JIMMA UNIVERSITY

INSTITUTE OF HEALTH
FACULITY OF HEALTH SCIENCE
SCHOOL OF PHARMA
CBTP PHASE IV EVALUATION REPORT

By: Buyo kechema group students.

August, 2022.
 CBTP PHASE IV EVALUATION REPORT

Evaluation Of Interventions Given On Social Drug Use, Drug Sharing, Self

Medication , Rational Drug Use, stocking of drugs, taking more doses,
and drug storage.

The study was conducted in Buyo kechema kebele, seka chekorsa woreda,
Jimma zone ,Oromiya region, south-west Ethiopia August 24-26 2022 G.C.

A survey report submitted to JU CBE coordinating office as a fulfillment of

the course CBTP phase IV.
2
 Outline
 Introduction
 Background of the study area
 Significance of the study
 Objective
 Method and material use
 Problem encountered during the data collection
 Result and discussion
 Conclusion and recommendation
 Acknowledgement
 Reference
3
 Introduction

 Phase IV CBTP is the last phase of CBTP which all the phases are
discussed together and changes secondary to students involvement in
the community are measured.
 It is an evaluation phase.
General objective
To measure the quantitative effect of changes due to intervention made on
use of social drugs, self-medication, drug sharing, stocking of drugs, taking
more doses, and drug storage.

4
 Cont..
 To measure the quantitative changes due to intervention made on
social drug use and self medication.
 To observe the quantitative changes due to intervention made on
sharing of drugs and stocking of drug.
 To measure the quantitative changes due to intervention made on
drug storage and taking more dose.

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 Significance of Phase IV CBTP

 It provides us some skill and experience on how to solve various

problems of the community.
 Led us to understand how a certain intervention can bring a
difference in the community.
 This Phase broaden our understanding of our community and
encourage us to engage in the events that can create awareness
about rational drug use as well as social drug use.

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 Operational definition of Terms

 Social drug: kchat, tobacco, alcohol, Coffee, tea

 Chewing kchat: more than 15 days per month
 Kitchen room: putting medication around the place where they Cooke,
bake.
 Visiting health institution: visit less than 1 yrs. Ago
 woina Dega a climate with average temperature is 22 °C, the annual
rainfall is between 800 and 1200 mm, and the average elevation ranges
between 1500 to 2500 m
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Term definitions
 modern medicine: Also known as Allopathic or western medicine, modern
medicine is the most advanced, scientifically based, and statistically
approved therapeutic system and diagnostic methodology.
 Complementary medicine :is a term used to describe types of treatments
you may receive along with traditional Western medicine. 
 Rational drug use (RDU): is the process of appropriate prescribing,
dispensing, and patient use of drugs for diagnosis, prevention, and
treatment of diseases.
 Self Medication: The act or process of medicating oneself especially
without the advice of a physician

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Background of intervention area

 Buyo kechema is one of the kebele found in ,seqa chekorsa woreda,

Jimma zone, Oromiya reigion, south-west Ethiopia, located about
15km away from main campus of Jimma University in North West .
 Have a total population of 8321 (Male 4189 Female 4132) and
Households are 1045.Climatic condition is Woina-dega.
 It is bounded by four kebele It has the boundaries East: kusaroo,
qofe, West: G/Boosee, south: D/Gibee, north: Allagaa,Aanaa yabbu

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Summary of previous phases of CBTP
 CBTP phase I
The general objective of phase-1 CBTP was:

 To assess the socio-demographic characteristics, vital statics, and means

of communication and income in Buyo kechema Kebele.

The specific objectives were:-

 To determine the socio-demographic characteristics
 To determine the vital statics of the community
 To know the average annual income of the community
 To collect, analyze and interpret health and health related data.

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The problems identified and prioritized from phase i

I. Home delivery
II. TTBA
III. Febrile illness
IV. Lack of access to postal and Telephone service
V. Poor hygiene

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 CBTP phase II
The general objective of this phase was: -
 To assess type, availability and distribution of health facilities, social drug,
rational drug use as well as complementary medicine practice in Buyo
Kechema kebele.
The specific objectives were:-
 To collect on the type, availability and distribution of health facility in the
study community.
 To identify the common complementary medicine practice and the community
attitude towards them.
 To know the understanding of community on some local drugs (alcohol, khat,
tobacco….)
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 Cont…
 To identify some common problems in setting the drugs community.
 To identify and prioritize some of the common problem related drugs.
 To use appropriate technique to asses drug using status of the community
 To organize, analyze, interprets and draw interference on the drug
information, self-medication, rational drug use, complementary medicine
and some social drugs using pattern.
 To draw an action plan for some of the drug related problems they identified
in the community.

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Identified and prioritized in phase II

 Social drug use

 Sharing of drugs
 Stocking of drugs
 Dissatisfaction of healthcare service
 Self medication and non adherence

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 CBTP phase III
In this phase students are supposed to make interventions based on the already
developed action plans in the previous CBTP phases (phase one and two).
General objective

 To perform an intervention on problems that are identified from phase II in

collaboration with the community members and governmental institution.
Specific objective
The students here are expected to :–
 Reconsider the previously identified and prioritized problems for possible
changes.
16
 Cont…

 Refine the action plans developed to make adjustments and corrections where
needed.
 Make interventions in the collaboration with the community members
governmental and non-governmental health institutions etc…..
 To educate the community about the rational drug use
 To aware the community on the dangers of self medication and non
adherence.
 To create awareness in the community about effects of sharing drug.
 To aware the community on the ways of transmission and prevention of Covid-
19

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 Problem intervened

Problems reprioritized after merging the problems in the two phases where :

 Social drug
 Sharing drug
 Self medication
 Drug storage
 Covid-19
 Inappropriate drug use
i.e unable to take medication accordingly, taking
more dose of medication than recommended.

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 CBTP Phase IV

19
 Study Method
 Study area – Buyo Kechema Kebele, Seka Chekorsa Woreda,
Jimma Zone, Oromia Region, South West Ethiopia
 Study period _August 24-26, 2022 GC
 Study design _cross-sectional study
 Target population_ all residents of Buyo Kechema(8321)
 Study population_ house hold in buyo kechema kebele(1045)
 Sample size_281 households (Buyo kechema Kebele)
 Sampling technique_ systematic random sampling

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 Sample size determination
n=

Correction formula
nf =n/1+n/N since our total population is less than 10,000
K =N/nf
Where N, total house hold (1045)
n, sample size(384)
nf, final sample size(281)
P, proportion rare and q, is 1-p, (p= 0.5)
d, Margin of error(5%)
z, Critical value of the normal distribution at the required confidence level,(1.96)
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Materials used

 Questionnaire

 Computer
 Pen
 chalk
 Calculator
 Mobile phone
Data collection and analysis

Data collection technique And tools

 Data was collected using standardized questionnaires applying face to face
interview.
Data analysis
 Data processing tally sheet was used.
 collected values were presented using tables, graphs, and pie charts.

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Limitation

◉ We faced a problem of getting all needed information from

the kebele.
◉ Scattered house in the community.

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 Problem encountered
 Unwillingness of the respondents to tell about their income.
 Some of the residents house were closed for 1st day
 Language barrier
 Most of the respondents lacked interest due to repetitive interview carried
out by different department of Jimma University.
 Most of the Community have little knowledge of the types of medication.

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Solutions

 Students were grouped according to language proficiency.

 We ask their daily expenditure and converting into annual income.
 We returned back on the second day.
 we told them about the importance of the research and they were willing to
cooperate with us.
 We try to list and describe the type of medications when we collect data

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Result And Discussion
A, Availability, Type and Distribution of Health Facilities
 In Buyo kechema kebele there is only one health center available and
there are no hospital and health post in this kebele.

 This health center located around kebele bureau and Buyo kechema
primary school on the side of main road of Jimma to seka chekorsa.

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 Table 1.The distance of households in terms of minutes from health institution in
Buyo kechema Aug 24-26 2022 G.C.

Distance <15 15-30 31-45 46-1hr Min. Max. Range Mean Std.Dev
in minute aition

Frequenc 74(26.3) 117(41.6 66(23.4) 24(8.5) 3 45 42 24.95 13..96

y (%) )
 CBTP PHASE II CBTP PHASE IV CBTP PHASE II CBTP PHASE IV

Have F % F % Do you F % F %
you satisfied
ever with the
visited service
HI

YES 279 99.3 96 YES 111 39.5 259 92.2

NO 2 0.7 4 NO 170 60.5 21 7.8

TOTAL 281 100 281 100 TOTAL 281 100 281 100
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Table 3. Reason for un-satisfaction by health service in Buyo Kechema Kebele
Aug 24-26 2022 G.C.

Reason for CBTP PHASE II CBTP PHASE IV

dissatisfaction
Insufficient service 54 54.5

Not respected by 28.4 22.7

health workers
Unavailability of 14.4 13.6
pharmaceuticals
Other * 3.7 9

* Poor hygiene, lack of quick and integrated work

Medicine preference for curative purpose in Buyo Kechema Kebele Aug 24-
26/ 2022GC

 In CBTP II 62.6% of the community preferred Modern medicine for

curative person over complimentary medicine.
 In CBTP IV this has been increased to 95%.
The reasons for increased preference for modern medicine,
 Health insurance program that has been started with in recent months.
 Increasing awareness about modern drug after the intervention.
 Increasing the trust of modern medicine than complimentary

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The source and preference of modern drugs in Buyo Kechema Kebele,
Aug 24-26 2022 G.C
 Most of the community in Buyo Kechema prefer The health center
pharmacy both on CBTP phase II (90%) and IV (98%)than the Hospital and
Red cross pharmacy.
 The reason they reported for choosing health center pharmacy is that
because it’s nearer and cost effective.
 Some of them (5.4%) in CBTP phase II and (0.7%) on CBTP phase IV
chooses the hospital pharmacy because it have high quality drugs.

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 45

40 39.8
35
%
30 27
25 %
20

15

10

5 2.49% 3.5%
0
Bone setting Herb Religious Quaternazation

Fig. 1 The most common complimentary medicine practice in Buyo Kechema

Kebele Aug 24-26 ,2022G.C
Cont..
 Most common complimentary practices are herbs and
bone setting
 They use complementary medicine because They
believe it’s effective.

35
The perception of community towards complementary medicine
practice in Buyo Kechema kebele, August 24-26 2022 G.C.

 The community members perception about the

complimentary practice is that 206 0f them said it’s
effective and cheap.
 146 said it’s easily accessible and also affordable.

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Table 4. Showing some of the plants used for the treatment of different
diseases in Buyo Kechema kebele in Aug 24-26 2022GC.
no Traditional Name Scientific name Used plant part Medicinal Use
1 Damakese Ocimum spp leaf Common cold and
anti-inflammatory
2 Togo leaf Eye inflammation
3 Tenadam Ruta graveolense Leaf Headache, evil eye
and abdominal pain

4 Qoricha Adi Steam Evil eye

5 Aramiro leaf abdominal pain

6 White eucalyptus Allium sativum Leaf Common cold

7 Grawa Veronia Leaf Abdominal pain
amygdalina
8 Moringa Moringa Oleifera leaf For all disease
 DISEASE CURED ONLY BY COMPLIMENTARY MEDICINE

4.00%
13.00%
1.20%
11.40%
66.20%
7.80%

Buda (Evil Eye) Mitch(Sun Stroke) Cold Hepatitis Almaz Balechra Bone setting 4

Fig 2.Diseases cured only by complementary medicine in Buyo kechema

kebele, Jimma zone, Oromia region, South west Ethiopia, Aug, 2022 GC.
38
 B. SOCIAL DRUGS

Social drug use

60

50

40

30

20

10

0
Alcohol Khat Tobacco Coffee Tea

Before intervention After intervention

Fig 3 .The most commonly used Social drugs in Buyo Kechema Kebele
before and after the intervention, Aug 2022 G.C.
39
 elder female

middle age female

young age female

elder male

middle age male

young age male

0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00% 45.00%

After intervention before intervention

Fig 4.The most frequent groups of community which use social drugs before and
after the intervention in Buyo Kechema Kebele Aug 24-26 2022G.C.
40
Cont..
 The most commonly used social drug in Buyo Kechema Kebele is
Khat (52.6%) followed by Coffee, Tobacco ,Tea and Alcohol both
before and after intervention.
 Before the intervention the most frequent community that use social
drugs were young age male(36.6%) and middle age male(21.3%)
 Despite the intervention it has increased however by 2.1 and 1.2%.
 The reason for this might be the political situation of the country
(schools were closed most of the time) and because of the COVID 19
lockdown (since there is nothing they can do)

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 Are you chewing khat?

32.4%

67.6%

YES NO
Fig 4. number of people chewing khat in buyo kechema kebele 2022GC
Study conducted in Buyo Kechema 2021 before intervention shows 40% khat chewing and 7%
alcohol consumption.Despite The intervention the khat chewing has increased by 27.6%

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C. Rational drug use
S t a t u s o f t h e co m mu n it y f o r ta k in g d ru g s a ccord in g t o t h e in terv en t io n .

Before intervention After intervention

4.4
83.30%

0.943

16.70%
YE S NO
Fig 5. Status of the community for taking drugs according to the information given by
the health workers before and after the intervention Buyo Kechema Kebele Aug 24-26
2022GC.
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 Table 5. Reasons for not taking the drugs according to the information given by
health workers in Buyo Kechema Kebele, Aug 24-26 ,2022 G.C

Probable reasons for not taking drugs Frequency %

according to info given

The information is not clear 12 75

The information is given verbally, hence forgettable 4 25

Total 16 100

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 D O Y O U T A K E M O R E D O S E S D U R IN G M E D IC A T IO N ?
BEFORE INTERVENTION AFTER INTERVENTION

92%

92%
8%
8%

YE S NO

Fig 6 . The percentage of community taking more doses before and after the
intervention in Buyo Kechema kebele , Aug 24-26,2022 G.C
As we can see from this figure most of the community don’t take more drugs before and also after
the intervention.
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 Reasons for taking more doses during medication

For fear of relapse of Disease

To get immediate relief

To shorten the duration of the medication

0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00% 45.00% 50.00%

Series3 After intervention Before Intervention

Fig 7. The probable reason for taking more dose by the community of Buyo
Kechema Kebele in Aug 24-26,2022 G.C
46
90.00%
DRUG SHARING STATUS
81.90%
80.00% 76.80%
70.00%
60.00%
50.00%
40.00%
30.00% 23.20%
20.00% 18.10%

10.00%
0.00%
YES NO

Series 1 Series 2
Fig 8 .The percentage of the community sharing drugs before and after the intervention
in Buyo Kechema Kebele, Aug 24-26 2022 G.C

47
Cont..
 In the figure above, it is clear to see that most of
population do not share drug with their family and
neighbors both before and after intervention.
Although, majority of the community doesn’t share
drugs, there is still some part of population sharing
drugs. But after the intervention, the habit of sharing
drugs has shown decrement by 10.2%.

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 Table 6 .The reasons for sharing drug in Buyo Kechema Kebele Aug 24-26,2022G.C

Reasons Frequency Percent (%)

For common symptom 3 13

For patient who are 20 87

unable to afford

From the previous table we have seen that 18.1% of the population share drugs and here
we can understand that some of the community share drugs with others for the reason of
relieving common symptom and also for patient who are unable to afford .
 Drug storage places
80.00% 74.70%
70.00%

60.00%
48.80%
50.00%
Before intervention
40.00%
After intervention
30.00% 25.90%

20.00%
12.50%12.50% 12.50% 12.80%
10.00%
0.30%
0.00%
locked cabinet bed room open area kitchen

Fig 9 . The place where the community keeps the drugs in households before and
after the intervention of Buyo kechema Kebele, Aug 24-26 2022 G.C.
50
Cont..

 The above figure shows some of the places where the

community stores drugs. Locked cabinet are the place where
most of the community uses to store drugs followed by bed
room ,open area and Kitchen.. After the intervention, there was
some change that the community tried to store their drug in
locked cabinet and there were an increment which is around
25.9%.

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Table 7. showing most commonly stocked drugs in the household medicine cabinet
in Buyo Kechema Kebele, August 24-26 2022 G.C

Most commonly Before intervention After intervention

stocked drugs

% %

NSAIDS 58.8 51.2

Antibiotics 31.6 39.5
Anti-helminthics 9.6 9.3
Total
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100 100
 Probable reason for stocking of drug in the community

for emergency case

for treatment relapse case

Lack of Knowledge about drug disposal

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

Series3 After intervention before intervention

Fig 10. Reasons for stocking Drugs in Buyo Kechema Kebele Aug 24-26 2022 G.C
53
 Having Drug information
23.80%
No
24.20%

After intervention
76.20% Before intervention
Yes
75.80%

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00%

Fig 11. The amount of community having information about drugs before and After
Intervention in Buyo Kechema Kebele Aug 24-26 2022G.C.
54
Table 8: the information that the community have about drugs in Buyo Kechema before and after
intervention.
The information they Before intervention After intervention
have % %

About drug storage 63.8 66.4

About drug toxicity 18.3 11.2

About (drug-drug, 8.45 1.8

drug-food) interaction
About drug expiry 9.38 20.6
date
Total 100 100
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 Before intervention After intervention

35.23
% 39.50
%
60.50%
64.70
%

YES NO
YES NO
Fig 12. Practice of self-medication in Buyo kechema kebele Before and after
56intervention Aug 24-26 2022 G.C
Cont..
 From the above pie chart we conclude that before our intervention majority
of the community (64.7% ) have no knowledge about the impact of using
self- medication. But after we intervene we slightly decrease the number of
the community that uses self medication around by 4.2%.

57
 Kind of illness for which the community uses self Med-
ication
120.00%

100.00%

80.00%

60.00%

40.00%

20.00%

0.00%
minor pain cough wound Helmentiasis

Before intervention After intervention

Fig 13. Kinds of illnesses for which the community use self-medication before and
after intervention in Buyo Kechema kebele, August 24-26 2022 G.C
58
 Cont..

From the data above, minor pain are the most self-
medicated followed by cough, wounds, helimentasis,
malaria.
 Compared to data before intervention there is slight
decline in self medication practice.

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Table 9. shows the most commonly used drugs for self-medication in the
community Before and After intervention Buyo Kechema Kebele August 24-26
2022 G.C.
Most common drugs Before intervention After intervention
used for self- % %
medication

NSAIDS 70.8 60.6

Antibiotics 16.8 35.4

Anti- helmentics 12.4 2

total
60 100 100
 Conclusion
 When compared with phase II results some good results were obtained on
intervened problems.
 Most of community members are satisfied by the service given in health
institution.
 The community prefers Modern medicine than the complementary because the
community has enough access for health institution.
 kchat is the most commonly used social drug followed by Coffee and Tobacco.
 Some of the community chew chat and their number is decreased after the
Cont..

 The main reason for chewing chat is for the purpose of Cultural practice and
to enhance social Interaction.
 Most of the community takes drug according to the information given by the
health worker both before and after the intervention.
 Most of them are not taking more dose, they also are not sharing drugs but a
considerable amount of the community share drugs for common symptoms.
 NSAIDS are the most frequently stocked drugs followed by Antibiotics for
the treatment of emergency cases and for relapse cases.
 Most of the communities practicing self-medication for some minor pain and
NSAIDS are used for that purpose.

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RECOMENDATION

1. The Buyo Kechema Kebele Health Institution & the Kebele

Administrators Should work on creation of awareness about impact of social
drugs, sharing of drugs & provision of information related to stocking of
drugs as well clearly identify reasons for community un-satisfaction helps to
solve problems easily.
2. The literate individual of the kebele such as health center workers, as well
as other people those know about the effect of chewing khat on social,
economy & health of the community should inform the community.
RECOMENDATION

3.Health extension workers should warn Buyo kechema kebele community

on drawbacks of sharing drugs so as to avoid possible accidents.
4. School of Pharmacy has to involve in studying medicinal plants that are
found in the community.
5. CBE office and Buyo kechema health institution workers should work in
cooperation with the kebele administrators on educating the community
about impact and benefit of complementary medicine together with modern
medicine
Ethical Consideration

 Permission letter was sent from Jimma University to the Buyo Kechema
kebele administration and approved by the head.
 The students surveyed throughout the kebele in a polite manner respecting
the culture, custom and belief of the society

65
 ACKNOWLEDGEMENT

We would like to express our huge gratitude of thanks to;

 our study community
 Kebele Administrative
 CBE coordinative office
 Our supervisors
 Finally we would like to appreciate the unity and active participation
of our group members in intervening the problems of society.

66
 REFERENCE

1.Previous Phases of CBTP Documents.

2. Asefa M., Community-based education: Concept and practice
Ethiop. J. Health Dev.2000; 14: 227-237.  

67
Thanks!

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