ABSTRACT The study was done to carry out a community diagnosis of Nakasongola subcounty,Nakasongola district a catchment area of Nakasongola HC IV. Methods used included both quantitative & qualitative.these werequestionnaires,interviews,documents review etc. key informants; LCI, VHT. Sampling: Household sampling-simple randomized sampling, sample size-120 households,Sample area; Kalubanga, Matuugo and Buruuli villages. Demography: 81%- female respondents, 57% of households-mother headed, majority ofhousehold members-below 5 yrs(45.2%), 6-18 (40.5%). Religion; anglicans, Catholics,Muslims, others – 47.6%, 21.4% 14.3% ,16.7% respectively.Occupation; peasants(69%), civil savants(11.9%) Nutrition and food security: Food source; from own garden(61.1%), rest from market.Availability(meals per day); 3-64.3%, 2-26.2%, 1- 7.1%. Diet-mostly carbohydrates(root tubers,maize & its products.), proteins(animal products).
ABSTRACT CONT’D Sanitation and hygiene: Water source; Tap water(50%),borehole(40.5%), wells (4.8%). Water treatment; Boiling(54.8%),Chemicals(9.5%). Other aspects; kitchen compound cleanlinessrubbish pits. Health seeking Behavior: Majority from the health facility. The above results were analyzed using Microsoft Excel spread sheetand presented in form of tables, bar graphs and Pie charts.
INTRODUCTION Community diagnosis is the comprehensive assessment of the health state of an entirecommunity in relationship to its social, physical and biological environment This assessment was carried out in Nakasongola sub-county , Nakasongola District. Political hierarchy included;district level-Nakasongola District; county-Nakasongola(originally called Buluuli);subcounty-nakasongola; parish-nakasongola town council;villages - buluuli, matuugo, kalubanga. Economically; the people were mainly dependant on agriculture and a few othersindulge in trade & commercial activities and others –transport & communicationservices. Socio-culturally;people generally fall among two established kingdoms which include ;the baganda and the baluuli. Originally these were the same kingdom people establishedin buganda kingdom but a segment of some people broke off as the a Baluuli people inthe name of need to have a separate political structure & region demarcation. During the assessment, we used questionnaires and a checklist to obtain information onsocial demographic factors, nutrition, hygiene, and health seeking behavior. The datacollected was then analyzed to come up with a report. Biggest health challenges were ; Malaria, Upper respiratory tract infections, anddiarrheal diseases. The major economic activity was farming. The results were analyzed using Microsoft excel and presented in form of tables, bargraphs, and pie charts
ObjectivesGeneral objective. To carry out the community diagnosis of nakasongola subcounty.Specific objectives. To determine social demographic characteristics of the community. To assess the nutrition status of the community To assess the sanitation and hygiene. To identify the commonest diseases. To assess the health seeking behavior of the people in the community. To assess the health service delivery system in this community
Methods and tools Study design:- The study design was a non interventional,descriptive cross sectional survey. Study population:- The target group was the community andlocal leaders. Sample size:- 120 participants from different villages ofnakasongola subcounty. Sampling technique:- Simple random sampling. Data collection techniques:-Primary data:- questionnaires and Checklist. Households wereselected at random and interviewed using close endedquestionnaires.-Key informants included VHT and LCI chairperson;Secondary data:- Documents used included District records,Hospital records.
Methods and tools cont’d Data processing and analysis: Data processing was donemanually by researchers with the help of calculators andcomputers. The analysis was done by microsoft excel andpresented in form of tables, Bargraphs and pie charts.
Results and Discussion Socio-demography;The study showed that the majority of the respondents were females(81%) & therest being males-as men were out for work by the time the surveys were carried out.Also, most families were mother headed (57.1%) implying a heavy burden loadedonto the females financially, that in a long run greatly impacted onto the maternalhealth.Households were established in a nuclear setting mainly(80%) with the most agedistribution below 18yrs as follows;<5yrs-(45.2%) & 6-18yrs-(40.5%). This shows theeconomical burden laid onto the breadwinners of the households as it wasimplicated in the poor standard of living evident with general source of incomebeing peasant farming(69%) generating below $3 @ day.Majority of household members were anglicans(47.6%) by religion & a significantothers being;catholics(21.4%),moslems(14.3%).this shows majority were christianswith spiritual faith that influences their health seeking behaviour as seen inindulging spiritual healing as part of their ways of managing different healthaspects
Nutrition & food security;Majority of households obtain food from their own gardens (61.9%),others bought food from the market.64.3% of the households would afford three meals a day, 26.2% hadtwo meals a day, and 7.1% had only one meal per day.Most of the meals were served with root tubers(81%), others being:-maize and its products(57.1%), matooke(38.1%) and animal products(31%).The results above depicted that most families had an unbalanced dietin their nutrition. Their meals were majorly protein deficient as shownby the few animal products consumed. They was as a significantVitamin deficient in their diet shown by absence of vegetables in theirdiet.However they had a strong food security depicted by the availabilityand accessibility (grew their own food and even had stores for it.)Cassava and sweet potatoes were dried and preserved as “kasedde” inpreparation for the dry season
Sanitation and Hygiene: Majority of the sampled households use tap water (about 50%),others obtained it from boreholes (40.5%) and wells (4.8%) especiallywhen there was water shortages. This was a good indicator water safety.However, they were affected by the long distance from the watersources.Water was mainly boiled for consumption (54.8%) and 9.5% usedchemicals like water guard tablets. The rest had no means of treatmentat all. The water safety accounts for the low prevalence of water bornediseases like Bilharzia and Typhoid as recorded at the health facility.As regards waste management, most households disposed off theirrubbish safely in rubbish pits and in their gardens for manure,accounting for the high percentage of observed clean compounds.Human waste was disposed off in regularly cleaned pit latrinesaccounting for the low prevalence of communicable diseases likecholera, Dysentery, e.t.c
Health Seeking Behavior:The study showed that the majority of people in the area (83%)sought health attention from the health facility.A significant number however, sought health attention fromtraditionalists (14%) and a few from spiritual healers and churches(3%).This implies good health seeking behavior shown by the highnumbers of people attending health facility. However, none of thesepeople were found to go for routine medical check ups.Also, this good health seeking behavior is attributed to the shortdistance to health facilities, therefore easy accessibility to medicalservices and awareness about the health services provided at thefacility such as immunization, safe male circumcision, e.t.c
Disease burden:Among the most common diseases affecting people in the areaincluded Respiratory tract infections( 46.2%), and Malaria (44.6%).The prevalence of diarrheal diseases was low ( 0.05%), mainly due tothe good general sanitation and hygiene as shown by; Cleancompounds, regularly cleaned pit latrines and good waste disposal.The frequency of these endemic diseases esp. malaria was almostevery month with a registered highest percentage(57.1%). This isattributed to a variety of factors such as breeding places and bushyareas around their compounds.
ConclusionsCommunity strengths include :- Easy access to medical and social services Good political leadership and communication with the community. Good Health seeking behavior. Good Sanitary conditions of the community. Good food security. Good road networks and communication.
Weakness of the community: Low levels of income. Poor nutrition Long distance from distance from reliable water sources. Poor housing facilities; Overcrowded and poor ventilated. Inadequate mosquito nets and bushes around homes. Ignorance about some essential health practices like routine medicalcheck ups and water treatment
Recommendations Health promotion and preventive activities ( like continuous healtheducation on usage of mosquito nets) should be implemented. A number of outreaches should be done to create more awareness onthe essence of routine medical check ups. In order to decongest the households, Family planning methods shouldbe emphasized. Diversification of the economy to improve on economic status of thecommunity. Provide Nutrition education to the community about theimperativeness of the consumption of a balanced diet.
References DHO offices. Higher local government statistical abstract, Nakasongoladistrict; 2008 http/en.wikipedia.org/w/index.php?title=nakasongola_district.downloaded at 20th April 2013 UBOS(2002), Uganda population and Housing census report, Ugandabureau of statistics, Kampala Uganda. WHO; World health report (2002,2004)