ARSI UNIVERSITY

COLLEGE OF HEALTH SCIENCE

DEPARTMENT OF CLINICAL NURSING

ASSESSMENT OF COMMUNITY HEALTH AND HEALTH RELATED PROBLEM IN WELKESA

KEBELE, ASSELLA TOWN, EAST ARSI ZONE, OROMIA REGION, ETHIOPIA, 2024

BY: GROUP 1 MEMBER OF 4th YEAR CLINICAL NURSING STUDENTS

ADVISORS:

1) Mr. GEMEDA A.(BSC, MSc in Adult health )

2) Mr. KETEMA D.( BSc, MSc in Pediatric and child Health Nursing)

A PROPOSAL SUBMITTED TO THE DEPARTMENT OF NURSING, COLLEGE OF HEALTH

SCIENCE, ARSI UNIVERSITY, IN PARTIAL FULLFILMENT OF REQUIREMENTS FOR
THE DEGREE OF BACHELOR SCIENCE IN NURSING.

Augest,2024

Asella, Ethiopia
 ARSI UNIVERSITY

COLLEGE OF HEALTH SCIENCE

DEPARTMENT OF CLINICAL NURSING

NUMBER NAME ID NUMBER RESPONSIBILITY

1 Aisha Hawas UGR/9918/13 Member
2 Alamudin Jemal UGR/11264/13 Member
3 Alemneh Genet UGR/8143/12 Member
4 Aleyka Nasir UGR/9971/13 Member
5 Asfaw Tesfaye UGR/10037/13 Member
6 Ayinetie Tenaw UGR/10091/13 Member
7 Betselot Edmealem UGR/10187/13 Rapporteur
8 Betsnat Mulugeta UGR/10189/13 Logistics
9 Biniam Shimelis UGR/11182/13 Leader
10 Dawit Solomon UGR/10321/13 Member
11 Debele Gadisa UGR/11357/13 Member

Augest,2024

Asella, Ethiopia
ACKNOWLEDGMENT
First of all, we would like to thank the Almighty God who give the chance of live and help us
during our studies and challenges. we would like to thanks our adviser Mr. Gemeda A.(BSC, MSc
in Adult health ) and Mr. Ketema D.( BSc, MSc in Pediatric and child Health Nursing) for giving
available comments and helping us on developing this proposal; , our genuine thanks also to
Nursing department and health science faculty to give chance to learn this course

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ACRONYMS

AIDS Acquired Immune Deficiency Syndrome

ANC Antenatal Care

CBE Community Based Education

CBTP Community Based Training Program

CVD Cardiovascular Disease

DHS Demographic Health Survey

EBF Exclusive Breast Feeding

GBO Global Burden of Disease

HIV Human Immune-Deficiency Virus

LRI Lower Respiratory Infection

MOH Ministry of Health

NGO Non-Governmental Organization

RDA Recommended Dietary Allowance

SDG Sustainable Development Goal

SPSS Statistical package for social science

SSA Sub-Saharan Africa

PNC Postnatal Care

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Content

s
ACKNOWLEDGMENT................................................................................................................................i
ACRONYMS.................................................................................................................................................ii
ABSTRACT................................................................................................................................................vii
CHAPTER ONE:-INTRODUCTION...........................................................................................................1
1.1 Background....................................................................................................................................1
1.2 Statement of the problem.....................................................................................................................2
1.3 Significance of the study......................................................................................................................4
CHAPTER TWO :-LITRETURE REIVEW.................................................................................................5
2.1 Socio demographic variable...........................................................................................................5
2.2 Maternal and Child health....................................................................................................................6
2.2.1 Maternal health...........................................................................................................................6
2.2.2 Child health.................................................................................................................................8
2.3 Environmental health issue..................................................................................................................9
2.3.1 Water supply...............................................................................................................................9
2.3.2 Housing......................................................................................................................................10
2.3.3 Latrine usage.............................................................................................................................10
2.4 Nutritional status................................................................................................................................11
2.5 Communicable and non communicable disease................................................................................12
CHAPTER THREE: - OBJECTIVE............................................................................................................14
3.1 General objective...............................................................................................................................14
3.2 Specific objective...............................................................................................................................14
CHAPTER FOUR: METHODOLOGY......................................................................................................14
4.1 Study area and period.........................................................................................................................14
4.1.1 Study area..................................................................................................................................14
4.1.2 Study period..............................................................................................................................15
4.2 Study design.......................................................................................................................................15
4.3 Source and Study population.............................................................................................................16

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 4.3.1 Source population.....................................................................................................................16
4.3.2 Study population.......................................................................................................................16
4.3.3 Sampling unit............................................................................................................................16
4.3.4 Study unit...................................................................................................................................16
4.4 Inclusion criteria and exclusion criteria.............................................................................................16
4.4.1 Inclusion criteria.......................................................................................................................16
4.4.2 Exclusion criteria......................................................................................................................16
4.5 Sample size and sampling procedures...............................................................................................16
4.5.1 Sample size determination.......................................................................................................16
4.5.2 Sampling technique and procedure.........................................................................................17
4.6 variable...............................................................................................................................................18
4.6.1 Dependent variable...................................................................................................................18
4.6.2 Independent variable................................................................................................................18
4.7 operational Definition........................................................................................................................19
4.8 Data collection tools and procedures.................................................................................................19
4.9 Data quality control............................................................................................................................20
4.10 Data processing and analysis...........................................................................................................20
4.11 Ethical consideration........................................................................................................................20
CHAPTER FIVE: WORK PLAN AND BUDGET BREAKDOWN..........................................................21
5.1 Work plan...........................................................................................................................................21
5.2 Budget breakdown.................................................................................................................................23
REFERENCE...............................................................................................................................................24
Annex: Questionnaire..................................................................................................................................26

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List of table
Table 1 Gaunt chart showing work schedule needed to assessment of community health and health
related problem in welkesa kebele, Assella town, East Arsi Zone, Oromia Region, Ethiopia. 2024..........22
Table 2 Budget needed for assessment of community health and health related problem in welkesa kebele,
Assella town, East Arsi Zone, Oromia Region, Ethiopia. 2024..................................................................23

LIST OF FIGURE

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Figure 1 Conceptual framework that shows the relation between health and health related problems and
those variables that affect it.........................................................................................................................13
Figure 2 Map of welkesa kebele(10),Asella,Ethiopia..................................................................................15

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ABSTRACT

Background: Community health is a critical aspect of public health, involving multi-sector and multi-
disciplinary efforts to optimize the health and quality of life of all individuals in a community. This study
assesses community health and related problems in Welkesa Kebele, Asella Town, East Arsi Zone,
Oromia Region, Ethiopia. It aims to identify and analyze key health issues affecting the community,
including socio-demographic variables, maternal and child health, environmental health, nutritional
status, and the prevalence of communicable and non-communicable diseases.

Objective: To assess community health and health related problems in kebele 10(Welkesa
kebele) in Assela town East Arsi zone, Oromia, Ethiopia,2024

Methods: The study will be conducted by fourth-year Clinical Nursing students from Arsi University
College of Health Science. A cross-sectional design will be employed, with data collected through
structured questionnaires administered via direct in-person interviews. The study population consisted of
residents of Welkesa Kebele, and systematic random sampling technique was used to ensure
representative sampling. Data will be analyzed using SPSS version 23, with descriptive statistics such as
frequency distributions, means, and percentages used to summarize the findings. The results are presented
in text, graphs, and tables, providing a comprehensive overview of the community's health status

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CHAPTER ONE:-INTRODUCTION

1.1 Background
Health as the capacity to deal with and control one's own illnesses and state of well-being. Being
in good health is the capacity to respond to many environmental circumstances with the
appropriate emotional, cognitive, and behavioral reactions while avoiding the unfavorable ones.
Health is a continuous process that is potentially feasible for everyone, in any situations.(1)

Community health is a multi-sector and multi-disciplinary collaborative enterprise that uses

public health science, evidence-based strategies, and other approaches to engage and work with
communities, in a culturally appropriate manner, to optimize the health and quality of life of all
persons who live, work, or are otherwise active in a defined community or communities .(2)
Community health is a medical practice which focuses on people's well-being in a particular
geographical area. This essential public health sector covers programs to help neighborhood
members in protecting and improving their health, deter the transmission of infectious diseases,
and plan for natural disasters.

The fourth Sustainable Development Goal (SDG 4) is to guarantee inclusive, equitable, high-
quality education and to encourage opportunities for lifelong learning for everyone. All people
must share in the goals of this global aim in order for future generations to continue living well
by 2030 and beyond. Thus, increased worldwide participation in sustainable living is required.
This can be accomplished by putting community education or community-based
education(CBE)-related initiatives into action.

The core of community-based education is the student's capacity to identify and respond to the
needs of the local community. Students are held responsible for delivering values that originate
from their freedom to articulate, explore, and resolve any innate issues or worries they may have
for their community. When this ideal model is used over time, everyone in the community will
get involved, which will cause the educational process to become circular and constantly driven.
(3)

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Community-based training programs, or CBTPs, are a component of community-based education
(CBE) and are intended to teach health science students about community diagnosis and how to
identify health-related issues in the community. It also enables students to put their theoretical
knowledge into practice.(4)

1.2 Statement of the problem

Poor health outcomes and a rise in the prevalence of diseases that can be prevented are caused by
the wide gaps in health education and access to resources in many communities. Health
inequalities are further exacerbated in underserved and marginalized populations by
socioeconomic hurdles, inadequate healthcare infrastructure, and low health literacy. In these
populations, the disparity is especially noticeable. Even though urban areas have access to
cutting-edge medical technology and healthcare services, community health professionals and
residents in rural and low-income areas frequently lack access to sufficient training programs.
This shortcoming makes it more difficult for the community to address prevalent health issues,
encourage preventative healthcare practices, and efficiently handle medical emergencies.
The lack of community-based training programs also results in a general lack of awareness about
essential health practices, such as proper nutrition, hygiene, disease prevention, and chronic
disease management. Consequently, many individuals in these communities suffer from
preventable conditions, leading to increased morbidity and mortality rates.

In 2015, 12.9 million births, or 9.6% of all births worldwide, were preterm. Approximately 11
million (85%) of these preterm births were concentrated in Africa and Asia, while about 0.5
million occurred in each of Europe and North America (excluding Mexico) and 0.9 million in
Latin America and the Caribbean. The highest rates of preterm birth were in Africa and North
America (11.9% and 10.6% of all births, respectively), and the lowest were in Europe (6.2%).(5)

In Ethiopia, The shortage of trained healthcare professionals and the uneven distribution of
healthcare resources further exacerbate these issues. In many rural areas, access to basic health
services is limited, and there is a critical need for community health workers who can provide
essential health education and services. However, the lack of comprehensive training programs

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for these workers hampers their effectiveness and the overall health outcomes of the
communities they serve.

Additionally, cultural beliefs and practices, coupled with low health literacy, contribute to poor
health-seeking behaviors and hinder the adoption of preventive health measures. Many
individuals are unaware of basic health practices such as proper nutrition, hygiene, and disease
prevention, leading to a higher prevalence of preventable conditions and a greater burden on the
healthcare system.

Ethiopia experiences a heavy burden of disease with a growing prevalence of

communicable infections. Many Ethiopians face high disease morbidity and mortality
largely attributable to potentially preventable infectious diseases and nutritional
deficiencies. Maternal mortality in Ethiopia is one of the highest in the world. It has declined to
590/100,000 though it still remains to be among major causes of maternal death, more over 6%
of all maternal death were attributed to complication from abortion. Under five child mortality
rate has been reduced to 101/1000 in 2010 and more than 90% of child deaths are due to
pneumonia, diarrhea, neonatal problems, malnutrition, HIV/AIDS and often a combination of
these. HIV/ AIDS is a disease mostly common in developing countries especially in Sub
Saharan African countries affecting peoples who are in the productive age group. It is one
of the key challenges for all over development of Ethiopia. This fact hinders the economic
development of the country. HIV also causes developmental problem that threaten human
welfare. Roughly 88% of diarrheal deaths and 1.5 million child deaths were caused by unsanitary
and hazardous conditions. Better access to water and sanitation caused a 20.27% decrease in the
prevalence of diarrhea among young children. Promotion of hand washing with soap reduced
diarrhea risk by 30%.(6)

To bridge this gap, it is imperative to develop and implement comprehensive community-based

training programs that empower local residents with the knowledge and skills necessary to
improve their health and well-being. These programs should focus on building capacity within
the community, fostering partnerships with local healthcare providers, and promoting sustainable
health practices.

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By addressing the root causes of health disparities through targeted education and training, we
can enhance the overall health of the community, reduce the burden on healthcare systems, and
improve the quality of life for all residents.

1.3 Significance of the study

This survey will provide information about Oromia region, arsi zone, Asella town, kebele 10. It
gives valuable information on the problems of the community, related to Socio
demographic Variables, Environmental health issues, Mother and child health issues, nutritional
status of community, drug abuse, and awareness of HIV/AIDS among residents. So, the finding
of this study will be used as a key data to make interventions and to establish new
strategies. The results of this finding will predominantly benefit the community as a whole. And
also result generated from this survey could benefit Zone health bureau Ministry of Health
(MOH), Non-Governmental Organizations(NGOs).Generally the above prioritized problems
are widely spread in the world especially in developing countries including sub Saharans
African countries and middle east Asians. Since Ethiopia is one of the Sub-Saharan African
countries these problems are widely found in it. Among the regions of Ethiopia, Asella town
is the one in which those problem mostly prevailed. Our study area is one of the 14 kebeles
in asella town kebele 10, in which the prioritized problems are mostly observed. Even if this all
has become a common problem in this kebele, only a little information is available. For this
reason, control of this problem must be given special attention and try to identify the underlying
causes to prevent those health related problems.

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CHAPTER TWO :-LITRETURE REIVEW

2.1 Socio demographic variable

According to the study of GBD there were 232 million LRI incident episodes in females and
257 million in males worldwide in 2019. One and a half million male deaths and one and a half
million female deaths were caused by LRIs in the same year. In 2019, the age-standardized rates
of incidence and mortality were 1·17 and 1·31 times higher in men than in women. LRI
incidence and mortality rates decreased between 1990 and 2019 at varying rates for all age
groups. All adult age groups showed an estimated increase in LRI episodes and deaths, with men
70 years of age and older experiencing the largest increase. During the same period, LRI
episodes and deaths in children younger than 15 years were estimated to have decreased, and the
greatest decline was observed for LRI deaths in males younger than 5 years. The leading risk
factors for LRI mortality varied across age groups and sex. The primary risk factor for LRI
deaths in females 70 years of age and older was ambient particulate matter, accounting for
11·7% of cases.(7)

According to the study conducted in the united states The finding indicate that the sample
includes 1,408,287,218 annual observations for individuals aged 40 to 76 years (mean age, 53.0
years; median household income among employed persons, $61,175 per year). There are
4,114,380 deaths in men (mortality rate, 596.3 per 100,000) and 2,694,808 deaths in women
(mortality rate, 375.1 per 100,000).higher income is associated with greater longevity across the
income distribution. The gap in life expectancy between the richest 1% and the poorest 1% was
14.6 years for men and 10.1 years for women. Inequality in life expectancy has increased over
time. Between 2001 and 2014, life expectancy increased by 2.34 years for men and 2.91 years
for women in the richest 5% of the income distribution, but by only 0.32 years for men and 0.04
years for women in the poorest 5% .(8)

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2.2 Maternal and Child health

2.2.1 Maternal health

2.2.1.1 Early marriage

Early marriage is one of the most important health issues for young women and can have many
effects. According to study conducted on sub-Saharan Africa In 2015, 28% of adolescent girls in
SSA were married before age 18, declined at an average annual rate of 1.5% during 2000–2015,
while 47% of girls gave birth before age 20, declining at 0.6% per year. (9)
According to study conducted in Ethiopia The rate of early marriage among women was high.
The study's conclusions show that mothers who live in rural regions, have less education, and are
susceptible to family decision-making are more likely to get married young. The prevalence of
early marriage among women in Ethiopia was 56.34%. The Amhara region exhibited the highest
prevalence of early marriage, with a rate of 59.01%, whereas the Oromia region demonstrated
the lowest incidence, with a prevalence rate of 53.88%. (10)

2.2.1.2 Antenatal Care visits

According to The study conducted in sub Saharan Africa DHS statistics from SSA nations from
2018 to 2020 were examined in this study. In all, 92.3% of the SSA nations under study had
noncompliance with at least eight ANC visits, with Zambia having the highest and Libya having
the lowest prevalence (98.7%, and 73.4%, respectively).(11)

According to the study conducted in south western Ethiopia The result showed that 44% of
women did not make the full recommended number of ANC visits, whereas 56% of women
made the minimal number of ANC visits. In comparison to the Kaffa zone, the Bench Maji zone
showed a lower odds ratio for the prevalence of ANC visits. ANC visits are 2.67 times less
common among women living in rural Sheko zone than they are among women living in rural
Kaffa zone, holding all other factors equal.(12)

2.2.1.3 Abortion
According to the study conducted in Ghana the finding indicated that 20.43% (3707) of the
18,116 women who said they had been pregnant in the five years prior to the poll said they had
an abortion. About 18% of the respondents were between the ages of 15 and 24; 43.8% had
completed secondary school; 52.3% were rural residents; 57.0 % belonged to "other Christian"

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(non-Catholic) denominations; 35.3% were Akan ethnic; 58.0% were married; 56.1 % had three
or more children; and 12.2%were residents of the Ashanti region. Over half (55.7%) started
having sex before turning 18; 68.5% did not use contraception at the time; 67.0% had been
exposed to media in some capacity; and only 10.3% were aware of Ghana's abortion laws.(13)

2.2.1.4 Postnatal care

According to the study conducted in Sierra Leone 6625 (90.4%) of the 7326 women had at least
one PNC contact for their infant, 6646 (90.7%) underwent a postnatal checkup following
delivery, and 6274 (85.6%) had PNC for both themselves and their offspring. Higher
probabilities of PNC utilization were linked to caesarean delivery (8.01%), a visit from a health
field worker (1.80%), eight or more ANC contacts (1.37%), postsecondary education (2.71%),
and not having any major issues asking for permission to access healthcare (1.51%).(14)
According to study conducted in ethiopia, only 563 women (16.14%) received proper
postpartum care. Strong predictors of adequate postnatal care included age between 25 and 35
(1.55%), secondary education level (2.23%), having parity between two and four (0.62%),
having ANC follow-up four and above ( 1.74%), and living in the Oromia region ( 0.10%).(15),

2.2.1.4 Family planning

According to the quadratic model, the annual rates of changes in the prevalence rates of modern
contraceptives among all women of reproductive age (15–49 years) ranged from as low as 0·77
percentage points in Lagos, Nigeria, to 3·64 percentage points (2·81 to 4·47 in Ghana). Uganda,
Burkina Faso, Kinshasa (DR Congo), Kaduna (Nigeria), and Kinshasa (DR Congo) all had high
rates of change (>1·4 percentage points). The use of contraceptives was increasing quickly in
Ethiopia prior to the Summit, but our findings indicated that the linear model indicated a recent
halt in the annual growth rate (0·92 percentage points). Based on the meta-analysis, all women in
all nine settings had a weighted average annual rate of change in the prevalence of contemporary
contraceptives of 1·92 percentage points. The total weighted average was 2·25 percentage points,
with annual rates of change among married or cohabiting women being greater in most contexts.
(16)

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2.2.2 Child health

2.2.2.1 Immunization
According to the study conducted in Ghana the incidence of partial immunization was minimal
(15.5%), indicating a high level of immunization coverage; however, the second dose of the
measles, administered at the age of 18 months, had the lowest coverage (23.9%). Eighty-nine
percent of the moms were aware of at least one sickness or symptom that might be prevented by
vaccination and that vaccination is important. Similarly, the probability of incomplete
immunization (0.53%) was unaffected by the mother's ignorance of the number of doses of the
polio vaccine administered to her children.(17)
According to the study conducted in Eastern Ethiopia 249 children (41.4%) had received all
recommended vaccinations based on maternal recollection and vaccination cards, compared to
87 children (29.7%) who had received vaccinations just through cards. Just 238 people, or
39.5%, were well-informed about vaccinations. (18)

2.2.2.2 Childhood illness Under 5 years

According to the study conducted in Sub-Saharan Africa the prevalence of common diseases in
children under 5 years of age was 50.71% with large differences between countries, ranging
from Sierra Leone (23.26%) to Chad (87.24%). In multilevel analysis, rural residence, currently
breastfeeding mothers, educated mothers, poor soil quality, high education level of women in the
community, and high poverty in the community were positively associated with common
childhood diseases in sub-Saharan African countries. In contrast, children of older mothers,
children of wealthier households, and children of larger families, as well as access to
telecommunications, electricity, refrigerators, and improved sanitation at home were negatively
associated.(19)

2.2.2.3 Breastfeeding
According to the study conducted in Kenya All mothers (99%) breastfed their babies. Of those
who breastfeed, the majority (61.1%) reported initiating breastfeeding within one hour of birth.
The main reasons for not breastfeeding within one hour of birth were insufficient milk
production (28.5%), inability of the baby to latch on (18.6%), and maternal fatigue. The majority
(90.6%) of mothers practiced breastfeeding on demand. In addition, 79.0% (326) did not feed

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their newborns before breastfeeding. French Of the 21.0% who received prenatal food, 44.6%
were sugar/glucose water, 21.7% plain water, 18.1% formula milk, 9.6% saline sugar water, and
6.0% other milks and colic drinks. Only 12.6% of infants over 6 months of age were exclusively
breastfed for the first 6 months, and 34% of infants Under 6 months of age were still breastfed at
the time of the study. The remaining 66% had received complementary feeding. The mean age at
which complementary feeding was introduced was 2.9 months. Mothers who were practicing
exclusive breastfeeding at the time of data collection intended to introduce complementary
feeding at a mean age of 4.4 months two thirds of those aged less than 4 months had been
introduced to complementary. Feeds and only 39.0% was exclusively breast feeding (EBF).
Virtually all the Children (97.8%) were on breast milk regardless of the age group.
Discontinuation of Breastfeeding increased gradually with age. The proportion of bottle fed
children was Highest among the 0-4 months old children (31.1%) and lowest among the 13-
24Months old (7.3%).(20)

2.2.2.4 Nutritional status

According to the study conducted in Kenya the Distribution of children by nutritional status No
children had edema on examination. The majority of children had good nutritional status, with
2.2% having acute malnutrition, 6.2% being underweight and 10.6% having chronic
malnutrition. Different age groups of children in the study had different nutritional status by age
groups. Stunting was most common in children over 7 months of age at 12 months, almost three
times higher in children 0 to 6 months, but decreased slightly in children 13 to 24 months.
Underweight increased with age and was more common in children aged 13 to 24 months.
Wasting was highest in children aged 13 to 24 years. Overall, children aged 0-6 months are less
likely to be malnourished than other age groups. It is important to note that most mothers
reported introducing complementary foods by the time their children were 9 months old.(20)

2.3 Environmental health issue

2.3.1 Water supply

58% of the houses in Jimma town claimed to utilize protected sources, while the remaining
households used unprotected water from sources such wells, springs, and rivers, according to a
research published in the Ethiopian Journal of Health Development. Of those who have access to
safe water, 23.4% have indoor plumbing or a yard tap; the remaining individuals must walk for

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five to ten minutes to receive water. The majority of survey participants (66.6%) obtained their
water straight from the tap or brought only a small amount many times a day, while 33.4% stored
water in barrels or clay pots that are mostly uncovered.(21)
A survey carried out in Mettu Town found that 5.87% of people use spring or steam water and
54.79% of people use pipe water.(22)

2.3.2 Housing
According to the Ethiopian Journal of Health Development, 53.2% of the people who reside in
Jimma Town own their home, while 46.8% rent. 43.9% of homeowners have cattle, 3.4% have
horses, and 9.5 have sheep and goats; in contrast, tenants have few of the aforementioned
animals. Eighty percent of animal owners share a living quarter with their animals, mostly goats,
sheep, and cows. Ten percent tie their animals to the porch, and nine percent keep them in the
kitchen. Moreover, 58% of the bed rooms were discovered to be unclean; 60.7% of the
complexes assessed had badly managed trash, and 28.6% had excreta visible. 71 out of the 123
residences that were observed had a kitchen (57.7%). Because of the high standard of hygiene in
the kitchens, 84.5% of them utilize conventional floor-level stoves and 87.3% of them do not
have chimney(21)

A research conducted in Debre Markos Town found that 83.3% of the homes investigated had a
dirt floor, with cement accounting for the remaining 17.4% of floors. Moreover, 30 (60.6%)
homes had their windows open. 40.6% of them have had sporadic openings, while half of them
have been opened every day. Out of all the houses that were chosen, 57.78% of them have an
extra door for escape in an emergency. The majority of the Thirty-one percent of dwellings
(91%) receive morning light. Light afternoon is gained by 17.39% of the chosen homes, while
the remainder 52.49% of people get light in the morning and afternoon. Among the research
homes, of which 70.4% are isolated from their neighbors homes and the remaining 29.6% of
them are connected to the surrounding homes. Furthermore, 89.22% of the dwellings that were
chosen had a kitchen; 86.58% of these were isolated from the main house, while 12.8% were
connected to it. Just two (6.87%) of the 29 families have a kitchen with windows.(23)

2.3.3 Latrine usage

Only 71.9% of Jimma Town residents have sanitary facilities, despite the fact that 97.8% of
respondents to a research published in the Ethiopian Journal of Health Development agree that

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such facilities are essential. The type that was determined to be most common (93.7%) was pit
latrine. There were 3.3% and 3.0% of VIP and water carriage restrooms, respectively. Twenty-
one percent of the sanitary facilities that were in use at the time of the assessment were deemed
to be unclean.(21)
According to a survey done in Debre Markos Town, all homes share a common latrine, however
only 47 (94%) of them have a latrine. 35 homes, or 70.32 percent, lack a cover for their latrine.
22 houses, or 44.5%, maintain good hygienic conditions.(23)

2.4 Nutritional status

A study carried out in a sub-Saharan country found that 27.4% of preschool-aged children are
underweight for their age and 38.6% of youngsters are stunted. As a result, 31.6 million children
are underweight and 44.6 million children are stunted. The greatest rates of underweight and
stunting are seen in Western Africa (37.9%) and Eastern Africa (47.0 and 31.0%, respectively).
In Northern Africa, the prevalence of underweight and stunting is 11.3% and 25.4 percent,
respectively. Although statistics for Southern Africa are scarce, they suggest that underweight
prevalence is between 9.3% and 26.2% and stunting prevalence is between 22.9 and 30.3%. Out
of all the African countries, South Africa has the lowest prevalence of underweight children
(9.3%) and stunted children (22.9%). In emerging nations, the prevalence of iodine deficiency
has decreased significantly worldwide, from 28.9 to 13.7%.(24)

based on research done in Gonder The average daily consumption of fat, protein, and
carbohydrates (in grams), together with their respective percentage contributions, were 80, 79,
and 320. 90%, 100%, 73%, 92.4%, 86.2%, and 95.5% of the participants had inadequate intakes
of calcium, retinol, thiamin, riboflavin, niacin, and ascorbic acid. In contrast, iron and
phosphorus intakes were found to be adequate, with the exception of a small number of subjects
(0.3% and 1.4%, respectively), and energy was 33.0%, 14.1%, and 52.9%, respectively.
Furthermore, 11.2% (40/356) of the subjects had insufficient protein intake (<0.8 g/kg/day). Just
2.8% (10/356) of respondents said they consumed less carbohydrates than the RDA (130 grams
per day). A third (31.7%) of the research participants (13/356) consumed fat, which accounted
for less than 30% of their daily energy consumption. The prudent dietary requirement, which
calls for a daily consumption of 25 g for women and 38 g for men, was not met by the mean
dietary fiber intake of 19 g.(25)

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 2.5 Communicable and non communicable disease
According to study conducted in addis abeba about half of the 3,709 persons for whom verbal
autopsies were performed were women, and 60 of them were between the ages of 15 and 64 55
was the average age of death (range, 15-105). In all, non-communicable diseases accounted for
51% of deaths, communicable diseases (42%), of which very few deaths were caused by
nutritional and maternal issues, and injuries (6%). In 7% of cases, the reason of death was not
clear. Since one death could have numerous causes, these percentages were higher than 100%.
Similar percentages of men and women died from communicable and non-communicable
diseases, although more women than men died from both. In contrast, 10% of deaths in males
and 3% in females were attributed to injuries. Cardiovascular disease (CVD) accounted for 24
percent of deaths; the majority of CVD deaths were caused by stroke (11%) and hypertension
(12%).HIV/AIDS (19%) and tuberculosis (12%), respectively, were the second and third most
prevalent causes of death. The most prevalent neoplasms were other neoplasms (4%) and
stomach cancer (2%) and malignant neoplasm (10%) was the fourth greatest cause of death.
Chronic liver illness accounted for 4% of deaths, while digestive tract diseases caused 9% of all
deaths. Three-fourths of all deaths were caused by these five major causes of death. Type 1 and
type 2 diabetes (5%) and injuries (6%) were the other leading causes of death.(26)

Socio-demographic Nutritional Status:

12 | P a g e
Variables: overweight, underweight,
stunting, daily intake of
Age, education level,
nutrients
Environmental Health
Geographical Location:

Rural

Urban

Figure 1 Conceptual framework that shows the relation between health and health related problems and
those variables that affect it.

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CHAPTER THREE: - OBJECTIVE
3.1 General objective
To assess community health and health related problems in kebele 10(Welkesa kebele) in
Assela town East Arsi zone, Oromia, Ethiopia,2024

3.2 Specific objective

 To assess nutritional status of the welkesa kebele
 To assess prevalence of early marriage in welkesa kebele
 To assess the utilizations of family planning in welkesa kebele
 To assess prevalence of abortion in welkesa kebele
 To assess the utilization of antenatal and postnatal care
 To determine child health issue
 To assess prevalence of communicable disease
 To assess the prevalence of non-communicable disease
 To determine sanitation condition of the community
 To assess housing condition of the community
 To identify water supply of the community
 To assess latrine usage of the community

CHAPTER FOUR: METHODOLOGY

4.1 Study area and period

4.1.1 Study area

The study will be conducted in Welkesa kebele(10), which is found in Asella town. Asella is
a town located in the Arsi Zone of Oromia Regional state about 175 Km from Addis Ababa
and 75 Km from Adama, Ethiopia. It has a latitude and longitude of 70 57N and 390 7E
respectively. The town is located on an elevation of 2430 meters above sea level. The town
has subtropical highland climate with the annual average perception of 1300 to 1350mm,
shortly occurred between March and April and long rain occurred between July to
September. The 2007 national census reported a total population for Asella of 67,269, of
whom 33,826 were men and 33,443 were women. The majority of the inhabitants said they

14 | P a g e
 practiced Ethiopian orthodox Christianity, with 72.43% of the population reporting they
observed this belief, while 22.59% of the populations were Muslim, and 9.75% of the
population were Protestant. The city has fourteen kebeles .Welkesa Kebele(10) will be our
study area which is one of the kebele of Asella Town .

Figure 2 Map of welkesa kebele(10),Asella,Ethiopia

4.1.2 Study period

Study will be conducted from August 5 to August 23,2024GC

4.2 Study design

A community based descriptive cross- sectional study will be conducted from August 5 up to
August 23,2024GC

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 4.3 Source and Study population

4.3.1 Source population: All people who live in Asella town.

4.3.2 Study population: All population who live in kebele 10 of Asella town.

4.3.3 Sampling unit: Households

4.3.4 Study unit: The representative of selected household.

4.4 Inclusion criteria and exclusion criteria

4.4.1 Inclusion criteria

 All the selected households who are voluntary to respond
 Household Individual above 18 years old
 Peoples who reside in study area at least for six months

4.4.2 Exclusion criteria

 Households who are not voluntary to respond

 Households with severely ill ( respondents who are unable to respond properly due to
severe illness)
 Peoples who temporarily reside in study area for less than six months.
 Household individual less than 18 years old, except women who are married and/or had
a child

4.5 Sample size and sampling procedures

4.5.1 Sample size determination

The sample size required for the study will be calculated using the formula to estimate a single
population proportion. We use Low usage of contraception of problem 34.1% occurrence and a level
precision at 95% level of confidence and taking 10% for non-respondent then the minimal sample size
was calculated:

ni = [(Zα/2)2 p (1-p)]/d2

ni= [(1.96)2 (0.341) *(1-0.341)]/ (0.05)2

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ni=317

n=ni / 1+ ni /N

n=317/1+317/3770

n=347

n= 347+35(10% of sample size for non-response)

n= 382(sample size)

Where:

ni= initial sample size

n = the desired / minimal sample size.

N=total number of house hold

Zα/2 = Standard normal deviate of 1.96 which corresponds to 95% confidence Level (z value

at alpha= 0.05)

P= proportion from the largest to have a particular characteristic which is 0.341(34.1%)

d= an absolute precision (margin of error) is 5% (0.05)

q= 1-p = 0.659

nf = 382

k = N/n =3770/382= 10, where k = sampling interval

4.5.2 Sampling technique and procedure

In our study from the 14 kebeles of Asella town Welkesa kebele(10) was selected by simple random
lottery method and then systematic random sampling will be used. Means all households was numbered
to get the sample frame which is the most important and must present to use our technique, systematic
random sampling. Then we calculate K-value to determine which household is going to be included in our
study unit population. We can calculate our K-value by using the following formula:-

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K= Total number of households / Sample size

N 3770
Whichk = = =10
nf 382
Then the first household sample will be picked randomly. After that every 10 household’s data will be
collected.

4.6 variable

4.6.1 Dependent variable

 Nutritional Status: Measures such as overweight underweight, stunting, daily intake of
nutrients, etc.
 Maternal Health: Metrics such as early marriage rates, antenatal care visits, abortion
rates, postnatal care visits, and family planning usage.
 Child Health: Indicators like immunization, prevalence of childhood illnesses, infant and
under-5 mortality rate and nutritional status
 Prevalence of Communicable Diseases: Rates of diseases such as HIV/AIDS and
tuberculosis.
 Prevalence of Non-communicable Diseases: Rates of cardiovascular diseases, diabetes,
cancer, etc.
 Sanitation Condition: Access to clean water, type of latrine used, cleanliness of the
living environment.
 Housing Condition: Ownership of home, presence of animals, kitchen conditions, types
of flooring, etc.
.

4.6.2 Independent variable

 Socio-demographic Variables: Age, education level, income, employment status,
marital status, household size, etc.
 Environmental Health Issues: Access to clean water, waste disposal methods, housing
quality, etc.
 Community Interventions: Presence and effectiveness of public health programs,
educational initiatives, community engagement activities.

18 | P a g e
  Geographical Location: Rural vs. urban setting, specific regions or zones within the
study area.

4.7 operational Definition

Nutritional Status: The health condition of individuals as determined by the intake and
utilization of nutrients from food.

Maternal Health: The health of women during pregnancy, childbirth, and the postpartum
period.

Child Health: The physical, mental, and social well-being of children from birth to
adolescence.

Communicable Diseases: illnesses caused by viruses or bacteria that people spread to one
another through contact with contaminated surfaces, bodily fluids, blood products, insect bites,
or through the air.

Non-Communicable Diseases: diseases that are not spread through infection or through other
people, but are typically caused by unhealthy behaviors

Sanitation Condition: The state of cleanliness and hygiene in the community, including access
to clean water, proper waste disposal, and toilet facilities.

Housing Condition: is physical state of the living environment, including the structure of homes
and access to basic amenities.

Water Supply: The availability and quality of water for drinking and household use in the
community.

4.8 Data collection tools and procedures

Fourth-year students in the clinical nursing department of Arsi University College of Health
Science will produce well-structured questionnaires to be used in the data collection process. The
socio demographic status, environmental sanitation, health and disease conditions of mothers and
children, and nutritional status within the household are all included in the questionnaire. Fourth-
year students from the Clinical Nursing department of Arsi University College of Health Science
will conduct direct, in-person interviews with the randomly selected houses in order to gather the

19 | P a g e
data. To guarantee accurate questionnaire completion and maintain the consistency of our data, a
shared understanding among all group members will be established prior to the data gathering
procedure. Students will arrive in pairs and be divided into groups of Amharic and Afaan Oromo
language speakers in order to overcome any language barriers.

Pencil, papers, and markers are Tools used for data collection.

4.9 Data quality control

Our Adviser will verify the data's accuracy, consistency, clarity, and completeness to guarantee
its quality. Before data collection, a thorough discussion will be held to ensure that all data
collectors have a common understanding of the questionnaire. Prior to data entry and analysis,
data cleaning and cross-checking will be performed to ensure completeness. a backup copy of
the data kept on many devices, including computers, flash drives, and memory, to prevent data
loss. Before analysis, each data set will be coded independently.

4.10 Data processing and analysis

A computer running SPSS version 23 will be used to carefully examine the data, and the results
will be displayed as a graph, table, and chart. The measurements of dispersion (variance,
standard deviation, etc.) and descriptive statistical measures (mean, median, percentage) will be
employed. Lastly, text, graphs, and tables will be used to present the findings.

4.11 Ethical consideration

In order to get permission, formal letter will be written by Arsi University College of Health
Science Department of Clinical Nursing office and submitted to kebele 10 administrative office.
Before students perform data collection each explains them selves, the aim and purpose of the
study by respecting the right, privacy, dignity, language and cultural issues of the society.

20 | P a g e
CHAPTER FIVE: WORK PLAN AND BUDGET BREAKDOWN

5.1 Work plan

Week 1(jul29-aug02) activity Jul 29 Jul 30 Jul 31 Aug 01 Aug 02
orientation
Grouping
Proposal development
Work plan development
Development of data collection
tool
Gaining feedback from
supervisor

Week 2(aug5-9)activities Aug 05 Aug 06 Aug 07 Aug 08 Aug 09

Ethical consideration
Identifying the community
Arranging and collecting
reasonable logistics
Arranging data collection
instrument

Data collection

Week 3 (Aug 12-16)activities Aug 12 Aug 13 Aug 14 Aug 15 Aug 16

Data summarization

21 | P a g e
Data analysis and
interpretation
Priority setting
Developing action plan

Week 4 (Aug 19-23)activities Aug 19 Aug 20 Aug 21 Aug 22 Aug 23

Report writing
Gaining feed backs
Rehearsal
Presentation in symposium and
defense
Evaluate the learning
experience and service
provided to the community

Table 1 Gaunt chart showing work schedule needed to assessment of community health
and health related problem in welkesa kebele, Assella town, East Arsi Zone, Oromia
Region, Ethiopia. 2024

5.2 Budget breakdown

No Budget categories Unit cost Multiplying Total cost

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 factor
1 Paper 1pac=550 3 x 550 1650 birr
2 Note books 50 5 x 50 250 birr
3 Pen 30 6 x 30 180 birr
4 Pencil 20 6 x30 180 birr
5 Eraser 10 6 x10 60 birr
6 Sharper 10 6 x10 60 birr

7 Printing and binding 70 2 x70 140 birr

TOTAL 2520 birr

Table 2 Budget needed for assessment of community health and health related problem in
welkesa kebele, Assella town, East Arsi Zone, Oromia Region, Ethiopia. 2024

23 | P a g e
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4. Bureau C. Statistical abstract of the United States: Statistical Abstract of the Un; 2009.
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6. Wolf J, Hubbard S, Brauer M, Ambelu A, Arnold BF, Bain R, et al. Effectiveness of
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8. Chetty R, Stepner M, Abraham S, Lin S, Scuderi B, Turner N, et al. The Association Between
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9. Melesse DY, Cane RM, Mangombe A, Ijadunola MY, Manu A, Bamgboye E, et al. Inequalities
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10. Gebeyehu NA, Gesese MM, Tegegne KD, Kebede YS, Kassie GA, Mengstie MA, et al. Early
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11. Odusina EK, Ahinkorah BO, Ameyaw EK, Seidu A-A, Budu E, Zegeye B, et al. Noncompliance
with the WHO’s Recommended Eight Antenatal Care Visits among Pregnant Women in Sub‐Saharan
Africa: A Multilevel Analysis. BioMed Research International. 2021;2021(1):6696829.
12. Belay A, Astatkie T, Abebaw S, Gebreamanule B, Enbeyle W. Prevalence and factors affecting
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factors. Journal of biosocial science. 2022;54(2):257-68.

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14. Sserwanja Q, Nuwabaine L, Kamara K, Musaba MW. Prevalence and factors associated with
utilisation of postnatal care in Sierra Leone: a 2019 national survey. BMC public health. 2022;22(1):102.
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care in Ethiopia: evidence from 2019 Ethiopia mini demographic and health survey. BMC Pregnancy and
Childbirth. 2023;23(1):834.
16. Ahmed S, Choi Y, Rimon JG, Alzouma S, Gichangi P, Guiella G, et al. Trends in contraceptive
prevalence rates in sub-Saharan Africa since the 2012 London Summit on Family Planning: results from
repeated cross-sectional surveys. The Lancet Global Health. 2019;7(7):e904-e11.
17. Wemakor A, Helegbe GK, Abdul-Mumin A, Amedoe S, Zoku JA, Dufie AI. Prevalence and
factors associated with incomplete immunization of children (12–23 months) in Kwabre East District,
Ashanti Region, Ghana. Archives of Public Health. 2018;76:1-9.
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26. Misganaw A, Mariam DH, Araya T. The double mortality burden among adults in Addis Ababa,
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Annex: Questionnaire
ARSI UNIVERSITY

COLLEGE OF HEALTH SCIENCE

CLINICAL NURSING DEPARTEMENT

Study information sheet and consent form

This questionnaire is prepared for collecting information to assess health status of the
community.
Introduction
My name is------------and I’m 4th year nursing student at Arsi University College of health
science. I’m conducting a study on assessing health status of the community in kebele
10(welkesa).your experience and insight would be invaluable to this research.

I would like to invite you to participate in this study by completing a short questionnaire.
The questionnaire will take approximately 30 minute to complete and identify health and health
related problems among this kebele. Your participation is entirely voluntary and all responses
will be kept confidential. The information gathered will be used solely for academic purpose.

If you are willing to participate please sign below.

Signature…….

If you have any questions please ask and get further information.
Thank you in advance for considering this requires. Your participation would greatly contribute
to the success of this research.

Warm regards,

26 | P a g e
Questionnaire identification number_______
kebele _______
Household ID_______

Part 1 socio demographic and economic factor

NO Variable Category Skipping

Q 101 Sex of the head of house 1. Female
hold? 2. Male
Q 102 Age of the head of house ________________
hold?
Q 103 What is your Religion? 1. Muslim
2. Orthodox
3. Protestant
4. Catholic
5. Others (specify )
________________
Q 104 What is your marital status? 1. Single
2. Married
3. Divorced
4. Widowed
5. Separated
Q 105 Have you attended formal 1. Yes
education? 2. No
If Q106 yes, what is your 1. Primary school
level of education 2. Secondary school
3. Diploma level
4. College level
5. University level
6. Degree level and above
7. Other(specify)----------

27 | P a g e
Q 106 What is your Job? 1. Student
2. House wife
3. Merchant
4. Civil servant
5. Private employee
6. Farmer
7. Daily laborer
8. Other (specify)………….
Q 107 What is your Average ……………….
income in birr within
month?

Q 108 How many family members 1. Male________________

do you have? 2. Female________________
3. Total________________

part 2: Environmental Health and Personal Hygiene

section 1 Environmental Health

I. Housing condition

Code Variable Category Skipping

Q201 Number of rooms in the house --------------
Q202 Building materials of the wall 1. Soil
(observational ) 2. Cement
3. Brick
4. others--------------
Q203 Type of house roof 1. Corrugated iron
(observational ) 2. Composite shingle
3. Thatched
4. Others ---------------------

28 | P a g e
Q204 Type of house floor 1. Ceramic
(observational ) 2. Cement
3. Soil
4. Other --------------------

Q205 Are windows available? 1. Yes

2. No
If Q205 yes, how many? --------------------
Q206 Does the house have good 1. Yes
ventilation? 2. No
Q207 Is there available kitchen? 1. Yes
2. No

If Q207 yes, , determine its 1. Attached to the main house

location 2. Separate to the main house

If Q207 yes, are the kitchen 1. Yes

have chimney? 2. No
Q208 Where were you keep cooked 1. Open environment
food? 2. On shelf
3. Refrigerator
4. Packing
5. Other(specify)
--------------------
Q209 What is the energy source for 1. Electricity
the cooking? 2. Charcoal
3. wood
4. Other
sources---------------------
-
Q210 What is the energy source for 1. Electricity

29 | P a g e
 light? 2. Biogas
3. Solar
4. Other
sources-------------------
Q211 Which domestic animal Do 1. Dog
2. Cat
you have?
3. Cattle
4. Chicken
5. Other-------------------
6. No domestic animal
If Q211 yes, where did they 1. Separate to the main house
live? 2. Attached to or within the
same house

Q212 Is there any extra space for 1. Yes

gardening or farming? 2. No

213 3.

II. Water supply

Code Variable Category Skipping

Q213 What is the source of your 1. Pipe
water supply? 2. Well
3. River
4. Spring
5. Other sources--------------------

Q214 Does the water source 1. Animals( cattle)

shared by other? 2. Factories or industries
3. Others
4. No share

Q215 Amount of water used daily --------------------

30 | P a g e
 in house by liters?
Is this frequency sufficient 1. Yes
for your needs? 2. NO
Q216 Is the water supply is 1. Yes
adequate throughout the 2. NO
year?

If Q216 no, which time of --------------------

the year (month) would you
face scarcity?
Q217 Do you have a water 1. Yes
container? 2. NO

Q218 What method do you use 1. In its original form

for the treatment of 2. Boiling
drinking water? 3. Filtering
4. Chemically treating
5. Other methods----------------

Q219 What are the causes of 1. No pollution

pollution of your water 2. Soil
supply? 3. Animal wastes
4. Plastic materials and bottles
5. Other ----------------

III. Waste disposal and Sanitation

Code Variable Category Skippin

g
Q220 Do you have a latrine? 1. Yes
2. No

31 | P a g e
 If Q220 Is yes :-
What type of latrine do you 1. Pit latrine
have? 2. Ventilated improved pit
latrine(VIP)
3. Water flushed
4. Other types(specify)
---------------------------
Is the toilet attached to the 1. Yes
main house? 2. No
If no, determine its location ----------------------
How many toilets does the --------
house have?
Is the toilet sufficient for the 1. Yes
family? 2. No

Does the toilet have sufficient 1. Yes

water supply 2. No
Latrine distance from water 1. < 5 m
source? 2. 5-10 m
3. > 10 m
If Q220 Is No :-
Where do your family use? 1. Common latrine
2. Sharing with the neighbor
3. Open field
4. Other(specify)
----------------------------------

Q221 How do you dispose solid 1. Put in the sack

waste? 2. Burning
3. Disposing in open holes
prepared for this purpose

32 | P a g e
 4. Dispose in open field
5. Collected by municipality
6. Other(specify) ----------------
Q222 Do you have any recycling 1. Yes
mechanism? 2. No
If yes what is the ---------------------------------
mechanism(Specify)
IV. Environmental pollution

Code Variable Category Skipping

Q223 Is there any source of noise? 1. Yes
2. No
If yes, what is the source? 1. Clubs( music)
2. Construction sites sounds
3. traffic
4. Others---------------------------
Q224 Is there any source of air 1. Yes
pollutants? 2. No
If Q224 yes, what is source? 1. Factories
2. Local air pollutants
3. Other
V. Vectors

Code Variable Category skipping

Q225 Which vectors are common 1. Common house fly
in your environment/ house. 2. Cockroach
(more than one can be 3. Flea
selected) 4. Tick
5. Mosquitos
6. Other
7. No vector
If common vectors are …………………..

33 | P a g e
 present, What kind of
control mechanism do you
use prevent vectors?

A. Personal hygiene

Code Variable Category Skippin

g
Q226 When do you wash your 1. Don’t wash
hand?(multiple response is 2. Always before meal
possible) 3. Always after meal
4. Always after toilet
5. Always when touching dirty
things
6. During food preparation
7. Other -------------------------
Q227 What kind of material did 1. Water only
you use while you wash your 2. Water and soap
hand? 3. Other -----------
Q228 Do you brush your teeth? 1. Yes
2. No
If Q228 is yes, how many 1. once daily
time? 2. twice daily
3. more than twice
If Q228 Is yes, what material 1. Tooth brush
did you use? 2. Other materials.(specify)
-------

If Q228 is yes, at what time --------------------------------

If Q228 is yes, How often do 1. Every month
you change your tooth brush? 2. Once in 3 month

34 | P a g e
 3. Once in 6 month
4. Other .(specify) -------
Q229 How often you take bath? 1. Once in 3 days
2. Once in week
3. Once in 2 week
4. Other----------
Q230 Do you cut you nail 1. Yes
regularly? 2. No

part3: Communicable disease

Code Variable Category Skippin

g
Q301 Is there Sick person within 1. Yes
past 14 days in your 2. No
family?
If Q301 yes, what type of 1. Common cold
disease? (More than one 2. Tuberculosis
may be selected) 3. Typhoid
4. Cholera
5. Pneumonia
6. Others-------------------------

Q302 Did you seek care for these 1. Yes

diseases? 2. No
If Q302 yes, where did you 1. Health institution
seek care? 2. Home remedy
3. Self-treatment
4. Others-----

Q303 What do you know about -------------------

35 | P a g e
 the transmission of these
diseases?
Q304 Did you know about the 1. Yes
prevention and controlling 2. No
method of these diseases?
If Q304 is yes, specify -----------------------------------

part Four: Non Communicable disease

Code Variable Category Skipping

Q401 Is there a family member 1. No
who has one or more of the 2. Hypertension…..
following chronic 3. Diabetes mellitus……
diseases?(more than one 4. Cardiac disease……..
option can be selected with 5. Renal disease………
frequency) 6. Cancer (specify)……..
7. Mental illness………
8. Other(specify)

Q402 Did they seek medical 1. Yes

intervention? 2. No
If Q402 is no, why? 1. Due to Inaccessibility
2. Due to Inconvenience
Q403 What do you think about ………….
the cause of these chronic?
Q404 Do you know about the 1. Yes
prevention mechanism of 2. No
it/them?
Q405 Was there any death in the 1. Yes
last time in the family? 2. No
If yes :- 1. Number of death………….

36 | P a g e
 2. Sex………….
3. Age at death………….
4. Cause of death………….

Part 5: Maternal and child health status

Code Variable Category Skipping

Q501 how many children do you ………….
have
Q502 What was your age at first
marriage
Q503 Number of pregnancy
Q504 Number of birth 1. Live birth
2. still birth
3. Total
Q505 Were there any Abortion? 1. Yes
2.No
Q506 How old were you when
you gave birth to your first
child
Q507 Was your last pregnancy 1.Yes
planned? 2.No
If yes which types of 1. Condom
family planning is it 2. Oral contraceptive
3. implanted contraceptive
4. emergence pill
5. other

Q508 Do you have Antenatal 1.yes

care follow? 2. No

37 | P a g e
 If yes when did you go? 1. for check up
2.when sick
3. other------------------

How many times did you

go until giving ------------------------
birth(frequency)
Did the mother take any 1. Yes
vaccination? 2. No
If yes, what kind of 1. Td vaccine
vaccination? 2. TT vaccine
3. TDaP vaccine
4. Others-----------------
How many --------------------------
times(frequency)
Q509 Where was your last 1. hospital
delivery? 2. house
3.others
Q510 Type of last delivery 1. spontaneous vaginal deliver
2.Instrumental delivery
3. Cesarean Section

Q511 Any complications with it? 1. yes

2.NO
If yes what is the ------------------
complication
Q512 Did you have post natal 1.Yes
care follow up? 2. No
if yes 1. Within 6-24hrs after delivery
2. On 3rd . day of labor
3. on 7Th day of delivery
4. On 4th week of delivery

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 5. after 6 week of delivery
6. other-----------------

Q513 Is your last child 1 Yes

immunized? 2.No
If yes, which type of 1. Polio
vaccination is it 2. Tetanus
3. measles
4. BCG
5. Others ………………
Q514 Do you have a child who 1. Yes
died under the age of five 2. No
If Q514 is yes ,what was
the cause of his/her death
Have you ever had HIV 1. yes
Q515 test before? 2. No
If yes when was the last -----------------
time of HIV test
Q516 when did you start breast 1. Within 1 hour after birth
feeding 2. After 1 hour of birth
3. not at all

Q517 for how long have you feed ……………

your child only breast milk
Q518 Number of less than five 1. male -----------------
years of age children in 2. Female-----------------
your household? 3. total
Last child's age ……………….
Q519 gestational age at birth 1. less than 9 month
2.at nine month

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 3.Greater than nine month
4. Not sure

Part six: Nutritional status

Code Variable Category Skipping

Q601 How many times do you 1. Once

eat per day? 2. Twice
3. Three times
4. Above three

Q602 What type of food item 1. Injera

you consume mostly? 2. Cereals
3. Fruit and vegetable
4. Meat and diary
5. Others ………………….
Q603 Have you experience any 1. Yes
nausea vomiting or 2. No
diarrhea
If yes when? 1. past 3days
2. In past 4-6 days
3. Greater than 7days

Q604 Have you ever been 1. Yes

diagnosed with an eating 2. No
disorder?

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 If yes for what? 1. Cholera
2. Amoeba
3. Typhoid
4. others
Q605 Weight of household in kg
Q606 Height of household in
meter
Q607 BMI of household
Q608 in the last 30 days did you 1. Yes
experience weight loss 2. No

Q609 According to you what Is 1. Lack of water 6.

the main constraints you 2. Lack of access to market
are facing for your family 3. Lack of money
to get balanced diet and 4. Lack of availability of product at
diversified diet the market
5. Other-----------------------------
Q610 Your appetite 1. Very poor
2. Poor
3. Average
4. Good
5. Very good

If Q610 answer is either

than ”Good” ,Why -----------------------
Q611 Do you have a kitchen 1. Yes
2. No

If yes what about its 1. Good

hygiene 2. Average

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 3. Poor

Q613 How many glass of water

you drink per day ------------------

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43 | P a g e