Final PPT of CBTP.pptx

HARAR HEALTH SCIENCE COLLEGE
COMMUNITYY BASED TRAINING
PROGRAM (CBTP) ON SOFI WOREDA IN
GELMESHIRA KEBELE
OCTOBER 2023
10/25/2023
BY: HO CBTP GROUP MEMBERS
1

Name list of Group members
1. 15. 29.
2. 16. 30.
3. 17. 31.
4. 18. 32.
5. 19. 33.
6. 20. 34.
7. 21. 35.
8. 22. 36.
9. 23. 37.
10. 24. 39.
11. 25. 40.
12. 26. 41.
13. 27. 42.
14. 28. 43.
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2

Presentation Outlines
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 Introduction
 Statement of the problem
 Objectives
 Methods and Materials
 Result
 Action plan vs. Achievements
 Strengths and Limitations
 Challenges and Action attempted to solve the
challenges
 Conclusion and Recommendation
 References
 Acknowledgment

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Back ground
 Community based education (CBE) is introduced to the
world in the late 1970’s as a response to a popular demand
that education should give service to the society.
 The Community-based Training Program is an integrated institutional
program that runs in phases from the first year to graduation.
 It involves students, the communities and government departments
responsible for health, education, water sanitation and technology.
 It has promoted an integrated, holistic approach in addressing societal
problems.
(www.ju.edu.et/ community-based training program )
Introduction

Introduction Cont.…
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5
Statement of the problem
 In 2016, 91% of the world’s population did not breathe
clean air, and more than half of urban population were
exposed to outdoor air pollution levels at least 2.5 times
above the safety standard set by WHO.
 It has been estimated that in 2016 outdoor air pollution in
both cities and rural areas caused 4.2 million deaths
worldwide.
 Taken together, indoor and outdoor air pollution caused an
estimated 7 million deaths- one in eight deaths globally in
2016 (WHO; 2018. available at:

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Statement of the problem cont. …
 Access to clean fuels and technologies for cooking has
marginally improved and in 2016 reached 59% globally
an increase of 10 percentage points since 2000.
 The resulting household air pollution is estimated to
have caused 3.8 million deaths from NCDs (including
heart disease, stroke and cancer) and acute lower
respiratory infections in 2016 (World Bank; 2017, WHO;
2018)

Introduction Cont. …
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7
 An estimated 2.6 billion people lack access to improved
facilities for the disposal of human excreta, such as a basic
pit latrine.
 One billion people, including an estimated 638 million in
India alone, still practice open defecation (WHO/UNICEF,
2010)
 In sub-Saharan Africa, open defecation rates increased
from 204 to 220 million (WHO/UNICEF, 2017).
 Unsafe drinking water, unsafe sanitation and lack of hygiene
also remain important causes of death, with an estimated
870 000 associated deaths occurring in 2016 globally (WHO;

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 Globally, in 2015, an estimated 303,000 women died as
a result of pregnancy and childbirth-related complication.
(WHO , World Bank, 1990-2015 and WHO, 2018)
 Almost all 99% (302, 000) of global maternal deaths
occurred in Developing countries (WHO , World Bank,
1990-2015)
 Sub-Saharan Africa (SSA) countries alone accounted
for 66% of maternal death (WHO, World Bank, 1990-
2015)

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 levels of more recently recommended vaccines such as
rotavirus vaccine and pneumococcal-conjugated vaccine
(PCV) are still under 50% globally.
 By the end of 2016, PCV had been introduced in 135
countries with global coverage of the third dose (PCV3)
reaching 42%. (WHO/UNICEF; 2017).

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Significance of the study
 The result of this study will be had a positive impact to
improve the health our catchment area societies.
 The finding from this study will be provide directions for
all concerning bodies to implementing successfully
different health strategies activities.
 The study participants also will be become beneficial
from the finding because, Harari regional health bureau
may be done different interventions based up the
findings.

Objectives
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General Objective
 To assess community health related problem and
environmental condition in Gelmeshira Kebele, Sofi
Woreda, Harar Region, Eastern Ethiopia, 2023.
Specific Objectives
 To identify latrine condition of the community
 To assess the kitchen condition
 To identify dray waste disposal mechanism of the
community
 To assess maternal ANC follow up among pregnant
women

Objectives cont. …
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12
Specific Objectives cont. …
 To identify methods of family planning usage among
reproductive age group women
 To identify immunization status among infants
 To differentiate breast feeding condition of children
 To assess HIV status of the community
 To assess general drug utilization of the community

Methods and Materials
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13
Study Area and Period
 The study was conducted in Harar Town, Eastern Ethiopia
which is located 526 km from Addis Ababa the capital city
of Ethiopia.
 This survey was conducted in Gelmeshira Kebele (around
Menshin), Sofi woreda.
 The study was conducted from October 16-18/2023G.C.
Study Design
 Community based cross-sectional study was
employed.

Methods Cont. …
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14
Dependent Variable:
 Environmental conditions
 Housing condition (latrine, kitchen,
etc.)
 Maternal health condition (ANC,
Abortion, Institutional delivery
family planning, etc.)
 Child health condition
(immunization, Brest feeding, etc.)
 Family health condition
 Drug utilization
Independent
Variables:
 Socio-demographic
variables ,, (sex,
age, etc… )
Study Variables

Methods Cont. …
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15
 Populations
Source Population:
 All Households of Sofi woreda in Harar City
Study Population:
 All systematically selected households in Gelmeshira Kebele
(around Menshin)
Inclusion criteria:
 All households in Sofi woreda Gelmeshira Kebele (around
Menshin)
Exclusion
 Households with the resident of less than 6 months.
 Houses that had no any person (permanently closed for a long
period of time)

Methods Cont. …
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16
Sample size determination
 The sample size required for this study was calculated
based on a single population proportions formula
n =
Where:
 n= the desired sample required
 Zα/2 = the standard normal variable at 95% confidence
level=1.96
 p = prevalence or proportion which is 50%
 d= is the margin of error assumed to be tolerated (5%)
 Hence, n = 384.

Methods Cont. …
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17
 Since the study population was below 10,000, we
applying the correction formula as follow
 n= 217
 The final sample size was 217 house holds.






500
384
+
1
384
=
n

Methods Cont. …
10/25/2023
18
Sampling techniques and Sampling
procedures
 In Sofi woreda, there are four kebeles.
 From these four kebeles, Gelmeshira Kebele was
selected via simple random sampling technique.
 Systematic sampling technique was used in
selecting of the study participants’ (households) with
K value of 2.

Methods Cont. …
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Sampling techniques and cont. …
 The first participant (household) was selected
randomly by lottery method in the selected Kebele.
 Households were closed during data collection time;
the data were taken from the next household.

Methods Cont. …
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20
Data collection instrument and techniques
 A structured questionnaire which had four parts was
prepared in English language.
 Data were collected via Face to face interview and
observation through electronics device.
 The data collection process was organized by the assigned
instructor.
 Data were collected by 3rd year Public health students of
Harar Health Science College.
 Training was given for the data collectors on the instrument
and ways of approaching the study participants prior to the
data collection process.

Methods Cont. …
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21
Data Quality Control
 Before starting the data collection the group members were
discussing thoroughly with assigned teacher on the
questioners in details so that common understanding were
created among the group members.
 The collected data were checked for completeness
daily base during data collection period.
 After data have been collected completed also, the
data were checked for completeness before starting
analysis.

Methods Cont…
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22
Data processing and analysis
 After data collection, the data was downloading in to
excel for further analysis.
 The collected data was analyzed by using excel and
Presented by using different result presentation such
as words, tables, graphs, etc.

Methods Cont. …
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23
 Ethical clearance was obtained from Harar Health
Science Collage CBTP Coordinator office.
 To keep the confidentiality of the participants, personal
identifiers like name of the participants were not included
in the data collection format
 The participants were informed that they had full right not
to participate in the study or to stop participation at any
time during the data collection was reassured.
Ethical Considerations

Result
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Socio-demographic Characteristics of respondents
 From 217 household samples of the study area, all were
participated with the response rate of 100%.
 The total population among 217hhs in the study area was
834.
 From this 452(54%) were males.
 Most of the respondents age group falls on the range of 20-
24.
 Regarding to education majority, 242 (29%) were attending
primary school.
 table 1.docx

Result
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Socio-demographic Characteristics of respondents
80 70 60 50 40 30 20 10 0 10 20 30 40 50 60 70 80
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
>=65
Male Female
Fig.1. Age-sex frequency distribution of respondents in Gelmeshera Kebele , Sofi
Woreda Menshen village Harar Town from October 4 to 25/2023G.C

Results Cont. …
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26
Housing condition of respondents
 Majority 158 (73%) of the study participants’
households windows were opened during visit
 And also more than half 202 (93%) of households
have latrine.

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Variables Category Frequency Percentage
Number of class One 58 26.7%
Two 48 22.2%
Three 39 17.9%
>/=4 72 33.2%
Total 217 100%
Number of window No 20 9.2%
one 57 26.3%
two 61 28.1%
Three 33 15.2%
>/=4 46 21.2%
Total 217 100
Condition of window during
visit
Opened 158 73%
Closed 59 27%
Total 217 100%
Kitchen attached to house Yes 103 56%
No 80 44%
Total 217 100%
is there kitchen yes 183 84%
No 34 16%
Total 384 100%
Table 1:- Housing condition of respondents in Gelmeshera Kebele , Sofi Woreda Menshen village Harar Town from
October 4 to 25/2023G.C

Results Cont. …
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28
 Majority (93%) of respondent households have latrine
accesses.
 Of them 157 (72%) respondent use pit latrine as shown on
the figure below.
Figure: -1 Latrine condition of respondents in Gelmeshera Kebele , Sofi Woreda
Menshen village Harar Town from October 4 to 25/2023G.C
72.0%
27.0%
1.0%
0.00%
20.00%
40.00%
60.00%
80.00%
pit water carriage Other

Results Cont. …
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29
Sanitation and waste disposal condition
 Regarding to place solid waste disposal 65(30%) were
using in compound, while 9(4%) were using in outside
the compound.
31%
30%
4%
22%
13% in the compound
In the pit
out side compaund
Manucipality
Open field
Fig2. Waste disposal condition of study participants in Gelmeshera Kebele , Sofi
Woreda Menshen village Harar Town from October 4 to 25/2023G.C

Results Cont. …
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Water supply and storage
Variables Category Frequency Percent
Water Sources Public bono 131 60%
In compound 38 18%
Not protected 6 3%
Spring 40 18%
Other 2 1%
Water storage
material
Jerican/Bido 162 75%
Roto 54 25
Table2: in Gelmeshera Kebele , Sofi Woreda Menshen village Harar Town from

Results Cont. …
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 More than half 135(62%) of the respondent use
bishangar/Wehagar for water treatment at the home
whereas, 63 (29%) were not anything for treating water
at home .
62%
6%
29%
3%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
bishagar boiling none others
Fig3. in Gelmeshera Kebele , Sofi Woreda Menshen village Harar Town from

Results Cont. …
32
Maternal and Child Health condition
 From reproductive age group only 80 (37%) received Td
vaccine.
 Regarding TT immunization among reproductive age group
100%, 44% of respondents were took TT1 and TT2 as shown
on the figure below.
Figure 4:- TT vaccination status for women’s of reproductive age group in in
Gelmeshera Kebele , Sofi Woreda Menshen village Harar Town from October 4 to
100%
44%
34%
30%
11%
63%
TT1
TT2
TT3
TT4
TT5
Not vaccinated

Results Cont. …
33
 Among reproductive age group women, 137(79%) were not
family planning users.
 Among 217 household family planning users of reproductive
age group, were only 45(21%).
Figure 5: current Frequency distribution of type of family planning methods usage among
women in reproductive age group women in Gelmeshera Kebele , Sofi Woreda Menshen village
Harar Town from October 4 to 25/2023G.C
0%
50%
100%
yes no
21%
79%

Results Cont. …
25-10-2023
34
 According to our study almost (89%) of respondent are
heard about HIV and
 Most of them 156(72%) got the information’s from mass
media
0%
20%
40%
60%
80%
MASS MIDA HEALTH
INSTITUTION
FRIENDS SCHOOL
72%
16%
4% 8%
Figure 6: Frequency distribution of respondents’ source of information about HIV in Gelmeshera
Kebele , Sofi Woreda Menshen village Harar Town from October 4 to 25/2023G.C

Criteria for prioritizing the identified problems
Table 8: Criteria for prioritizing the identified problems in Gelmeshira Kebele (around Menshin) Sofi woreda, Harar,
Town Eastern Ethiopia, 2023.
10/25/2023
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No Identified problem Magnitude Severity Feasibility Government
Concern
Community
Concern
Total Rank
1 Lack of latrine coverage materials 4 4 4 3 3 18 4
2 lack of hand washing facility
attach to the latrine
3 4 3 3 3 16 6
3 Usage of open field for solid
waste disposal
3 4 2 4 3 16 6
4 Low intake of Tetanus diphtheria
(Td) vaccination
4 5 5 5 5 24 1
5 Low utilization of contraceptive
among reproductive group woman
3 4 2 5 2 16 6
6 Lack of compound cleanness 3 3 4 4 3 17 5
7 Usage of untreated water at home
for drinking
2 4 5 4 4 18 4
8 High experience of cutting tonsil 4 5 4 4 2 19 3
9 High experience of milk teeth
extraction
3 3 5 4 3 18 4
10 Presence of house fly in the house 5 2 3 2 2 14 7
11 Low HIV tasting practice in the
community
4 4 4 5 5 22 2

36
Identifie
d
problems
Objectiv
e
strategie
s
Activity
Target
populati
on
Responsi
ble
person
Units
of
measure
ment
PLAN
Achievement Re
ma
rk
In No In %
Low intake of
Tetanus diphtheria
(Td) vaccination
To increase the intake of
Tetanus diphtheria
(Td) vaccination from
80(37%
)to 150(69%) on
October 30
Campaign Providing
Health
education and
TD vaccination
Menshin
Group
members,
HEW &
communiti
es
HHs
70
Low HIV tasting
practice in the
community
To increase the HIV
tasting practice in the
community from
111(51%) to 200(92%)
on October 31
Coffee
ceremony and
health
education
Providing
Health
education and
performing HiV
test
Menshin
Group
members,
HEW &
communiti
es
HHs
89
High experience of
cutting tonsil
To decrease the high
experience of cutting
tonsil from 71 (47%) to
25(17%) on Nov 1
Campaign
Providing
Health
education and
awareness
toward tonsil
cutting
experience in
the community
Menshin
Group
members,
communit
y, and
HEW
HHs
47
Identified
problems
Objective
strategies
Activity
Target
population
Responsible
person
Units
of
measurement
PLAN
Achievement Re
ma
rk
In No In %
Action plan vs. Achievement for the selecting problems

Strengths and Limitations
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Strength
 Commitment of group members to perform the
activities.
 Well organized group
 Different educational back ground and work experience
of the group members
 Strong relationship with concerning bodies such as
Health extension workers
 Team spirit and good time management

Limitations
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 No basic limitations are appeared during the CBTP
program, except the shortage of time.

Challenges during intervention
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 Some community members of our target individuals
were not cooperative
 The dogs scared us many times
 Language barriers at the time of providing health
education
 Some people considered as a politicians by relating the
current political situation.

Action attempted to solve the challenges
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 Communicate with community smoothly
 We were going to as a small team by including different
language ability has.
 We explain everything about the intention of CBTP and
we were out politics rather than solving our community
health problems.

Conclusion and Recommendations
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Conclusion
 In our study in Gelmeshera Kebele, more than one third of the
households have one rooms.
 Majority of the houses we visited are using In the pit for dray
waste disposal and they use public bono for water resource
 some of the respondents not use any types of treatment for
household drinking water.
 Regarding to Latrine usage, the majority of the community are
users of Pit type latrine.
 And the insignificant percentage of the community have hand
washing materials attached to the latrine .

Conclusion cont. …
10/25/2023
42
 With respect to Family planning utilization among
reproductive age group women, most of female around
the area do not use any type of family planning
methods.
 All under five children were started complementary
feeding after 6month and more than half of them
continue breast feeding up to 3years.
 Approximately one fourth of the respondents have been
tested for HIV and most of them use full dose that
prescribed by physician.

Recommendations
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 Improve access to clean water and sanitation facilities:

 Increase investment in water infrastructure to ensure access to clean and safe
drinking water for all communities.
 Promote the construction of latrines and hand washing facilities to improve
sanitation practices and reduce the risk of waterborne diseases.
 Implement water treatment and purification processes, especially in rural areas, to
ensure the availability of safe water sources.

 Strengthen health education and awareness campaigns:

 Develop comprehensive health education programs that focus on preventive
measures, such as proper hand washing, safe food handling, and personal
hygiene practices.
 Utilize various communication channels, including radio, community meetings,
and local influencers, to disseminate health-related information.
 Raise awareness about common health issues prevalent in the countryside,
including malaria prevention, HIV/AIDS, and maternal and child health.

 .



Recommendations cont. …
10/25/2023
44
 Expand access to healthcare services:

 Increase the number of healthcare facilities, especially in rural areas, and equip
them with necessary resources and healthcare personnel.
 Establish mobile health clinics or outreach programs to provide medical
assistance in remote areas.
 Encourage the training and deployment of community health workers to provide
basic healthcare services and education within their communities.

 Promote vaccination and immunization programs:

 Strengthen existing vaccination programs and ensure the availability of vaccines
for common diseases, such as tetanus, polio, and measles.
 Conduct vaccination awareness campaigns to address misconceptions and
increase vaccine uptake in rural communities.
 Develop strategies to reach out to underserved populations and remote regions
with targeted vaccination programs.
 encourage family planning and reproductive health services:


10/25/2023
45

Engage community leaders and stakeholders:
Involve community leaders, local authorities, and NGOs in health and
hygiene promotion initiatives.
Seek community input and involvement in the planning and
implementation of health programs to ensure their sustainability and
effectiveness.
Foster partnerships with local businesses, schools, and community
organizations to support health and hygiene initiatives.
Strengthen monitoring and evaluation systems:
Establish robust systems to monitor the progress and impact of health
and hygiene interventions.
Regularly assess health indicators, such as vaccination coverage,
disease prevalence, and sanitation practices, to track improvements
and identify areas for further intervention.
Use data to inform policy decisions and allocate resources effectively
for health and hygiene programs.
Improve access to contraceptive methods and family planning services around
Gelmeshira.
Provide comprehensive reproductive health education that addresses myths,
misconceptions, and cultural barriers.
Train healthcare providers to offer counseling services and support women in
making informed decisions about contraceptives and reproductive health

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46
 Implement waste management systems:
Establish community-based waste collection and
disposal systems to prevent open field waste
disposal.
Promote waste segregation and recycling practices
to reduce environmental pollution and improve
hygiene standards.
Educate communities on the importance of proper
waste management practices and the potential
health risks associated with improper waste disposal

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To Gelmeshera Kebele administration
 Integrate with HEWs to Mobilize community to conduct
sanitation campaign on regular bases
 Construct common dry waste disposal sites together
with the city municipality
 Give suitable intervention to the main problem of the
community
 Protect illegal common sites used by community for dry
waste

Acknowledgement
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48
 We would like to Acknowledge Harar Health Science
Collage for providing us the chance to conduct and
present this community based training program (CBTP)
successfully.
 We would also like to give our big gratitude to Harar
Town, Gelmeshera Kebele community and administration
office for providing us necessary information with great
interest and permission to conduct CBTP with in
community.
 Furthermore we would like to give our sincere
appreciation to our advisor amanuel and Gizaw Kifle
who tirelessly gave us valuable and continuous, all
rounded guidance and comments for accomplishment

Reference
10/25/2023
49
1. Who E, Group WB. Trends in Maternal Mortality : 1990 to 2015. 2015.
2. WHO. World health statistics 2018: monitoring health for the SDGs,
sustainable development goals. Geneva: World Health Organization;
2018.
3. Global Health Estimates 2016: Deaths by cause, age, sex, by country
and by region, 2000–2016. Geneva: World Health Organization; 2018
(http://www.who.int/healthinfo/global_burden_disease/estimates/en/in
dex1.html).
4. Public health and environment [online database]. Global Health
Observatory (GHO) data. Geneva: World Health Organization
(http://www.who.int/gho/phe/en/).
5. WHO/UNICEF Joint Monitoring Programme for Water Supply and
Sanitation. Progress on Sanitation and Drinking Water: 2010 Update;
WHO Press, Geneva, 2010.

Thank You All
!!!
10/25/2023
50

Final PPT of CBTP.pptx

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