, semi-urban and rural communities with approximate population size of 600-10,
1000 within 50 km radius form JU as identified by the CBE coordinating office. During
each phase of CBTP,3-5 staff members assigned to supervise students’ activity (2).

8
1.2 Statement of the problem
Traditional educational approach is not helping the development and health needs of the
society. Cognizant of this fact, countries adopted new educational strategy which is
activity based; engaging students in a challenging, novel and unpredictable problem-
solving skills through field works, community attachments and case studies that have the
potential for nurturing learners’ imagination and creativity (3).
This strategic educational approach needs continuous assessment tool to evaluate the
learning- teaching activities and the intended outcome of the programs (5).

Despite of this fact, experience has shown that in some educational institutes planning,
implementation and evaluation of educational programs have tended to be haphazard,
uncoordinated and ineffective, resulting in poor student motivation (6,7).

Adequate Knowledge on behalf of the students aids in near accurate identification of

timely community heat waves, deep sited initiation & positive work ethics essential in
undertaking intervention in timely and appropriate manner.
Adequate response & intervention from students, CBE programs & higher learning
institutions will form the bases & monuments for the community to build confidence on
its fellow trainees & make them a strong building fist in their upcoming professional lives
in undertaking their responsibility thoroughly. Nevertheless, inefficient CBE program
will give rise to staggering professionalism, poor community compliance & worsening of
social problems.

In Jimma University during community-based education, the learning-teaching process

fairly follows the new strategic educational approach. To date though there are some
attempts made to evaluate community-based education in general, researches on specific
strategy of CBE are limited. So, this research was conducted to assess the knowledge
and attitude towards one of the strategies of CBE; CBTP from the perspective of health
science students in Jimma University, south west Ethiopia.

9
1.3 Significance of the study
CBE is a strategy in education which moves training into the community to make

education serve people in improving their life & at the same time curve students in a way

that they will be capable to meet ever changing society needs as professionals in the

future. But how can we be sure that these objectives are meet?

Only a few studies were made evaluating Community Based Training Program activities

in JU since the launch of the program. Hence this study will provide baseline data for

further studies made on the evaluation of the program & to fill the gap in information for

future planning of CBE activities.

In addition, findings & recommendations of this study could possibly be used to redesign,

modify & redefine the program in a more effective & fruitful making it a fertile ground

for both the participants & community.

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CHAPTER TWO: LITERATURE REVIEW

Almost three decades have elapsed since the World Health Assembly of the world Health
Organization (WHO) declared its intent to achieve `health for all`. Consequently,
governmental and non-governmental bodies declared primary health care as the key to
attain the goal of HFA (4).

Jimma university of Ethiopia, a member of international network of community-oriented

education (COE) institution for health sciences, CBE is used to link the community with
students learning where students are given a wide range of learning opportunities to apply
their theoretical knowledge to assess, plan and solve community health problem (5).

Despite the importance of CBE, experience has shown that in some educational institutes
planning, implementation and evaluation of educational programs have tended to be
haphazard, uncoordinated and ineffective, resulting in poor student motivation ( 6,7).

Adequate Knowledge on behalf of the students aids in near accurate identification of

timely community heat waves, deep sited initiation & positive work ethics essential in
undertaking intervention in timely and appropriate manner.
Adequate response & intervention from students, CBE programs & higher learning
institutions will form the bases & monuments for the community to build confidence on
its fellow trainees & make them a strong building fist in their upcoming professional lives
in undertaking their responsibility thoroughly. Nevertheless inefficient CBE program will
give rise to staggering professionalism, poor community compliance & worsening of
social problems.
In a study conducted here In JU on medical and graduating post basic students’ majority
of the participants with mean score of 3.66 had adequate orientation and knowledge about
the concept, principle & objectives of the program. Regarding overall effort of students &
supervisors in making Community Based Training Program fruitful was 3.1 & 2.7
respectively. While majority of the students with mean score of 3.31 had a positive
attitude towards the program 24% had poor or very poor outlook of which 78% said
11
inability to implement action plans due to low resources were their reason. Many students
also agree on continuation of the program with improvement.

A study done in Indonesia identified one of the main problem in CBE, was students’ poor
participation in a group (9).

Studies from Africa showed factors affecting CBE. The studies identified short practice
time, lack of regular contact of mentors with students and dominance of the group by
individual students as detrimental to learning in CBE (10). It also mentioned that mentors
bias towards individual students who dominate the group, domination of the group by
mentors and lack of prior knowledge of students hinders learning in CBE (11).

Sufficient time for students’ interaction with the population in the placements and
development of practical skills is an important factor that facilitates learning in CBE(12).

CBE found to be successful in some countries. In Nigeria one of the factors contributing
to the success of CBE was agreement of students and mentors on prioritizing identified
health and social problems (14).

A study done in Nigeria showed that, the activities performed by students during CBE
were, ‘health survey (23.8%), health education activities (16.7%) and clinical based
activities (14.4%) (16).

Mackenzie (1992). Indicated the positive qualities of mentors as awareness of students’

previous experience, demons trating practice, enabling students to practice, reassuring &
Encouraging student & monitoring students’ work.

A study done at Jimma University on nurse students with covage of 90% of students
identified that, dominance of the group by individual students (50%), emphasizing
mistakes by mentors (50%), low credit rating (52%) were hindering factors to learning in
CBE, While relevance to future career (72%), orientation to placements (72%),

12
explanation to some questions by mentors (52%) and participation in group work were
factors that facilitate CBE.
The study also assessed the of CBE met and found that identifying socio demographic
data (93%), drawing action plan (82%), identifying community health problem (77%)
and preventive health intervention (54%) were the met. But, implementation of action
plan and evaluation of CBE was found to be poor as most of the emphasis was only on
data collection and analysis (19).
In all studies done in Jimma Ethiopia, majority of the respondents agreed on the
continuity of CBTP and CBE with modification and believe that the programme is
advantageous (2, 19, and 20).

13
CHAPTER THREE: OBJECTIVES

3.1. General Objective

To assess the knowledge and attitude towards Community Based Training Program

among regular Graduating class students of Institute of health science in jimma

university, Southwest Ethiopia 2021.

3.2. Specific Objectives

- To assess knowledge about CBTP among graduating students of Institute of

health science in jimma university.
- To determine the attitude towards CBTP among graduating students of Institute of
health science, jimma university.
- To identify problems in implementation of action plans during Community Based
Training Program

14
CHAPTER FOUR: - METHODOLOGY

4.1. Study area

The study was conducted in Jimma University, located in Jimma town 355 km south west
of Addis Ababa.
4.2. Study period
The study was conducted from August 16 To August 20, 2021.

4.3. Studs design:

A cross sectional study design was used.
4.4 Population:
4.4.1 source population:

Source population of the study was all students enrolled in the academic year to institute

of health sciences.

4.4.2 Study population:

Graduating class students of institute of health sciences at Jimma university in the

academic year 2021.

4.5 Eligibility criteria

4.5.1 Inclusion criteria
All Graduating class students in Institute of health science, Jimma University, who
attained their education in 2021 academic calendar.

4.5.2 Exclusion criteria

 Institute of health science students, who are not graduating students.
 Institute of health science students, who attained their education in Jimma
University, but who withdraw before the study conducted.
 Critically ill students who can’t respond to the question during data collection.

15
4.6 Sampling
4.6.1. Sample size determination
No need of sample size determination since the study subjects under each faculty are

manageable within the given time and resource.

4.6.2. Sampling technique and sampling procedure:

Convenience sampling technique was used. In which all the GC students under institute

of health science were included in the study because the sample size is manageable

within the given time and resource.

The study subjects for my study was all graduating class students who are enrolled under

the three faculties of institute of health which are Faculty of medical science (medicine,

dentistry and anesthesia), Faculty of health (pharmacy, medical laboratory, nursing and

midwifery) and Faculty of public health (HO and Environmental Health).

S. No Faculty Department Total no of GC Students

1. Faculty of medical science Medicine 100

Dentistry 27
Anesthesia 25
2. Faculty of health Pharmacy 50

Medical lab 50
Nursing 80

Midwifery 40
3. Faculty of public health HO 50

Env’tal health 35
4. Total 457

4.7 Variables
4.7.1 Dependent variables
 Knowledge

16
  Attitude
4.7.2 Independent variables
Socio-demographic characteristics

 Age

 Sex

 Year

 Department

4.8 Data collection & quality control

Data was collected using self-administered structured questionnaire format by the

principal investigator and trained personal who will be supervised by the investigator

4.9. Data process analysis

Data was entered into computer by coding after it has been collected and will be

expressed in text, tables, pie charts etc.…

4.10 Pretest
Pretest was conducted on 5% of study samples.

4.11 Ethical consideration

The purpose of the study was explained to each participant along permission prior to

filling out the form. All information obtained was confidential. Data collection was

started after permission from the student research program office at Institute of health

science, Jimma University.

4.12 Limitation of the study

 Shortage & missing references for literature review

 Short study period

 Shortage of financial sources

 Study population is large and dispersed.

17
4.13 Operational definition
 Attitude - Way of feeling, perceptive about someone which influences one’s

behavior, favorable if agree answers are greater than or equal to 6 & unfavorable

if agree answers are less than 6

 Knowledge - what person know, the fact, information, skill, understand that one

gains through experience, GOOD if yes answers are greater or equal to 3 & poor

if yes answers are less than 3

4.14 Plan of distributing the result

The result will be distributed after data is analyzed and finding is revealed to relevant

offices.

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CHAPTER FIVE: RESULTS

19