RESEARCH community mobilization ACTS TO IMPROVE SANITATION ENVIRONMENT for ethnic minorities in especially difficult REGION OF Dong Hy district, Thai Nguyen Associate professor. PhD. §µm Kh¶i Hoµn, MSc. Hoàng Anh Tuấn Thai Nguyen medical and pharmacy University, Viet nam
<ul><li>Environmental sanitation is one of issues that is interested in all over the world. - Implementing environmental sanitation well is to improve life condition and health of rural people, to contribute to eliminate hunger and reduce poverty. - Economic, cultural and social condition in special difficult areas in Dong Hy is slow, especially about environmental sanitation behavior… It is necessary to improve environment, to implement environmental sanitation well. The solution to mobilize community to take part in improving environmental sanitation behavior is a good heading. </li></ul>Introduction
1. To evaluate the real situation of environmental sanitation of ethnic minority people at 4 difficult hamlets in Dong Hy district, Thai Nguyen province. 2. To develop the model of mobilizing community in improving environmental sanitation behavior for people in Cay Thi hamlet, Thai Nguyen province. 3. To evaluate the effect of model in improving environmental sanitation behavior for ethnic minority people in Cay Thi Hamlet after 2 months to carry out. Research target
<ul><li>Householders in hamlets - Medical personnel in hamlets - Collaborators of population and nutrition - Officers at medical and demorgraphic station - Senior excutive in the hamlets Teacchers and pupils at secondary schools in the hamlets. - Young people in the hamlets. </li></ul>1. Research subjects and methods.
2. Location: Dong Hy Distrist and 4 communes Cay Thi, Hop Tien, Tan Long, Van Lang. 3. The time: From 1/2006 to 12 /2007 4. Research method: Interrupting description and epidemiology interfere. 5. Sample: Choosing 200 households of ethnic minority people in remote villages in each commune (Far from the city center about 5km and above). 4 communes with 800, real investigated samples are 830) Sample unit: Choosing household, choosing one adult in each household (the head of a household). Choosing randomly by draw lots method .
Research model is interfering before and after with control group basing on the following outline: <ul><li>Interfere </li></ul><ul><li>Cây Thị commune (experiment) Figures after interfered </li></ul><ul><li>( Figures before interfered) </li></ul><ul><li>Non-interfere </li></ul><ul><li>Hợp Tiến Commune (control ) After figures </li></ul><ul><li>(Before Figures) </li></ul>Comparison Comparison
<ul><li>Conducing to develop interfering model with: </li></ul><ul><li>- Developing Steering Committee that carries out model in Cay Thi hamlet </li></ul><ul><li>- Training for members to participate model at basic issues of environmental sanitation communication and activity method in model (training time is 1 week) </li></ul><ul><li>- The role of members in model. </li></ul><ul><li>- Health volunteer, collaborators population, nutrition are the main people who carry out: teachers, pupils, young people , and authority organizations, unions who participate to support. </li></ul><ul><li>- The head of hamlet is a person who create good conditions sor members. The head of medical station is responsible to supervise the carrying out tasks of members. The president of the hamlet manages commonly. </li></ul><ul><li>- Steering Committee has a meeting with members once a month to examine the rate of progress to carry out model, complement, update some issue of knowledge for members. </li></ul>
<ul><li>- Activity of research group: Supervise 0nce per 2 months to examine the progress of carrying out model and support main issues. </li></ul><ul><li>Model activity takes place continuously in 2 years </li></ul><ul><li>Information collecting technique. </li></ul><ul><li>- Quantitative: Interviewing and observing </li></ul><ul><li>- Qualitative : To analyze the deep aspect of culture, customs of inhabitant’s hygiene and evaluate accepting ability the model of community. Group discussion is the main method. </li></ul><ul><li>Evaluating method. </li></ul><ul><li>- Comparing the changing KAP of environmental sanitation of people in Cay Thi and Hop Tien at the time before and after interfering. </li></ul><ul><li>- Evaluating interfering results based on effect index and interfering effect. </li></ul><ul><li>Data processing method. </li></ul><ul><li>- F ollowing biomedical statistics methods on computers with the software EPIINFO 6.04 </li></ul>
Diagram 1: Model of mobilizing community to take part in improving environment sanitation behavior in Cay Thi commune, Dong hy Distrist, Thai Nguyen City Reseach result Steering Committee for implementation of communal sanitation Steering Committee for implementation of communal sanitation Communal departments Medical Stations The communal organizations Village health workers Organizations in villages Local leaders Inhabitants
Graph 1 . Training course result of model carrying-out
Table 1. Concrete activity results of member who participate model 3.963 1.672 168 Total 132 24 12 The other mass organizations 678 490 24 University medical student 234 78 13 Teachers 'plug' 125 45 8 Farmer 1.235 387 42 Youth Union 379 120 8 Women 982 423 51 Village health workers 198 105 10 Commune health station staff Number of listeners Number of communication sessions in households Number of sessions transmitted through meetings Indicators Member
Graph 2 . Changing KAP of environmental sanitation of Inhabitant in Cay Thi hamlet
Graph 3 . Changing behavior of using hygiene work of inhabitants in Cay Thi Hamlets.
Graph 4 . Changing KAP of environmental sanitation of inhabitants in Hop Tien
Graph 5 . Changing KAP of environmental sanitation of inhabitants in Hop Tien
Graph 6. Changing KAP of environmental sanitation of inhabitants in 2 communes after interfered
Graph 7. Changing to use hygiene work of inhabitants between 2 communes after interfered
Mrs Hue – A cell secretary of Hoan village “ Although the Hoan Village has slow life condition, after carrying out program, the hamlet's Environmental sanitation is improved a lot The program integrates the Yong Union and it is supported by many people. Carrying out the environmental sanitation work based on officers’ instruction. Inhabitants’ awareness is improved. We desire to continue carrying out environmental issue in the local…” .
Mr Phuong – Young union secretary at Khe Can hamlet “Ethnic minority takes up majority, education level is slow, especially the old people. Having the participation of students, all people carry out well. However, Propagandizing is not good. Some people have changing of behavior but majority is not good because some officers are not good model. The integration of hygiene work and propagandizing hasn’t got good effect.
Mr Hien – The head of medical station at hamlet. “The rate of household with safe hygiene work increases so much. Inhabitants support to improve hygiene work 1 part divided 2 parts. Man-made cisterns ensure hygiene, on- site dust-hole. Having participation of union, senior executive. People’s council are good model to carry out, However there are some senior executive are not good model. The subject is needed to deploy in the local.
Result <ul><li>1. The rate of people who have the environmental sanitation attitude is : Good knowledge : 21,57% ; Good attitude : 18,92% ; Good practice : 9,52%. </li></ul><ul><li>2. Model of mobilizing community to communicate environmental sanitation, organizations in the local share responsibility with the public health in improving people’s environmental sanitation behavior, combining the carrying out model with the tasks of each individual and unit… Research model is integrated with CSSKBĐ in commune. In order to carry out the model, it is necessary to develop a commune steering committee. In mobilizing community to develop function, concrete task to ensure the good –working and integrating the environmental sanitation communication and the managing profession for medical station. </li></ul>
Conclusion <ul><li>3. Activity results of model after 2 years to carry out at Cay Thi gets the changing in environmental sanitation behavior such as the increasing of knowledge 63%, attitude 33,2% practice 14,5%. The clearest changing in Interfering result is environmental sanitation knowledge (323%), practice (253%) attitude (206%). After interfering , in Cay Thi there is a clear changing about building and using hygiene toilets ( increasing 26,5% household), interfering result is 217,22%. </li></ul><ul><li>Recommendation: </li></ul><ul><li>The model of mobilizing community in improving environmental sanitation communication is a effective model to implement the early health care work in common, for people in ethnic minority in remote mountainous areas in general. The model is the solution that need to be researched and applied by authority leaders and public health profession. </li></ul>