A presentation of community health attachment carried out at Emusire community of Abanyore sub-tribe of the Luhya from August to September 2016

1. PRESENTATION OF COMMUNITY ENTRY AND
DIAGNOSIS OF HEALTH OF MUSINAKA
VILLAGE, ESIRULO SUBLOCATION, TONGOI
LOCATION, EMUHAYA SUBCOUNTY, VIHIGA
COUNTY

2. ACKNOWLEDGEMENT
• Special thanks to Maseno University, School of Medicine, Emusire
Health Center and Musinaka villagers.
• They made the research process a success.
• WE ALSO ACKNOWLEDGE OUR TUTORS 1. DR BENSON NYAMBEGA,
2. MS SCOLASTICA KORIR, 3. MS LINDA MOGAMBI, 4. DR OKOTH
MOLLY E.

3. EMUSIRE TEAM
STUDENTS
NAME REG. NO
1. MAKUNDI THOMAS KITAVI MS/00006/014
2. MOREMA CYNTHIA MORAA MS/03027/014
3. SEGA DORAH NEKESA MS/03020/014
4. OMONDI LINUS MS/00035/014
5. ONGONGE COLLINS
ONYANGO
MS/03016/014
6. OWENGA PHELIX MS/00038/014
SUPERVISORS
1. DR BENSON NYAMBEGA
2. MS SCOLASTICA KORIR
3. MS LINDA MOGAMBI
4. DR OKOTH MOLLY E.

4. OBJECTIVES AND RESEARCH QUESTIONS
MAIN OBJECTIVE
• To appraise the health status of
Musinaka Village.
SPECIFIC OBJECTIVE
• To carry out community entry in
Esirulo Sub location.
• To conduct community diagnosis in
Esinaka/Musinaka village
• To participate in health center
activities and outreach activities
• To conduct a nutritional assessment
in a Musinaka community
• To give back to Musinaka village
feedback
RESEARCH QUESTION
• In what ways does nutrition, water,
waste disposal, population and
culture affect the health status of
Emusire community?
• What strategies does the community
put in place to maintain their
health?
• What major problems does the
community face in their attempt to
improve their health?
• What is the level of HIV/AIDS
awareness of the people in
Musinaka.

5. INTRODUCTION
EMUSIRE HEALTH CENTRE
• LOCATION - Vihiga County, Emuhaya
Sub-county, Central Bunyore Ward,
Tongoi Location, Emusire Sub location
and Emuhaya Constituency
• Level – 2
• Catchment population – Emanyinya sub
location
• Departments – registration/Records,
outpatient Department, Comprehensive
Care Unit, Maternal Child Health/Family
Planning/Ante-Natal Care, Laboratory,
Pharmacy, Public Health Office
• Staff – 2CO, 3 Nurses, 2 lab
technologists, 1 TBA, 2PHO, 1 CHEW,1
Peer educator,1 Records Officer.
COMMUNITY
• TRIBE- Luhya, sub-tribe-
Abanyore.
• Historical events-
famine(Sabalala, Nyangweso,
Esikombe)
• Culture – male circumcision,
after-death rituals,
• Health-seeking behavior- all
visited the health center at times
of illness

6. METHODOLOGY AND SAMPLING
METHODOLOGY
SOURCES OF DATA
FGD
OBSERVATIONS
PHOTOGRAPHS
GOVERNMENT SOURCES -- KDHS
THE CONSTITUTION OF KENYA 2013
SECONDARY COURCES - BOOKS *(MEDICAL
BOOKS)
DATA COLLECTION METHODS
FGD
OBSERVATION
INTERVIEWING AND ADMINISTERING
QUETIONAIRES
PHOTOGRAPHING AREAS OF INTEREST
SAMPLING TECHNIQUES
• MAIN SAMPLING TECHNIQUE
USED WAS PURPOSIVE
SAMPLING
• ONLY HOUSEHOLDS WITH
CHILDREN UNDER FIVE WERE
SAMPLED AND INTERVIEWED

7. BACKGROUND
PROBLEM STATEMENT:
• This study sought to appraise the
health status of people in
Musinaka village of Esirulo sub
location, Tongoi location in
Emuhaya sub county of Vihiga
county
• the health status of people in
Musinaka village is poor.
• The health determinants of people
in Musinaka are scanty.
JUSTIFICATION OF THE STUDY
This study will provide important
information that will aid future
studies of the health of Musinaka
Information in the study is
authentic and original.
STATEMENT OF HYPOTHESIS
• The people of Musinaka village
are well-informed about the
determinants of health.

8. RESULTS AND DISCUSSION
DEMOGRAPHY
• Total household size-320. An average of 6
per house.
• Total children-191; male
88(46.07%),female 102(53.93%)
• Total deaths 25 last 5 years.
• The main occupation is farming (71.67%).
• Most have attained primary education
(63.33%),secondary 30%, tertiary 3%.
HOUSING
• Semi permanent-95%,permanent 5%,
• Ventilation good 68.33%, poor 31.67%
• Firewood (85%) and paraffin lamp (55%)
were main source of lighting.
• Most houses have corrugated roofs
(98.33%), with earthen floor (90%)
• Earthen floor-90%(jiggers),cemented-
10%
NUTRITION AND LIFESTYLE
• MAIN TYPE – CARBOHYDRATES 100%
• VEGES – SUKUMAWIKI ,KUNDE,
MIROO, MCHICHA, SEVEVE, SAGA
• MAIN PRESERVATION- DRYING,
CHEMICALS, ASH,
• FRUIT FREQUENCY- DAILY 30%,
WEEKLY – 30%, RARELY- 40%
• FOOD TABOO-1- PREGNANT WOMEN
NOT ALLOWED TO EAT EGGS AND
BACK OF HEN
• EXERCISE- 25%- YES, 75%- NO,
• DRINKING WATER

10. HIV/AIDS AND HSB
HIV/AIDS
• ALL WERE AWARE OF EXISTENCE
HIV -100%
• AWARENESS LEVEL -53% FAIR,
37%GOOD, 10%POOR.
• TESTED FOR HIV:93% - YES, 7%-
NO
HEALTH SEEKING BEHAVIOR
• HEALTH CARE PROVIDERS- TBAs,
CHWs, NURSES, CLINICAL OFFICERS
• INSTITUTION VISITED DURING
ILLNESS:98%- HEALTH CENTER, 2%-
RELIGIOUS LEADERS
• OTHER HEALTH FACILITIES VISITED-
DISPENSARIES, PRIVATE HOSPITALS
,DISTRICT HOSPITALS, CHEMISTS

12. COMMON HEALTH PROBLEMS AND MCH
COMMON HEALTH PROBLEMS IN THE COMMUNITY
• Most prevalent: malaria-100%,
common cold-100%, URTI-67%,
eye infections-57%, skin
infections-55% diarrhea-53%.
• Least prevalent: TB-27%,
malnutrition- 30%, STIs- 33%
• Commonest in children-malaria
and common cold- 100%
• Age of first pregnancy:16-20yr=63%,
21-25yrs=27%, above25yrs=10%
• Place delivered.65%-health center,
28%-home with TBA support, 7%-
home without TBA support
IMMUNISATION
• BCG, Polio, DPT 1, and DPT 2. DPT 3
and measles. 100% had gotten the
BCG injection. 97% had gotten the
polio vaccine. 93% had gotten DPT1,
90% had gotten DPT2 and 88% had
gotten DPT3. 83% had gotten measles
vaccine. And 12% had gotten
pneumonia vaccine.
MATERNAL CHILD HEALTH (WOMEN ONLY)

13. SANITATION
WASTE DISPOSAL
• General liter –burning (46%)
• Farm waste – manure (58%)
• Kitchen waste – compost pit (56%)
HUMAN WASTE
• Pit latrine -100%, 87% semi-permanent, 13%
permanent.
• 77% more than 30m from the water source,
23%less than 30m
• 53% less than 10m from the house, 47% more than
10%
• 67% uphill, 23% downhill, 10% same level of the
water source
• 50% using ash, 17% chemicals, 19% sweeping, 3%
wash with soap and water, 9% detergents,2%
none.
HYGIENE
• Compound tidiness, 68% well kept,
27% littered, 5% bushy
• 100% were washing their hands
and wash their vegetables,
• 52% had at one time have oral ill
health, 48%-no
• Action taken 32% visited dental
clinic, 8% used herbs, 57% did
nothing, 3% used painkillers to
subside the pain
• Dental frequency checkup: 93%
not at all, 5% once, 2%more than
twice

14. WATER SUPPLY AND ENVIRONMENT
WATER SOURCE
20%-spring, 20% -borehole,5-river,
28%-spring and rainwater, 12%-
borehole and rainwater and 15%-
spring and river
78% used protected water source
while 21.6% the water source was not
protected.
Distance of latrine from water source :
over 100m, 75%; 50-100 m,16%; 10-50
m,6.7%;5-10m, 1.7 %
WATER TREATMENT
• 52% treat their water. 48% do not.
• Treatment type: chlorination 35%, boiling
52%, boiling and chlorination 6.4%,
sedimentation 6.4%
POLLUTION
• The most common cause of air pollution in
Musinaka is smoke and dust. Smoke as a
result of many households cooking within
the main house.
• Water pollution was caused by domestic
waste and soil pollution caused by general
litter disposed by landfill and burying.
• Water pollution was controlled to some
extent by water source protection via SOFDI
(NGO)

15. CULTURAL PRACTICES AND TRADITIONS
RITES OF PASSAGE
• Circumcision done to boys of
various ages, especially 6-10
years.
MARRIAGE
• Marriage was done
• Polygamy – 62%
• Monogamy- 38%
• 58% of marriages was
traditional.
• 42% was religious marriage
done in church.
RITUALS
BIRTH RITUALS
• However, 73.3% did not perform. 26.7%
performed afterbirth rituals.
• 88% shaving of hair and baptism.
• 6% no removal of child from the house
before 1 monthpasses;6% baptism only
DEATH RITUALS
• 55% performed after death rituals.
• 45% did not perform after death rituals.
• Of those that did, 94% performed
shaving of hair, 6% prayers.
• Burial ceremony was conducted
religiously 100%

17. PESTS AND VECTORS
PRESENT
• Rats- 80% present, 20% no rats
• Cockroaches-57% present, 43% absent
• Bed bugs – 15% present, 85%
• Housefly and mosquitoes – 100% present,
• Ticks – 25% present, 75% absent.
• Jiggers – 32% present, 68% absent.
CONTROL
• 71% controlled rats, 29% did not control, 53% used
pesticides only, 21% used cats and pesticides, 24 %
used cats only. 2% used rat traps.
• 56% controlled cockroaches, 44% did not. All that
controlled used insecticides (100%)
• 67% controlled bedbugs using pesticides and
cleaning. 33% did not control
• 20% controlled jiggers,

18. CONCLUSION
• LIMITATIONS: stigma(incorrect
information), adverse weather
(rain), fatigue, Insufficient time to
cover the study
• IMPORTANT FINDINGS: the
society is mostly educated,
developed (corrugated iron roof,
solar), informed health wise ( visit
hospitals, CHV’s outreach)
FUTURE
• Health education to counter stigma.
• Research on malaria prevalence in
the area.
• Outreach services to treat jiggers
and pests in most homesteads.