CBTP

1. 1
ARBA MINCH UNIVERSITY
COLEGE OF MEDICINE AND HEALTH SCIENCE
DEPARTMENT OF COMPREHENSIVE NURSING
ASSESSMENT OF HEALTH AND HEALTH RELATE PROBLEMS IN
ARBA MINCH TOWN MEHAL KETEMA, NECHSAR KEBELE.
NOVEMBER 2023 G.C
SOUTH ETHIOPIA

2. I
Group Members
NO. NAME ID NO
1 ATALAY SHITAHUN NSR/080/14
2 DAGMAWIT MADE NSR/1551/14
3 DEBELA SHIFERAW NSR/167/14
4 MEDHANIT GUNDARE ANS/010/14
5 MIKIYAS ADAMU NSR/1700/14
6 NARDOS ESHETU NSR/1843/14
7 REDIET ABERA NSR/2898/14
8 SEMAYAT OCHE NSR/2580/14
9 SOLOLMON SIRAW NSR/1996/14
10 TIRSIT GEREMEW NSR/1340/14
11 WONDISHET MEKONNEN NSR/2708/14
12 YARED MINDA NSR/2065/14
13 YEABSIRA TARIKU NSR/2068/14

3. II
Acknowledgment
We would like to express our genuine gratitude for Arba Minch University College of Medicine
and Health Science specifically comprehensive Nursing for giving us this ideal Opportunity to
perform the community-based training program (CBTP) which is really helpful
To implement what we learnt theoretically in public courses. Next, we would like to present
great thanks to our Advisors Wubshet E (Assistant professor in AHN) and Aste (MSC) for their
guidance on each footstep while preparing this proposal also following with their satisfactory
comments.

4. III
Table of Contents
Acknowledgment............................................................................................................................................
Abbreviations and Acronyms .........................................................................................................................
List of table .....................................................................................................................................................
SUMMARY....................................................................................................................................................
CHAPTER ONE-INTRODUCTION..............................................................................................................
1.1 Background of study.................................................................................................................................
1.2 Statements of the problem.........................................................................................................................
1.3 Significance...............................................................................................................................................
CHAPTER TWO: OBJECTIVES...................................................................................................................
2.1 General objective ......................................................................................................................................
2.2 Specific objectives ....................................................................................................................................
CHAPTER THREE: METHODOLOGY .......................................................................................................
3.1 Study area and study period......................................................................................................................
3.2. Study design.............................................................................................................................................
3.3. Population ................................................................................................................................................
3.3.1 Source (Target) population ................................................................................................................
3.3.2. Study population...............................................................................................................................
3.3.3. Sampling unit....................................................................................................................................
3.3.4 Study unit...........................................................................................................................................
3.3.5. Sample size determination and sampling technique .........................................................................
3.3.6Sampling Technique ...........................................................................................................................
3.4 Selection criteria ......................................................................................................................................
3.4.1 The inclusion criteria .........................................................................................................................
3.4.2The exclusion criteria..........................................................................................................................
3.5 Study variable ...........................................................................................................................................
3.5.2 Dependent variable ............................................................................................................................
3.6 Data quality control measures...................................................................................................................
3.7 Data collection procedure .........................................................................................................................
3.8 Operational definition...............................................................................................................................
3.9 Data processing and analyzing technique .................................................................................................
3.10 Ethical Consideration..............................................................................................................................
3.11 Dissemination and utilization of the result..............................................................................................

5. IV
3.12. Problem faced and solution during CBTP .............................................................................................
CAPTER FOUR: RESULT ............................................................................................................................
4. RESULTS ...................................................................................................................................................
4.1 Socio demographic data............................................................................................................................
4.1.1 Age and Sex.......................................................................................................................................
4.1.2: Distribution of religion status ...........................................................................................................
4.1.3: Educational status .............................................................................................................................
4.1.4: Occupational status...........................................................................................................................
4.1.5: Marital status.....................................................................................................................................
4.1.6. Economic status ................................................................................................................................
4.2 Environmental health status......................................................................................................................
4.2.1 Housing condition..............................................................................................................................
2. Kitchen condition........................................................................................................................................
4.2.3 Liquid waste.......................................................................................................................................
4.2.3.1 Latrine.........................................................................................................................................
4.2.3.2 Water source &utilization...........................................................................................................
4.2.4. Solid waste........................................................................................................................................
4.2.5 Domestic animals...............................................................................................................................
4.2.7 Insects distribution.............................................................................................................................
4.2.7.1 Insect control method......................................................................................................................
4.2.8 Electricity service...............................................................................................................................
4.2.9 Light adequacy...................................................................................................................................
4.3 Maternal and Child health.........................................................................................................................
4.3.1 Maternal Health .................................................................................................................................
4.3.2 Family planning status .......................................................................................................................
4.3.2.1 Reason for not using and discontinue using family planning .....................................................
. 4.3.3 Abortion status.................................................................................................................................
4.3.4 Pregnancy and child birth ..................................................................................................................
4.3.5 TT vaccination service.......................................................................................................................
4.3.6 Birth, mortality and Breast feeding....................................................................................................
4.3.7 Harmful traditional practices .............................................................................................................
4.3.8 Immunization.....................................................................................................................................
4.4 MORTALITY AND MORBIDITY CONDITIONS ................................................................................

6. V
4.4.1MORBIDITY CONDITIONS.............................................................................................................
4.4.1.1DIARRHOEA CASE IN LAST 2 WEEKS.................................................................................
4.4.1.2 Prevalence of malaria..................................................................................................................
4.4.1.3 Stagnant water.............................................................................................................................
4.4.1.4 Bed net ........................................................................................................................................
4.4.1.5 When family members become ill where they take first.............................................................
4.4 .2 Disability...........................................................................................................................................
4.4.3 MORTALITY CONDITIONS...........................................................................................................
4.5 HIV/AIDS.................................................................................................................................................
4.5.1 Risk factor for HIV/AIDS..................................................................................................................
4.6 MENTAL ILLNESS.................................................................................................................................
4.6.1 CAUSES FOR MENTAL ILLNESS.................................................................................................
4. 6.5 Thought about mental illness is contagious or not............................................................................
4.6.6 Presence and absence of mental illness in the family ......................................................................
4.6.7 Symptoms of mental illness...............................................................................................................
4.6.8 Family members who has been treated for mental illness .................................................................
4.7 Epilepsy.....................................................................................................................................................
4.7.1 Sign and symptom 0f epilepsy...........................................................................................................
4.7.2 Cause for epilepsy..............................................................................................................................
4.7.3Treatment for epilepsy ........................................................................................................................
4.8 Substance abuse ........................................................................................................................................
4.8.1 Benefit of substance...........................................................................................................................
4.8.2 Sign and symptom of substance abuse...............................................................................................
4.9 What did they do when they were seriously ill? .......................................................................................
4.10 Utilization of medication ........................................................................................................................
4.10.1 What kind of medicine do you prefer?.............................................................................................
4.10.2Taking medicine BID, TID, QID......................................................................................................
4.11 Knowledge about tropical disease...........................................................................................................
4.11.1Source of knowledge about NTD..................................................................................................
Chapter 5: Problem identification and prioritization ......................................................................................
5.1. List of identified problem ........................................................................................................................
5.2. Prioritization ............................................................................................................................................
5.3 Criteria for prioritization...........................................................................................................................

7. VI
5.4 Prioritized problems..................................................................................................................................
5.5 SWOT analysis .........................................................................................................................................
CHAPTER 6: ACTION PLAN.......................................................................................................................

8. VII
Abbreviations and Acronyms
SER......................................................... South Ethiopia Reign
CBTP...................................................... Community based training program
DTTP…………………………………….… Developmental team training program
SRP………………………………………... Student research project
TTP……………………………………….. Team Training Program
E.C.......................................................... Ethiopian calendar
PO............................................................ Per oral
ORS.......................................................... Oral rehydration salt
HH............................................................ Household
WHO........................................................ World health organization
HIV........................................................... Human immune deficiency
AIDS......................................................... Acquired immune deficiency
NGOs……………………………………….. Non-governmental organizations
G.C………………………………………….. Gregorian calendar
NTDs………………………………………….Neglected tropical disease
SWM------------------------------------------------- Solid Waste Management

9. VIII
List of table
Table 1; Level of education of the population Nechsar Keble, Mehal Ketema Kebele, Arba Minch town,
SER, Ethiopia, Nov 2-3/2023G.C..................................................................... Error! Bookmark not defined.
Table 2 Occupation of the population in Awura godana village, mehal ketema kebele, Arba Minch . Error!
Bookmark not defined.
Table 3: Housing condition of the study population in awura godana village, mehal ketema kebele, Arba
Minch, Ethiopia, 2015E.C............................................................................... Error! Bookmark not defined.
Table 4: Source of fuel and kitchen condition in Nechsar Kebele, arba mich town, Ethiopia, Nov. 2023 EC.
....................................................................................................................... Error! Bookmark not defined.
Table 5: latrine condition in awura godana village, mehala ketema kebele, Arba mich town, Ethiopia,
Nov/ 2023 G.C................................................................................................ Error! Bookmark not defined.
Table 6: Water supply and consumption in Gebriel village, Mehal ketema , Arba Minch Town, SER,
Ethiopia, Nov/ 2023 G.C................................................................................. Error! Bookmark not defined.
Table 7: Solid waste storage and disposed methods in Gebreal village, Mehal ketema, at Arba Minch
Town, SER, Ethiopia, Nov/2023 G.C............................................................... Error! Bookmark not defined.
Table 8: Number of households with domestic animals in Gebreal Village, Mehal ketema kebele, Arba
Minch Town, SER, Ethiopia, March, 2016E.C................................................. Error! Bookmark not defined.
Table 9: Insects in Gebreal village, Mehal ketema kebele, Arba Minch, SER, Ethiopia, Nov/ 2023 G.C.
....................................................................................................................... Error! Bookmark not defined.
Table 10: insect controlling method in Gebreal village, Mehal ketema kebele, Arba Minch, SER, Ethiopia,
Nov/2023G.C.................................................................................................. Error! Bookmark not defined.
Table 11:shows distribution of electricity service in Gebreal village, Mehal ketema kebele, Arba Minch,
SER, Ethiopia, Nov/2023 G.C.......................................................................... Error! Bookmark not defined.
Table 12: shows light adequacy in Gebreal village, Mehal ketema kebele, Arba Minch, SER, Ethiopia,
Nov/ 2023 G.C................................................................................................ Error! Bookmark not defined.
Table 13: Family planning coverage of Gebreal village, mehal ketema kebele, Arbaminch, Ethiopia, Nov
2023 G.C......................................................................................................... Error! Bookmark not defined.
Table 14 : TT vaccine Coverage in Gebreal village, mehal ketema kebele, arbaminch,Ethiopia ,Nov/ 2023
G.C.................................................................................................................. Error! Bookmark not defined.
Table 15:Period of Breast feeding and Start of complementary feeding in Gebreal village, mehal ketema
kebele ,Arba Minch Town, SER, Ethiopia, Nov/ 2023 G.C.............................. Error! Bookmark not defined.
Table 16;Immunization coverage of under 1 year children, Gebreal village, mehal ketema kebele, Arba
Minch Town, SER, Ethiopia, Nov/2023 G.C.................................................................................................23
Table 17; Treatment for diarrhoea in Gebreal village, mehal ketema kebele Arba minch Town SER
Ethiopia, Nov/2023 G.C...............................................................................................................................23
Table 18; show prioritization of bed net in family member in Gebreal village, mehal ketema kebele Arba
minch Town SER Ethiopia, Nov/ 2023 G.C..................................................... Error! Bookmark not defined.
Table 19; shows first choice household during ill inGebreal village, mehal ketema kebele Arba minch
Town SER Ethiopia, Nov/2023 G.C................................................................. Error! Bookmark not defined.
Table 20: Community view about HIV/AIDS transmission methods in Gebriel , village,mehal ketemakifle
ketema nechisar kebele,Arbaminch ,Ethiopia, Nov/ 2023 G.C...................................................................24

10. IX
Table 21: shows HIV/AIDS prevention methods in Gebriel village, mehal ketema kifle ketema , nechisar
kebele,Arbaminch Ethiopia, November 2023 G.C ......................................... Error! Bookmark not defined.
Table 22: Risk factors that cause HIV virus in Gebriel ,village,mehal ketema kifle ketema, nechisar
kebele Arbaminch, Ethiopia, november 2023 G.C. ....................................... Error! Bookmark not defined.
Table 23: Source of information about VCT for Gebriel village, mehal ketema kifle ketema, nechisar
kebele,Arba minch ,Ethiopia , November 2023 G.C. ..................................................................................25
Table 24: Reasons of lack of information about VCT in Gebriel village,mehal ketema kifle ketema,
nechisar kebele ,arbaminch Ethiopia , november 2023 G.C........................ Error! Bookmark not defined.
Table 25: shows information about VCT in Gebriel village village,mehal ketema kifle ketema nechisar
kebele ,arbaminch Ethiopia , november 2023 GC ........................................ Error! Bookmark not defined.
Table 29; Sign and symptom in Awura godana village,mehal ketema kebele ,arbaminch Ethiopia , Nov,
2016 E.C ......................................................................................................... Error! Bookmark not defined.
Table 30; Cause for epilepsy in Awura godana village,mehal ketema kebele ,arbaminch Ethiopia , Nov,
2016 E.C ......................................................................................................... Error! Bookmark not defined.
Table 31; Treatment for epilepsy in Awura godana village,mehal ketema kebele ,arbaminch Ethiopia ,
Nov, 2016 E.C................................................................................................. Error! Bookmark not defined.
Table 32; Substance abuse in Awura godana village, mehal ketema kebele , Arba minch Ethiopia , Nov,
2016 E.C ......................................................................................................................................................31
Table 33; show Benefit of substance in Gebreal village, mehal ketema kebele , Arba minch Ethiopia ,
Nov, 2016 E.C................................................................................................. Error! Bookmark not defined.
Table 34; Shows Sign and symptom of mental illness in Gebreal village, mehal ketema kebele , Arba
minch Ethiopia , Nov, 2016 E.C..................................................................... Error! Bookmark not defined.
Table 35; medication during serious illness in Gebreal village, mehal ketema kebele , Arba minch
Ethiopia , Nov, 2016 E.C.............................................................................................................................32
Table 36; shows medication preference in Gebreal village, mehal ketema kebele , Arba minch Ethiopia ,
Nov, 2016 E.C..............................................................................................................................................32
Table 37; shows the time taking of medication in Awura godana village, mehal ketema kebele , Arba
minch Ethiopia , Nov, 2016 E.C..................................................................... Error! Bookmark not defined.
Table 38; shows knowledge about tropical disease in Awura godana village, mehal ketema kebele ,
Arba minch Ethiopia , Nov/2016 E.C.....................................................................................................33
Table 39; shows source of knowledge about tropical disease in Gabriel village, mehal ketema kebele
, Arba minch Ethiopia , Nov/2016E.C....................................................... Error! Bookmark not defined.
Table 40; willingness, not willingness and intestinal parasite medication for childGebreal village, mehal
ketema kebele , Arba minch Ethiopia , Novenber, 2016 E.C. ....................................................................34
Table 41; worm infection transmission in Gebreal village, mehal ketema kebele , Arba minch Ethiopia ,
Nov 2023 G.C ................................................................................................. Error! Bookmark not defined.
Table 42; Shows trachoma transmission, willing or not willing and reason for willingness and not
willingness in Gebrel village, mehal ketema kebele , Arba minch Ethiopia , Novenber, 2016E.C.............35

11. X
SUMMARY
INTRODUCTION
CBTP is a means of achieving educational relevance to community needs and consequently of
implementing community oriented educational problem. Therefore, this study aims to ascertain
how far CBTP courses are integrated into the curriculum and used in accordance with
recommendations. This programmers major goal is to educate students about the community,
particularly how to integrate, solve problems and serve it.
It also hopes to inspire the community to share its problems with others. The goal this study is to
determine the society health state and any problems there may be. The study will be assessed the
use of toilet, SWM, housing conditions, water and electricity use in Gabriel village, Mehal
ketema, Nechsar Keble, Arbaminch town, Nov 2023 G.C
OBJECTIVES
- To assess health and health related problem in Gebriel village, Mehal ketema, Nechsa
kebele, Arba Minch town, Gamogofa zone, SER, ETHIOPIA Nov /2023 G.C
METHODS
- Community based cross sectional study will be conducted in Gebriel village, Mehal
ketema, Nechsar kebele, from Nov 2-3, 2023. Multi stage sampling method will be used
129 household will be selected.

12. 1
CHAPTER ONE-INTRODUCTION
1.1 Background of study
-Community is defined as a collection of people who interact with one another and whose
common interest or characteristics gives them a sense of unity and belonging. Also, it’s a group
of people in a defined geographical area with common goal and objectives.
- The term “community health” refers to the health status of a defined group of people, or
community and actions and conditions that protect and improve the health of the community.
The actions and conditions that protect and improve community or population health can be
organized into three areas: health promotion, health protection, and health services. This
breakdown emphasizes the collaborative efforts of various public and private sectors in relation
to community health. (Santa Cruz county community assessment project, 1999)(1)
Community problems: are issues that society perceives as being common problem faced by
their community and impeding its ability to function at a precise level. Everyone in society is
affected by social issues. Less access to safe drinking water, drug use, pollution,
mismanagement of resources, inadequate emergency services, air pollution, poverty,
starvation, substandard housing, employment discrimination etc. are some examples of
community concerns. (University of Kansas)(2)
- The influence of community problems is poor infrastructure, unemployment, lack of basic
services like hospitals and other health centers, unhygienic latrine systems, poor sanitation,
poor waste disposal, being vulnerable to different communicable diseases that are prevalent
in poor community and poor personal and environmental hygiene like malaria, typhoid etc.
(Richard G. Wilkinson, social determinants of health, 2005)( 3)
 Prevention methods: some can be listed as health promotion, giving education for the
community in a way they could understand, investing in health sectors with money,
creating awareness about personal and environmental health, proper waste management
and other different issues.
-CBTP(community-based training program) - is one of the components of CBE (the
components are CBTP, DTTP, SRP, TTP). CBTP is an integrated institutional program
which runs in phases from first year to graduation along with an in-built regular follow up
program. As part of CBE activity students are given orientation before they are assigned to
the community.(Ju.edu .et)4
-This is due to the fact that students must be aware of the community by which they are assigned
to as they may have different culture and norms with the society; they must respect and ask their
questions in a way they could understand. In addition, the main aim is to orient students about

13. 2
data collection, analyzing the data up to evaluation in detail. Advisors are assigned to each group
to help and manage each step the students go during their work. There must be team spirit among
the students and engage in every part of the program so that there will be properly done research.
-Jimma University was the first to launch this program. Throughout its history the university has
been committed to this scheme, and almost all the academic curriculums are based on CBE
program. Nowadays it is practiced by many Ethiopian universities.
 What will students do in the community after CBTP is done?
-After data is collected students will identify the prioritized problems in the community and try
to solve them.
-Create awareness in the community through different way like media, schools...
-Have open discussion with society about solutions for those problems
-Try to reach government offices that are assigned to give solution in the community like kebele.
-Develop programs to implement the action plan and bring about some changes
-If it is needed and possible, try to prepare funding programs that is aimed to support the
community in building infrastructures and latrine for those who don’t have proper one
-Teaching about family planning, HIV/AIDS prevention methods and about other communicable
and feco-oral diseases and how to prevent themselves from these diseases.
In general, CBTP program is launched to address community problems starting from assessment
by different methods to intervention depending on resources availability and government
support. As we are part of the community, all of us are influenced by the problems although the
severity and type may differ. So as to solve those problems we must be actively participate in the
society and drive others to have positive impact in the society, and this program let students to
contribute and participate actively as well as surmount their role in the community.( Ju.edu.et)
1.2 Statements of the problem
Community health problems are more serious issues that have an impact on health of a people
live in that community. These problems are mainly affected less developed countries or
developing countries such as Ethiopia. These problems arise from many social, environmental,
economic, and psychological factors. Among these factors access to clean water, waste
management, the use of latrine, maintaining self and environmental hygiene, awareness about the
transmission and impact of various diseases, lack of skilled manpower, and lack of health care
centers and facilities near to the community as needed are the main causes.

14. 3
-Africa is the main continent that has a poor health care facilities and equipment’s due to
poverty, low skilled manpower and has poor awareness about health. Ethiopia is one of the
developing countries in the world. According to UN Ethiopia ranks 18th
from the 46 least
developed countries and according to the WHO report and Ethiopia ranks in health system 180
out of 189 in the world. Ethiopia there is widespread poverty that leads the country to have
inadequate access to clean water and sanitation facilities, poor nutritional status, poor skilled or
educated man power, poor health care facilities and services and a high fertility rate, together
with low levels of access to health services contributing to the high burden of weakened or ill
health statuses in the country.
-Due to the above reasons different types of diseases and health problems are prevailed in
Ethiopia. Diseases like malaria, scabies, TB, HIV/AIDS, cholera, typhoid, trachoma, giardia,
amoeba, and other diarrheal are some of the diseases. Ethiopia also faces high prevalence of
maternal and infant mortality. From this malaria and diarrheal diseases are the main common
diseases in Arbaminch city and its surrounding. As Arbaminch is one of the cities that located
under the rift valley, the climate is tropical which is more suitable for different diseases like
malaria.
-The distributions of malaria in the world according to WHO in 2021 are estimated about 247
million cases of malaria are detected and 619000 deaths are recorded. In these amounts of cases
and deaths Africa shares around 95% of malaria cases and 96% of malaria deaths are recorded.
This shows how much Africa is affected by malaria and other community health problems. Child
under 5 accounts about 80% of all malaria deaths in Africa.
-About 75% of the land mass of Ethiopia is considered malicious and approximately 68% of the
population lives in malaria risk area. About 2.9 million cases of malaria and 4782 related deaths
have been reported annually and the rate of morbidity and mortality increases during epidemics.
-In addition to malaria according to UNICEF Ethiopia 60 up to 80% of communicable diseases
and an estimated 50% of the consequences of under nutrition or malnutrition are attributed to
limited access to safe water and inadequate sanitation and hygiene services which include poor
clean water distribution, poor utilization of latrine and poor waste management.
-These diseases are occurring due to lack of adequate awareness about keeping hygiene, poor
water supply and waste management facilities, and poor environmental health activities.
-Every year 381,000 children in Ethiopia die before their fifth birthday in which 120,000 are
newborn babies. 26, 000 women also die annually from complications in pregnancy. Child birth
is a very risky situation for mothers in the developing world; around 50 million women give birth
each year at home with no professional help. This is due to lack of near health care institutions,
adequate skilled powers, lack of awareness, and soon.

15. 4
-In general, a lack of adequate awareness about infection prevention in the community and lack
of clean water for the purpose of drink and household activity, lack of health care facilities near
to the community, lack of adequate skilled health care workers, poor community cooperation,
poor attention from government bodies and poor waste disposal management affects the
community’s health, day to day activities and aesthetics of the environment. It creates excess
burden on the community and hinders their quality of life. It affects all the community but
mainly these diseases and health problems affect children under five years old and elder part of
the community because they has immature or depleted immunity rather than adults and mothers
that are pregnant.
-Even if there are different activities that has done to overcome these problems, still these health-
related problems are the major causes of death and debility in the developing countries.
In order to overcome these and other health related problems, different intervention mechanisms
have been implemented. For example:
 Educating the population about keeping self and environmental hygiene and its effect on
their health.
 Training adequate health care professionals and controlling them.
 Assign health extension workers .
 Empowering women.
 Distributing and building health care facilities and equipment’s.
 Vaccinating the risky groups, usually children’s and teach the family to vaccinate there
Childs.
 Building common community latrine and waste disposal channels.
 Reinforcing peoples that keep their self and environmental hygiene.
 Helping economically poor peoples.
- CBTP is believed to contribute for the achievement of the intervention mechanisms. CBTP
(community-based training program) is an institute base activity in which a group of students are
assigned to rural/urban community to expose them in greater depth to deal social, cultural and
environmental problems.
-By accessing the community’s problem, we are aimed to alleviate these problems by teaching
the communities about the importance using latrine, disposing waste products properly, keeping
self and environmental hygiene’s, taking vaccines completely, visiting of health care center
during pregnancy to follow-up their health status.

16. 5
-We also give these data to other stakeholder for intervention and are used to suppress the stake
holders to give attention to the identified problems.
-And we also have a chance to understand the important element of community life, level of
awareness and problems that they faced and also the community’s level of knowledge about
health-related problems and how we prevent these problems.
-Generally, there are lots of problems that are related to the community and need interventions
and by using this CBTP study, we try to trap attentions of both governmental and non-
governmental bodies to the community to solve these community health’s and health related
problems and this study supports and gives directions to interventions.
1.3 Significance
-As most of health-related problems in Ethiopia are preventable, community-based training
program is an important tool to identify health status, health related problems, and factors that
could affect the society’s health. This study enables to find out and address major health and
health related problems in the community which affects the society. Furthermore, community
health assessments help the students to get knowledge on how to identify and intervene the
health and health related problems of the community and to do further research.
- This survey will specifically benefit Nechsar kebele community residents by identifying gaps
in health-related problems. In -addition, the study findings will assist in raising community
awareness of health issues an in encouraging residents to work with relevant organizations to and
provide some guidance for government and non-governmental organizations (NGOs) looking to
intervene.
-This community-based training program [CBTP] will benefit different groups. One of the
groups is the community of Nechsar kebele and even the Arba minch city. From this study they
have gain a significant importance. During our study we would give awareness about community
health, teach about different topics and initiate them to do it. Due to this they will have a good
awareness about common community health problem and how they prevent these problems and
what to do if the problems are happened.
-They also have the knowledge about the importance of keeping personal and community
hygiene. They also get attention from the perspective stakeholders to do together to prevent or
alleviate the identified problems. This study also has great benefit for health extensions and the
communities’ health office by identifying the major health and health related problems in the
community to find the appropriate solutions and to take the best measures to resolve and manage
the identified problems.
-This study also used as a source or a base data for different groups like universities, private
researchers, NGOs and others to do other research or to take intervention. Under this study we

17. 6
try to identify problems in the community and describe the alleviating method or solutions to
overcome these problems.
-We also benefited from doing this study by different dimensions like we will have a chance to
deeply know the community real health problems and which problems are more prevalent,
serious and need aggressive intervention to overcome it, we will develop our communication
skills and interaction with the community and develop ability to identify problems and, and we
will have some clue about how we work different types community based research’s. Generally
this study has a significant importance to all groups that has a direct or indirect responsibility for
the community.
CHAPTER TWO: Objectives
2.1 General objective
Assessment of health and health related problems in Mehal Ketema Kifle Ketema , Nech Sar
kebele, Arba Minch City, Gamo Zone, South region, Ethiopia 2023 G.C.
2.2 Specific objectives
 To identify health related problems to solid waste management.
 To identify health problems related to housing conditions.
 To assess health problems related to water sanitation.
 To assess health seeking behavior of the community.
 To assess the awareness of prevention and transmission of HIV/AIDS.
 To assess health service utilization.
CHAPTER THREE:
Methodology
3.1 Study area and study period
- Arba Minch city is the town of Gamo zone that is located at southern Ethiopia about 454 km far
away from Addis Ababa and around 275 km southwest of Hawassa the town of SNNPR. It is
surrounded by Arba Minch zuriyaworeda, and two large lakes which are Abaya and Chamo in
North east and south east respectively. Arba Minch consists of uptown administrative center of
Shecha and downtown commercial and residential area of Sikela. Arbaminch city have six
kebele such as Limat, Gurba, Nechsar, Sikela, Secha,Bereedegetber and also have 12 villages.

18. 7
In Arbaminch town there are different governmental and private institutions. Our CBTP study is
targeted at nechsarkebele. Our study period is from November 2-4, 2023
Nechsarkebele has three villages(Gebriel, shell, and awragodana ). around 37,189 people, or
6075 house hold live with in Nechsarkebele. Around 762 households live in Gebriel village,
around 1699 households live in shel and around 1694 households live in awuragodana village
and there are more than 4 religions within the kebele.
The total area coverage of nechsarkebele is 3778.9 square metre.
3.2 Study design
-A community based cross sectional study design was used.
3.3 population
3.3.1 Source (Target) population
-All the households found in Nechsar kebele.
3.3.2 study population
-All households live in Gebriel village.
3.3.3 Sampling population
-Selected individual households
3.3.4 Study unit
-Household
3.3.5 Sample size determination and sampling technique
The sample size for our study is determined by using single population proportion.
we will use p=q=50% ( no study conducted)
C=confidence level 95% and 5% margin of error
N= the desired sample size
Z =the standard normal value Z Value 95% confidence level ie=1.96
P=Population proportion q=
d= 0.05 margin error i.e5%=0.05
Substitute the value in the formula

19. 8
n= (1.96 x 1.96 x 0.5 x 0.5) / 0.05 x 0.05
=384, but due to time and resource limitation our sample was fixed to 129 household.
3.3.6 Sampling Technique
We were selected Sample village from Nechsar kebele by using systematic sampling method and
we were also select a total of 129 households. Using N=762 and n=129.
 K=N/n
= 762/129
=6, where K= sampling interval
N= number of total house hold
n= sample size
- In the beginning the first house was selected at random by lottery method. Then starting from
the reference house, we counted K house called the second data. Then we selected 129 house
hold in an interval of 6 from 762 households. Because of resource and time constraint we
communicate with our advisors and ordered to connect per each student 10 households.
3.4 Selection criteria
3.4.1 The inclusion criteria
 Households who have lived at least 6 month in Nechsar village.
 Individuals who are more than 18
3.4.2The exclusion criteria
 Households, who critically ill, cannot talk during data collection..
3.5 Study variable
3.5.1 Independent variable
-sex

20. 9
-age
-Marital status
-Occupational status
-Religion
-Income
-Educational status
-Socioeconomic status of the population.
-Socio cultural factors.
3.5.2 Dependent variable
- Hygiene and sanitation problem
-Maternal child health problems.
-Major communicable disease and morbidity and mortality problems.
- Awareness of major tropical disease.
-Awareness and attitude about HIV transmission VCT.
-Awareness and attitude of psychiatric problem and epilepsy
-Awareness and attitude of drug usage.
3.6 Data quality control measures
We have taken orientation that mean what, when, where and how to collect our data by
instructors before starting our study. We were using Kobo Collect app for data collection, we
were mark the houses that we count and also daily checking for completeness, accuracy, clarity
and consistency by group members.To get accurate information, we were giving awareness to
community. And also to reduce language barrier, we were trying to find translators. Pretesting
the tool was done before using them in survey.
3.7 Data collection procedure
- During the period of collection, we were using face-to-face interview by using structured
questionnaires and checklist on Kobo Collect. The questionnaires and check list including, sex,
educational status, marital status, solid disposal management, housing condition, electrical usage.

21. 10
Those questioners and check list are adapted from different guide lines and customized
according to the study area setup. All procedures are tested and edited by supervisors before the
actual data collection. We were directly observing thing like latrine, number of windows, doors,
sanitation, ventilation and others.
In addition, we were gather information from Nechsar kebele administration bureau.
3.8 Operational definitions
 Villages: a sub class of kebele, a small community settling in it.
 Woreda:Is an administrative division managed by local government.
 Kebele: the smallest administrative unit of Ethiopia contained within a woreda
 Widowed: a woman whose husband has died
 Sufficient access of air and light: a home is said to have sufficient light if a person standing
at mid-point in the house with doors and windows opened can read 12 words effectively
written by pencil.
 Household: is the geographic place where the enumerated person usually resides, that is the
place at which he or she spends most of his/her daily night rest.(According to OECD
GUIDELINES FOR MICRO STATISTICS ON HOUSEHOLD WEALTH© OECD 2013)(6)
 Unmarried: a person who has never been married or whose marriage has been annulled. It
does not include a person who has been divorced or widowed.
 Unemployed: A person not to have worked at all in the reference week , to be available to
take up work within the next two weeks and to have been either activity seeking work in the
past four weeks or have already found a job that starts in the next three months. (According
to ILO ‘s definition) ‘
 Solid Waste: is a material which is not in liquid form and has no
o value to the person who is responsible for it. (According to Zurbrugg 2003)
 Latrine utilization: is the actual behavior in a practice of regularly using existing latrine for
safe disposal of excreta. (According to WHO’s definition ).
 Ongoing: Infants who are on breast feed.
 VCT: a process by which an individual undergoes counseling to enable him makes informed choice
about being tested voluntarily for HIV

22. 11
 Waste management- the strategy an organization uses to dispose, reuse, and prevent waste. Possible
waste disposal methods are recycling, composting, incineration, landfills,bioremediation, waste to
energy and waste minimization.
 Flush toilet-is a toilet that disposes of human waste by using the force of water to flush it through a
drainpipe to another location for treatment
 Water supply-is the provision of water by public utilities, commercial organizations, community
endeavour or by individuals, usually via a system of pumps and pipes.
3.10 Data processing and analyzing technique
-The questionnaire used for data collection is in software program (mobile application called
“KOBO”) and the data is initially prepared in Amharic language and translated in to English
language at the time of data analysis and writing the result. The data was analyzed using excel
and the percentage was calculated by calculator. The result was summarized by using graph, pie
chart and tables.
3.11 Ethical Consideration
First, the permission letter from Nursing department, College of Medicine and Health Sciences
of Arbaminch University was sent to Nechsarkebele administration office of Arbaminchtown.
Full consent from the participant prior to the study was taken . This means to participate in a
research study, participants need to be adequately informed about the research, comprehend
the information and have a power of freedom of choice to allow them to decide whether to
participate or decline. Participant’s agreement to participation in this study is obtained only
aftera thorough explanation of the research process.
The anonymity and confidentiality of the participants is preserved by not revealing their names
and identity in order to protect privacy of research participants.
The principle of justice is granted to avoid exploitation and abuse of participants. For example,
in our CBTP study we use systematic and take interval for selecting our participants.
The right of respondent and non-respondent should be respect, any deception or exaggeration
about the aims and objective of the research must be avoided
In any communication in relation to the research should be done with honesty and transparency
Give awareness and clearly talked about the benefit and harm of participating in the study.
3.12 Dissemination and utilization of the result

23. 12
- The result of this study will be disseminated to Arba minch university college of medicine and
health science, department of comprehensive nursing and to Nechsar kebele for intervention and
corrective measure and it used as a source of information for researchers.
3.13 problem faced and solution during CBTP
Response-rate: - First is the inability of the student’s team to contact the participant, perhaps
due to disorganized arrangement of households in slums, less community interaction of people in
general and busy schedule. In such situations, engagement of community leaders in the CBTP
activity shall be useful.
Fear of strangers: - People may refuse to participate when students are strangers to the
community. There is a lack of trust, especially for female participants and elderly persons if they
are likely to refuse if they are alone at home, because of perceived security issues. If there would
be presence of local volunteers from local area can be useful. The team members should
prominently display identifies cards from their institutions.
Lack of perceived benefits for the participants: - What people expect to hear is how the
students would be conducted and how the study will benefit them. If they are convinced that the
study will be beneficial for them, they would be more likely to cooperate in the study.
Participants need to be informed that appropriate management shall be provided for any clinical
condition diagnosed.
Poor timing: - Most often during the daytime, people are busy and cannot spare time to respond
to students’ questions. It is important to know the time when people are free, and this may
require special visits on holidays or evenings.
Previous bad experience: - Frequently researched communities may have participants who were
part of previous health students. They are likely to refuse if they experienced bad behavior of
students-related adverse health effects in the past. This is a difficult issue to address. The
reputation of the institution of the current student team may be used to persuade participants to
agree. If the previous unpleasant experience was in the recent past.
Privacy Concerns: - Asking for a lot of personal data could make residents fear that they could
be a victim of discrimination or experience a threat to their livelihood, so it’s important to be
transparent about why you want information and explain how it will be used, and how
confidential we could be.

24. 13
CAPTER FOUR: RESULT
4. RESULTS
-From 130 households 129 are response and 1 is nonresponse.
4.1 Socio demographic data
This study revealed that 517 people live in 129 households in which 240 (46.44%) was males and 277
(53.56%) females. The thier educational status indicate that most of them are collage and above
231(44.7%) and also most of them are Government employeee135(26.1%)
Variable Category Frequency Percentage
Age
0-15 28 5.41%
16-30 119 23.01%
31-45 90 17.40%
46-60 129 25.0%
61-75 92 17.8%
>75 59 11.4%
Occupational status Government
employee
135 26.1%
Unemployed 63 12.2%
Private worker 111 21.5%
Retirement 10 1.9%
Student 193 37.3%
Other 5 1%
Educational status Primary school 134 25.9%
Secondary school 117 22.6%

25. 14
Literate 13 2.5%
Read and write 22 4.3%
College and above
231
44.7%
Table 1: socio demographic data in Gebriel village Nechsar kebele, , Arba Minch Town,
SER, Ethiopia Nov 2023G.C
NOTE:
 other in occupational status include: farmers.
4.1.1: Distribution of religion status
From participants of this study in Nechsar Kebele Orthodox, 251(48.5), followed by 234 (45.3),
which is Protestants, and Muslim 32 (6.2%
Fig1. Religion by percent of total respondents in Nech sar kebele, Gebriel village, Arba Minch
town, SER, Ethiopia Nov 2023 G.C
4.1.2: Marital status
Among the respondents, 263(50.9%) are married, underage for marriage accounts 60(11.6%),
181 (35%) were unmarried, about 9 (1.7%) are widowed and the rest 4(0.8%) were divorced.
251
234
32
0
50
100
150
200
250
300
Orthodox Protestant Muslim
frequency
Religion status

26. 15
Figure 2. Marital status of the population in Gebriel village, Nechsar kebele, Arba Minch
town, SER, Ethiopia, Nov 2023 G.C
4.1.3. Economic status
Among 129 households, 17(13.2%) household's monthly income is categorized below 3000
ETB, and 49(37.2%) households monthly income included in categories greater than 6000ETB,
Whereas 64(49.6%) of household monthly income is between 3000 and 6000ETB.
Figure 3.Average family monthly income of residents in in Nechsar kebele, Gebriel village
Arba Minch town, SER, Ethiopia, Nov /2023 G.C
263
181
60
9
4
Marital status
Married
Unmarride
Underage merride
Widowed
Divoeced
17
64
48 <3000
3000-600
>6000

27. 16
4.2 Environmental health status
-Among 129 households Majority of houses use Cross ventilation 62(48.06%) and have private
latrine which is traditional cemented pit and most of them dispose it by suctioning.
-The majority of households source of water is protected spring 109 (84.5%)
-Although these households use different insect control method like pesticides, bed nets and
removing stagnant water.
-Among 129 households, 128(98.46%) have latrine, 1(1.43%). Among those who have latrine 24
(40%) are traditional Pit Latrine Floor 14 (10.8%), Ventilated improved latrine, 5(3.84),
18(13.8%) are Flush /pour septic latrine, Bucket Latrine 2(1.5%), Composting Latrine 1(0.8) and
72(56.1%) traditional cemented latrine.
From those 86(66.2%) households use privately and 44 (33.7. %) households share latrine in
common. From households having latrine, 82 (63.7%) have hand washing material attached to
the toilet, but 47(36.2%)) have no hand washing material attached to the toilet.
Among 129 houses holds 20 (13.4%) uses piped water and remain 110 (84.6%) use protected
spring water. From these, 115(88.5%) use piped water from their compound and the other
3(2.3%) houses use outside their compound and Private but outside the compound 11(8.5). The
time taken in the premise take < =5 minutes 103(79.2%), >2 minutes 27(20.8%) and .of total
households 56(93.33%) store their drinking water in a jerry can and, 4(6.67%) store in plastic
storage. The average daily water consumption of the populations <=5 liters is 29(22.3%), >2
litter is 101(77.7%).
From 129 households 101(77.69%) is not used any treatment and 29(22.3%) treat by using agar
and filtration.
-Among 129 households, 97(74.6%) have Temporal solid waste storage area and 32(24.6%)
household don't have solid waste storage area.

28. 17
Out of those 129 households that have solid waste storage area, 74(57.36%) have covered and 55
(42.63%) have open solid waste storage. Of 129 households, 119 (92.24%) disposed in bore
hole, 2 (1.5%) in the incineration and 8(6.2%) dispose waste by municipality.
From 129 house hold 73(56.5%) collect solid waste by engaged in private, 47(36.4%) by
municipality and 9(6.97%) by other ways
S.N Variable Category Frequency Percentage
1 housing
condition
Number of
class/room
<=2 23 18.4%
>2 106 81.5%
Number of window <=6 118 90.8%
>6 11 9.1%
Latrine
condition
Latrine Yes 128 98.46%
No 1 1.43%
Types of latrine Traditional pit latrine 14 10.8%
Traditional Cement
pit Latrine
72 56.1%
Ventilated improved
Latrine
5 3.84%
Flush /pour septic
latrine
18 13.8%
Traditional cemented
pit latrine
17 13.1%
Composite latrine 1 0.8%
Bucket latrine 2 1.5%
latrine usage Private 86 66.2%
Common 43 33.7%
latrine disposal By suction 93 72.2%
Released to river 3 2.3%
Not disposed 30 23.8%
Other 2 1.6%
Hand washing
material in the toilet
Yes 46 36.1%
No 83 63.8%
Water supply
and
consumption
Source of water for
drinking and cooking
Protected spring 109 84.5%
Piped water 20 13.4%

29. 18
Table2. Environmental health status in Gebriel village Nech sar Kebele,Arba Minch town,
SER, Ethiopia , Nov 2023 G.C
2. Kitchen condition
From 129 households 127(98.44%) of them have kitchen and 2(1.57%) have no kitchen. Among
those kitchen 27 (20.8%) of them are attached to the living house and 102 (79.2%) of them are
separated from the living house. And also 108(83.1%) of them have windows for ventilation
while 21(16.8%) of them do not have any window. And again 117 (90 %) of households have
ventilation pipe for kitchen while 12(10%) of households do not have ventilation pipe for
kitchen. And source of fuel of houses from 129 house 52 (40%) use wood, 70(54.5%) use
electric (3.8%) used charcoal and 2(1.6%) use kerosene.
Place where source of
water
Inside compound 115 88.5%
Outside compound 4 3.07%
Private but outside
the compound
10 8.4%
Storage of drinking
water
Jerycan 120 93.03%
Plastic storage 9 6.97%
Water treatment Yes 2 1.5%
Agar 3 2.32%
Filtration 2 1.5%
No 122 94.53%
How long it take to
get water
< =5 minute 103 79.2%
>2 minute 26 20.8%
Average daily water
consumption
<=5 L 29 22.3%
>2 L 100 77.7%
Solid waste Is there temporal
solid waste storage
Yes 97 74.6%
No 32 24.6%
Does the solid waste
storage have lied
/cover
Yes 74 57.36%
No 55 42.63%
Where solid waste
disposed
Field 8 6.2%

30. 19
Figure 4. Source of fuel in Gebriel Village, Nech sar kebele, Arba Minch town,
SER, Ethiopia, Nov 2023 G.C.
4.2.1 Domestic animals
Among 129 households 44(34.1%) have domestic animal. From those 27(20.9%) households
have dog. From those dogs 20(74.07%) are vaccinated and from these 22(81.48) Have separate
shelter.
4.2.2 Insects distribution
Out of 129 households, 72(55.8%) had insects in their house and the households uses different insect
control method like pesticides, bed nets and removing stagnant water.
4.2.9 Light adequacy
Among 129 houses 119(92.2%) of the households get sunlight, but 10(7.8%) do not have. From
this 55 houses 38(29.5%) households get morning sunlight, 30(23.3%) get afternoon sunlight and
51(39.5%) get both morning and afternoon sunlight.
3.9
55.0
0.8
40.3
0.0
10.0
20.0
30.0
40.0
50.0
60.0
Charcoal Electricity Kerosene Wood
Percent
Source of fuel

31. 20
4.3 Maternal and Child health
4.3.1 Maternal Health
All married women, 77 (80.20%) were married at above 18 years. And all had birth at age 19
and above.
From 129 households 25 children have birth certificate Among 25 births, males account
13(52.4%) and female account 12(47.6%) and there is one death female.
-From total of 25 which were under 5 age children, the majority for period of breast feeding is17
(68.0%) fed for less than 2 years.
-Within the 12 months, 1 women undergone abortion in the area of health center.
Among 129 households, there were 7(7.4%) pregnant women. All of them visit for ANC,
7(7.4%).
There were 7 (7.44%) women who delivered in the last 12 months. All of them 7(100%) were
delivered at health institutions, 6(85.71%) in hospital and 1(14.3%) in health center.
Row
number
Variable Categories Frequency Percentage
Birth Female 12 47.6%
Male 13 52.4%
Period of breast
feeding
<2 yr. 17 68%
=2 yr. 7 27%
>2 yr. 1 4%
Start < 6 m 5 20%

32. 21
complementary
feeding
=6 m 17 68%
>6 m 3 12%
Table 3 Immunization coverage of under 1 year children in Gebriel village, Nech sar
kebele, Gebriel village, Arba Minch town,SER, Ethiopia, Nov 2023 G.C
4.3.2 Family planning status
-Among all reproductive age group females 94(65.73%) from our total women population,
48(37.2%) women used family planning and 59 (45.7%) didn’t use family planning, and 22
(17.1%) had discontinued using family planning. Most of family planning users uses injectable
depo and use other methods.
-From 59 women who didn’t use family planning methods, 1(1.61%) didn’t use because of a
desire to have many children; 2(3.34%) didn’t use because of religion; 1 (1.69%) due to their
husband interference and 33 (55.93%) were due to other reasons. From those who had 22
discontinued, 18 (30%) discontinue in due to adverse effect; 4(6.77%) due to husband
interference.
4.3.3 TT vaccination service
Among 94 child bearing age women, there are 9(9.57%) women who are fully vaccinated.

33. 22
Figure 5.TT vaccine Coverage in Gebreal village, Mehal Ketema kebele,
Arbaminch,Ethiopia ,Nov/2023 G.C
4.3.4 Immunization
Among 30 under one year children, 9(30%) had immunization cards but 21 (70%) had no
immunization card but took required vaccines.
31.4
14.3 14.3
5.7
34.3
0
5
10
15
20
25
30
35
40
TT1 TT2 TT3 TT4 TT5
PERCENT
AGED BETWEEN 15-49 VACCINATED
Category Frequency
Not Received Once Twice Three times Received
PVC 6 8 9 5 -
BCG 7 - - - 21
HEPA 6 6 7 9 -
POLIO 6 8 9 5 -
IPV 3 - - - 25

34. 23
Table 4 ; Immunization coverage of under 1 year children, Nechsar kebele, Gebriel village
Arba Minch town, SER, Ethiopia, Nov /2023 G.C
4.4 MORTALITY AND MORBIDITY CONDITIONS
4.4.1MORBIDITY CONDITIONS
4.4.1.1DIARRHOEA CASE IN LAST 2 WEEKS
Among 129 house hold and 517 family members, 7(1.498%) family members had history of
diarrhoea on the last two weeks. From those no were fewer than five age children.
Variable Category frequency
(Total =129)
Percentage
(%)
Treatment for someone with
diarrhoea Taken ORS 72 55.83%
Taken other fluid 47 36.4%
Other (lemon
with sugar)
10 7.8%
Where they go during illness Hospital 92 71.3%
Church 5 3.9%
Clinic 32 24.8%
Table 5; Treatment for diarrhoea in Gebriel village, nech sar kebele Arba Minch town,
SER, Ethiopia, Nov /2023 G.C
4.4.1.2 Prevalence of malaria
Within the past one month, among 129 house hold, 15 (11.6%) house hold has history of malaria
diseases, and 114(88.4%) house hold had no history of malaria.
4.4.1.3 Stagnant water
Among 129 house hold, 6 (4.7%) house hold, there is present of stagnant water in their
surrounding and 123 (95.3%).house hold, there is no stagnant water in their surroundings.
4.4.1.4 Bed net
Among 129 house hold, the majority house holds 93(72.1%) had not enough bed net.

35. 24
4.4 .2 Disability
Among 129 households, the majority 128(99.2%) family members have no any disability
problems.
From the whole sample there is only one family with disability. The type of disability that faced
to the person is leg fracture. The societies stigmatize and discriminate the person because of his
disability.
4.5 HIV/AIDS
Among 129 household respondents who live in Gebriel village, 126(97.67%) know about
HIV/AIDS transmission and 3(2.3%) of them doesn’t know.
From those transmission ways the highest number of household say unprotected sex which is
115(91.3%) and the lowest is shaking hand 1(0.8%) said.
Table 6: Community view about HIV/AIDS transmission, prevention methods and exposing
factor in Gebriel village, nech sar kebele Arba Minch town, SER, Ethiopia, Nov /2023 G.C
S.N Characteristics Category Frequency Percentage
1 Did you know
transmission way of HIV
YES 126 97.7 %
NO 3 2.3 %
2 Which transmission
methods of HIV
During delivery 101 78.3%
Breast feeding 81 62.8%
Shaking hand 1 7.8%
Unsafe sexual
intercourse
115 91.3%
Sharp things
contaminated
with blood
113 87.6%
During
pregnancy
58 45.0%
Eating together 3 2.3%
Others 4 3.1%
3 Did you know about the
prevention method of HIV?
Yes 125 96.9%
No 4 3.1%

36. 25
4
prevention methods of HIV
Use condom 105 81.4 %
Having safe
sexual
intercourse only
109 84.5 %
Not using sharp
materials
together
103 79.8 %
5 Exposing factors for
HIV/AID
More than one
sexual partner
107 82.9 %
sexual workers 102 79.1 %
Using sharp
material
together
110 85.3 %
Marriage before
HIV test
87 67.4 %
Others 1 8 %
-Among 129 household respondents 113 (87.6 % ) know about VCT (voluntary counseling and
testing) and 16 ( 12.4 % ) didn’t know about VCT. Those households who know VCT got
information from different sources; the majority 87 (67.4 %) from Mass media like radio/ TV,
while least 14 (10.6 %) from other clubs.
Table 7:Source of information about VCT Gebriel village, nech sare kebele Arba Minch town,
SER, Ethiopia, Nov /2023 G.C
S..No Characteristics Category Frequency Relative
frequency
Have knowledge about
VCT
Yes 113 87.6 %
No 16 12.4 %
If yes, what is your
Source of information
about VCT
Mass media 87 67.4 %
Health facility 83 64.3 %
Health extension
worker
82 63.6 %
Partners and neighbors 46 35.7 %
Other clubs 14 10.6 %
Reasons of no source
of information about
VCT
Unable to use mass
media
10 7.8 %
Lack of health facility 4 3.1 %
Unable to health 8 6.2 %

37. 26
extension workers
provide information
properly
No willing to be tested 4 3.1 %
Have ever been
examined HIV
Yes 111 86.0%
No 18 14.0%
If not tested why? There is no health
facility nearby
18 14%
Afraid to take test 1` 0.8%
I am not vulnerable 9 7%
I think it may need cost 3 2.3%
I don’t know the
benefits
1 0.8%
I don’t have any reason 5 3.9%
NOTE:
 Other in source of information
Among 16 who didn’t know about VCT, 8( 6.2 % ) are due to unable to address enough
information from health extension workers , 4(3.1 % ) are due to no willing to be tested (3.1 % )
due to absence of health facility while the remain 10 ( 7.8 % ) are due to unable to use mass
media.
From 120 respondents, 111(86.0%) respondent had been tested and 18 (14.0%) had not been
tested for HIV AIDS. 9(7.0%) of the respondents who had not been tested since they do not
vulnerable to the virus, 1(0.8%) are due to fear, 1(0.8%) due to do not know the benefits and
5(3.9%) due to no reason..
4.6 MENTAL ILLNESS
Among 129 house hold, 109(84.5%) house hold heard about mental illness and 20(15.5%)
household not heard about mental illness

38. 27
4.6.1 CAUSES FOR MENTAL ILLNESS
Among 129 household, 100(77.519%) household had knowledge causes of mental illness.
Among 109 household who heard about mental illness, 36(35.65%) house hold Thought that
mental illness passed through heredity and 73(64.35%) house hold did not think that mental
illness passed through heredity.
Among 109 house hold who heard about mental illness, 96(82.15%) household Thought mental
illness is cured and 13(17.85%) household didn’t think mental illness is cured
Among 109 household whom heard about mental illness, 96 (88.07%) household have
knowledge about treatment of mental illness and the rest one didn’t have knowledge about the
treatment
Among 109 household who heard about mental illness, 16(20.15%) household thought mental
illness is contagious and 93(79.85%) household didn't think mental illness is contagious.
Among 109 household whom heard about mental illness, 24(26.35%) household, had family
members who have mental illness and 85(73.65%) household, had not family members who have
mental illness.
Symptoms of family members who have mental illness show in family and their surroundings.
Among 109 household whom heard about mental illness, 24(26.35%) households, their family
members have mental illness and show different symptoms.
Among 109 household whom heard about mental illness, 12(17.5%) household has been treated
for mental illness in both two households by modern medicine.
Table :8 cause for mental illness in Gebriel village, Nechsar kebele , Arbaminch SER
Ethiopia , NOV 2016 EC
Variable Causes of mental illness Frequency
(Total =100)
Percentage
(%)
Causes of mental illness Satan's plague 6 6%
Excessive substance use 10 10%
Head injury 14 14%
Excessive substance and
Head injury
26 26%

39. 28
Satan's plague and God
punishment
7 7%
Excessive substance and
God punishment
4 4%
Satan's plague and Head
injury
8 8%
Inherited and Head injury 5 5%
Excessive substance, God
punishment and Head injury
19 19%
Satan's plague, God
punishment and Excessive
substance
3 3%
Types of treatment for
mental illness
Modern medicine 34 26.4%
Imprison the patient at
home and modern medicine
8 6.2%
Traditional way(Tsebel or
Dua)
46 35.7%
Traditional way(Tesebel or
dua ) and imprison the
patient at home ,modern
medicine
2 0.16%
Imprison the patient at
home and modern medicine
6 4.8%
Symptoms of mental illness Unconsciousness 2 8.33%
Suicidal thought 3 12.5%
Loneliness 2 8.33%
Fighting other 8 33.33%
Change in mood 9 37.5%
Types of treatment for
mental illness
Modern medicine 34 26.4%
Imprison the patient at
home and modern medicine
8 6.2%
Traditional way(Tesebel or
dua)
46 35.7%
Traditional way(Tesebel or
dua ) and imprison the
patient at home ,modern
medicine
2 0.16%
Imprison the patient at
home and modern medicine
6 4.8%

40. 29
4.7 Epilepsy
Among 129 households 77(59.7%) have knowledge and 52 (40.3%) have no knowledge about
epilepsy.
Among those households 23(17.8%) seizure, 20(15.5%) fainting, 18(14.0%) fatigue and 16(12.4)
abnormal behavior
Among 129 respondents 101(78.3%) by head injury, 55(42.6%) by Spirit of Satan, 35(27.1%)
by wrath of god, 6(4.7%) another reason.
From 129 respondent 11(31.43%) Modern, 3(8.57%) traditional, 1(2.86%) modern and
traditional, 5(14.29%) Smelling of match smoke, 6(17.14%) modern and smelling of match
smoke, 5(14.29%) traditional and smelling of match smoke and 4(11.43%) I don’t know.
Table 9; Sign and symptom, cause and treatment of epilepsy in Gebriel village, Nechsar
kebele , Arbaminch SER Ethiopia , NOV 2016 EC
No Variable Category frequency percentage
1 Sign and symptom Seizure 23 17.8%
Fainting 20 15.5%
Fatigue 18 14.0%
Abnormal behavior 16 12.4%
2 Cause Spirit of Satan 55 42.6%
The wrath of God 35 27.1%
Head injury 101 78.3%
Another reason 6 4.7%
3 Treatment Modern 92 71.3%

41. 30
Traditional 56 43.4%
Smelling of match 47 36.4%
other 2 1.6%
NOTE: other in treatment of epilepsy include pray to GOD ,Dua
4.8 Substance abuse
Out of 129 households 14(10.9%) of them use and 115(89.1%) of them do not use abusive drug.
From the three abused persons 3 (21.42%) use Chat and cigarette, 4(28.57%) use Chat and
alcohol.
Out of 129 respondent 95(73.6%) to stimulate, 35(27.1%) treatment, 74(57.4%) recreational
purpose), 1(0.8%) for Stimulate, treatment &recreation and 16(12.4%) recreational &stimulate.
From 129 households 109(84.5%) knows about substance abuse is cause for mental illness and
20(15.5%) do not know substance abuse cause mental illness.
Out of 109 respondents 1(0.91%) behavioral change, 2(1.82%) Loss of consciousness)
,28(25.68% ) depression , and 17(12.11%) Feinting, Mood disorder 11(10.09) ,Dizziness and
Numbness 7(6.42%).
Drug abuse problem among from 129 household 119(92.2%) to know about the drug abuse
problem and 10(7.8%) don’t know. From those the problem it cause 9(7.56%) mental illness,
4(3.36)%Socioeconomic problem), 8(6.72%) mental illness &socioeconomic,4(3.36%) mental
illness &behavioral change ,4(3.36%) socio-economic&behavioral change , 37(31.09%)Mental
illness, socioeconomic & behavioral change and 43(36.13%) mental illness, socioeconomic,
behavioral and physical disorder.

42. 31
Table 10; Substance abuse in Gebriel village, Nechsar kebele , Arbaminch SER Ethiopia ,
NOV 2016 EC
No Variable Category Frequency Percentage
1 Substance abuse Chat and cigarette 3 21.42%
Chat and alcohol 4 28.57%
Hashish(shisha) 4 28.57%
Ganja 3 21.43%
2 Benefit To stimulate 95 73.6%
Treatment 35 27.1%
Recreational purpose 74 57.4%
Stimulate, treatment &
recreational
1 0.8%
Recreational &stimulate 16 12.4%
3 Does it cause mental
illness
Yes 109 84.5%
No 20 15.5%
4 Sign and symptoms Behavioural change 2 1.82%
Loss of consciousness 1 0.91%
Depression 28 25.68%
Feinting 17 12.11%
Dizziness and
Numbness
7 6.42%
5 Does drug abuse cause
mental illness
Yes 119 92.2%
No 10 7.8%
6 The problem it cause Mental illness 9 7.56%
Socio-economic
problem
4 3.36%
Mental illness &socio-
economic
8 6.72%
Mental illness
&behaviour change
4 3.36%
Socio-
economic&behavioural
change
4 3.36%
Mental illness, socio-
economic&behavioural
change
37 31.09%
Mental illness, socio-
economic,
behavioural,physical
disorder
43 36.13%

43. 32
4.9 What did they do when they were seriously ill?
Among 129 household 90(69.8%) use modern medicine, 21(16.3%) uses ttraditional medicine
and 18(14%) uses both medicine.
Table 11; medication during serious illness in Gebriel village, Nechsar kebele , Arbaminch
SER Ethiopia , NOV 2016 EC
Medicine Frequency Percentage
Modern 90 69.8%
Traditional 21 16.3%
Both 18 14%
Total 129 100%
4.10 Utilization of medication
-Out of 129 respondents majority prefer PO medication 54(41.86%) and majority of household
take their medication when they remember 35(58.33%), although from those respondents
majority say taking medication Twice a day means taking every 12 hour 114(88.4%), Three
times a day means Taking every 8 hour 115(89.1), and Four times a day means Taking every 6
hour 117(90.7%).
Table 12; shows medication preference in Gebriel village, Nechsar kebele , Arbaminch SER
Ethiopia , NOV 2016 EC
Variable Category Frequency Percentage
Medication preference PO 33 55%
Injection 21 35%
When forgetting time of
medication
Return back to profession to ask 14 23.33%
Any time they remember 35 58.33%
Taking
medication
Twice a day Taking every 12 hour 114 88.4%
Taking every 8 hour 7 5.4%
Taking with food 8 6.2%
Three times a
day
Taking every 8 hour 115 89.1%
Taking with food 9 7%
Taking every 12 hour 5 3.9%
Four times a Taking every 6 hour 117 90.7%

44. 33
day Taking every 8 hour 6 4.7%
Taking with meal 6 4.6%
4.11 Knowledge about tropical disease
Out of 129 households 113(87.6%) have information and 16(12.4%) have no information about
tropical disease. From those 58(45%) Intestinal parasite, 48(37.2%) Trachoma, 16(12.4%)
bilharzia, 12(9.3%) infectious elephantiasis, 8(6.2%) noninfectious elephantiasis, 12(9.3%)
Focket, 8(6.2%) onchocerciasis, 14(10.9) leishmania, 25(19.4%) scabies,
Table 13; shows knowledge about tropical disease in Nechsar village, mehalketema kebele ,
Arbaminch Ethiopia , Nov/2016 E.C
Variable category Frequency Percentage
Tropical disease Intestinal parasite 58 45.0%
Scabies 25 19.4%
Onchocerciasis 8 6.2%
Trachoma 48 37.2%
Infectious elephantiasis 12 9.3%
Non-infectious elephantiasis 8 6.2%
Bilharzia 16 12.4%
Leishemaniasis 14 10.9%
Focket 12 9.3%
Source of information Health facility 79 61.2%
Health extension 79 61.2%
Radio/TV 67 51.9%
I don't know 19 14.7%
Are you willing to take your
child medication campaign for
intestinal parasites
Yes 109 84.5%
No 20 15.5%
Reason of willingness for
intestinal parasite
19 14.7%
For disease prevention 38 29.5%
For treatment 49 38%
To protect from infectious
disease
23 17.8%
Has your child even take
intestinal parasitic medication
Yes 88 68.2%
No 21 16.3%
I don’t know 20 15.5%
Among 129 households 109(84.5%) are willing to take medication campaign for intestinal
parasites for theirs child but 20(15.5%) are not willing to take medication campaign for intestinal

45. 34
parasites for theirs child. The reason for theirs willingness are 38(29.5%) to prevent, 40(36.7)
eradicate parasite
Eradicate parasites, 23(17, 8%) to maintain healthy, 8(16%) for treatment. Out of 130
respondents 88(68.2%) have been taken medication their child’s, 21(16.3%) have not been taken
medication their child’s for intestinal parasites and 20(15.5%) have not been remembered
whether their child taken or not intestinal parasitic medication.
Table 14; willingness, not willingness and intestinal parasite medication for child Gebreal
village, mehalketemakebele ,Arbaminch Ethiopia , November, 2016 E.C.
Variable Category Frequency Percentage
(%)
Are you willing to take your child
medication campaign for intestinal
parasites
Yes 20 15.5%
No 109 84.5%
Reason of willingness for intestinal
parasite
19 14.7%
For disease
prevention
38 29.5%
For treatment 49 38%
To protect from
infectious disease
23 17.8%
Has your child even take intestinal
parasitic medication
Yes 88 68.2%
No 21 16.3%
I don’t know 20 15.5%
Out of 129 households, 120 house hold are know the transmission way of infection worm from
those 106(82.2%) by eating contaminated food, 108(83.7%) by drink contaminated water,
97(75.2%) by do not wash hand before eating and 56(43.4%) by do not use latrine.
Out of 129 households 122(94.6%) are willing to give medication for their Childs for trachoma.
The remain 7 (5.4%) are not willing to give medication for their child’s for trachoma. The reason
for willingness is for protection and maintain health and the reason for not willingness are have
not a child, not ill my child, I want to treat by self and I do not have evidence about medication.
About transmission of trachoma not maintain personal hygiene 37(61.67%), irregular face
washing 35(58.33%), not keeping environmental sanitation 23(38.33%), not keep home

46. 35
sanitation 14(23.33%) , Person to person via flies 10(16.67%) and Using towel or cloth
together.
Table 15; Shows trachoma transmission, willing or not willing and reason for willingness
and not willingness inGebrel village, mehalketemakebele ,Arbaminch Ethiopia , Novenber,
2016E.C.
Variable Group Frequency Percentage
Are you willing to give your
child medication for
trachoma?
Yes 122 94.6%
No 7 5.4%
How is trachoma transmitted? Not maintain personal
hygiene
66 51.16%
Not keeping environmental
sanitation
34 26.35%
Person to person via flies 29 22.48%
Among 129 house hold 31(93.94%) by maintaining personal hygiene, 27(81.82%) keeping
environmental sanitation and 13(39.39%) by taking a campaign drug.

47. 36
Chapter 5: Problem identification and prioritization
5.1. List of identified problem
1. Absence of ventilation pipe for kitchen (16.8%).
2. Absence of hand washing facility attached to the toilet (36.2%)
3. poor solid waste disposal system and closed temporary solid waste materials (67.23%).
4. High number of households with insects (55.8%)
5. Low utilization of family planning (45.7%).
6. Prevalence of malaria in past of 1 month duration and absence of bed net (ITN) (18.6%).
7. Lack of awareness about transmission, prevention and VCT for HIV/AIDS (17.8%).
8. Lack of information and awareness about NTD (27.1%).
9. Lack of immunization cards among less than 1 year (70%).
10. High number of substance abuse (10.9%).
11. Lack of knowledge about mental illness and epilepsy management (74.1%)
5.2. Prioritization
Table 16: prioritization of problems in Gebriel village, mehalketemakebele ,Arbaminch
Ethiopia , Nov , 2016 E.C.
Problem Seve
rity
Magn
itude
Governme
nt concern
Community
concern
Feasi
bility
Total Rank
Absence of ventilation pipe for
kitchen (16.8%)
3 1 2 2 1 9 11
Absence of hand washing
facility attached to the toilet
3 2 4 4 5 18 2

48. 37
(36.2%)
Poor solid waste disposal
system and closed temporal
solid waste material(67.23 % )
3 4 4 4 4 17 4
High number of households
with insects (55.8%)
3 3 3 5 2 16 6
Low utilization of family
planning (45.7 %)
2 3 5 3 2 15 8
Prevalence of malaria in past
of 1 month duration and
absence of bed net (18.6 %)
4 1 5 5 3 18 1
Lack of awareness about
transmission, prevention and
VCT for HIV/AIDS (17.8%)
4 1 4 3 5 17 3
Lack of information and
awareness about NTD (27.1%)
2 2 3 2 4 13 9
Lack of immunization cards
among less than 1 year
(70%).
2 4 3 2 1 12 10
High number of substance
abuse (10.9%).
4 1 4 4 3 16 5
Lack of knowledge about
mental illness and epilepsy
management (74.1%).
2 4 2 3 4 15 7
5.3 Criteria for prioritization
 Severity
 Magnitude
 Community concern
 Government concern
 Feasibility
Severity magnitude community concern
Fatal=5 </=20%=1 extremely felt=5
Very sever=4 21%-40%=2 very felt=4

49. 38
Sever=3 41%-60%=3 felt =3
Moderate=2 61%-80%=4 not very felt=2
Mild=1 >80%=5 not felt at all=1
Government concern feasibility
Extremely supported=5 extremely feasible=5
Very supported =4 very feasible=4
Supported =3 feasible =3
Not very supported =2 Not very feasible=2
Not supported at all=1 Not feasible at all=1
5.4 Prioritized problems
1. Prevalence of malaria in past of 1 month duration and absence of bed net (ITN).
2. Absence of hand hygiene.
3. Lack of awareness about transmission, prevention and VCT for HIV/ AIDS.
4. Poor solid waste management.
5.5 SWOT analysis
1. Strength
 Cooperation and commitment among group members for this work.
 There were divisions of labor in group and presence of motivation and team sprite
within our team worker.

50. 39
 Open -mindedness for advisors comment.
 Each group members donated 50 birr to buy materials that used to solve prioritized
problems.
 Knowing the community norms, culture and values.
2. Weakness
 Lack of punctuality.
 Being unfamiliar to computer program during data analysis.
 Unavailability of taxi transportation.
3. Opportunity
 Availability of WIFI connection in our campus.
 Cooperation of kebele manager.
4. Threatening
 Community fatigue.
 Lack of reliable statistical data on the village.

51. 40
CHAPTER 6: ACTION PLAN
Table 16; shows action plan for prioritized problems in Gebriel village, mehalketema ,
Nechsar kebele, Arbaminch Ethiopia , November, 2016 E.C.
S.
N
Prioritize
d
problem
Objecti
ves
Target
group
Respon
sible
bodies’
Indicato
rs
resource Strategi
es
Activiti
es
unit
s
Plan
for
one
day
Achieve
ment
nu
mb
er
%
1 Prevalenc
e of
malaria in
past one
month and
absence of
bed net
To
reduce
the
prevale
nce and
distribu
tion of
malaria
Househ
olds
who do
not use
bed net,
and
who
lives
near to
stagnat
ed
water.
All
group
membe
rs,
health
extensi
ons
workers
,
commu
nity
and
commu
nity
leaders
and
govern
ment
Househol
ds who
have not
prevalenc
e of
malaria
Bed net,
pesticides
To
educate
the
commun
ity about
prevalen
ce of
malaria
Create
awarene
ss to
commun
ity about
prevalen
ce of
malaria
Counseli
ng the
commun
ity about
treatmen
t of
malaria
and wise
use of
bed net
sess
ion
One
hous
e
(15
% )
1 10
0%
2 Absence
of hand
hygiene
To
increas
e
number
of
latrine
with
hand
washin
g
facility
attache
Househ
old
who do
not
have
hand
washin
g
facility
attache
d to
toilet
Team
membe
rs,
Kebele
leaders
and
Health
extensi
on
workers
Number
of
househol
ds who
have
hand
washing
facility
attached
to toilet
Jerk an
with
water and
soap,
Human
power.
Home to
home
visit
,mobiliz
ation
with
HEW
and
Keble
HID
about
proper
latrine
utilizatio
n,
constrict
ing hand
washing
material
s besides
toilet
sess
ion
Two
hous
e
(4%)
1 10
0%

52. 41
d to the
toilet
Constric
ting
hand
washing
material
s besides
toilet
Nu
mbe
r
3 Lack of
awareness
about
transmissi
on
,preventio
n and
VCT for
HIV/AID
S
To
increas
e
awaren
ess of
commu
nity
about
transmi
ssion
,preven
tion
and
encoura
ge to
examin
ation
Commu
nity
who
have
low
awaren
ess of
HIV/AI
DS
transmi
ssion
and
prevent
ion
Team
membe
rs,
individ
ual,
commu
nity,
health
care
professi
on, and
govern
ment
Househol
ds who
have
awarenes
s about
HIV/AID
S
transmiss
ion and
preventio
n.
Use
human
powers
Commu
nicate
with
commun
ity
member
HID
about
benefit
of know
the
transmis
sion way
of
HIV/AI
DS
sess
ion
One
hous
ehol
d
(4.3
%)
1 10
0%
4 Poor solid
waste
manageme
nt
To
decreas
e
improp
er
waste
disposa
l
system
enablin
g
closed
waste
storage
materia
ls
Househ
olds
who do
not
have
proper
solid
waste
disposa
l
system
and do
not
have
closed
waste
All
team
membe
rs,
health
extensi
ons
workers
and
govern
ment
Househol
d who
have
proper
solid
waste
disposal
system
and
closed
waste
storage
materials
Garbage
can,
basket,
trash can,
suck,
card
board
box
Home
to home
visit
To give
educatio
n for
society
about
risk of
imprope
r solid
waste
disposal
system
sess
ion
One
hous
e
(2.5
%)
1 10
0%

53. 42
storage
materia
ls
Intervention
Each group of members donated 50 birr with total of 650 birr to buy materials that were used to
solve the prioritized problems ( such materials like bed net , jerrycan and solid waste bin).We
gave out bed nets and provided education about mosquito control methods. We gave advice on
how to dispose of wastes and showed how and where to dispose solid wastes. We also gave
advice on the importance of of hand washing and showed how to properly wash hands after
using the toilet.
We also gave health education and awareness about HIV /AIDS transmission ,prevention and
encourage to test examination (VCT) .
Discussion
In Arbaminch town nechsar kebele gebriel village from 129 households were Our finding showed that
20.5% attended primary school education, and , 21.9% secondary, and 44.7% college and above
higher education. The study showed that 50.9%are married, and 35% married , clearly showing
that most of the population are married. stated that the married population group is greater than
the single ones. It reported that 63.4% are married, 35% married.
Total number of households with history of malaria was found to be, 15 (11.6%) and
114(88.4%) house hold had no history of malaria due to , 6 (4.7%) house hold, with present of
stagnant water in their surrounding and 123 (95.3%).house hold, there is no stagnant water in
their surroundings and , 93(72.1%) house hold, had enough bed net and 36(27.9%) had no
enough bed net.
Total number of households with hand washing facility was found to be 83 (63.8%) and those
who do not have washing facility was 46 (36.1%) .this contributes in large for transmission of
feco-oral disease and other health related problems associated with poor sanitation .
Giving effective education about HIV /AIDS transmission, prevention and encouraging to
examination is improve awareness and to know control and prevention methods .

54. 43
From total numbers of households 94 % was known about prevention , transmission and
voluntary to VCT and 6 % who do not known about transmission ,prevention and not voluntary
to VCT.
From total numbers households, (74.6%) have Temporal solid waste storage area and 32(24.6%)
household don't have solid waste storage area.
This contribute in lead environmental pollution wich release harmful chemicals and gases to
environment and accumulation of waste attract pests like rodents ,insects and others .these pests
can spread disease to humans, making the areas for various illness.
Conclusion
Nechsar Kebele, Gebriel village community the highest value of households have kitchen and
separated from the main house. From our study area the majority household have 2 and more
than 2 room and most of them have cross- ventilation system and majority of the household have
traditional pit latrine. Most of the populations are the follower of orthodox and male population
is slightly greater than female population. Nechsar Kebele, Gebriel village exposed to high
prevalence of mosquito and majority households use bed net to control insects. Above half of the
female household have good knowledge about FP . The populations have good understanding
about prevention and transmission of HIV/AIDS but some people have no understanding about
transmission prevention and not voluntary to VCT examination . These study population have
understanding about the cause and treatment of substance abuse and mental illness. Plus they
have good understanding on drug usage pattern.
Finally, we conclude that our study area has mosquito prevalence, poor waste disposal
practice,low awareness of HIV/AIDS transmission, prevention and VCT examination and lack of
hand washing facility.

55. 44
Recommendation
 We recommend that the Keble health office to work with the community and HEWs to
distribute adequate amount of bed nets( ITN.
 We recommend the community to have hand washing facility after using toilet.
 We recommend that all families should keep the hygiene of their home and environment .
 We also recommend that health extension workers should educate the community about the
prevention and transmission of HIV/AIDS .
 We recommend the community about VCT before marriage.
 To ensure the continuation of the CBTP, Arba minch University College of medicine and
health science should keep going on letting the next students to do this project in order to
solve the problems of community.
 We recommend school of nursing department of comprehensive nursing to revise the
curriculum for the next students CBTP after completion of professional courses.
8. Project exit strategy
Since the identified problems of our study needs commitment of every stake holders,
government, non-governmental organization and community, all individuals should work
cooperatively to reduce the problems and control as much as possible, this means only our
activity by itself can’t bring a great change, unless the community are willing to help us.

56. 45
REFERENCE:
1. (Santa Cruz county community assessment project, 1999)
2. University of kansas
3. Richard G. wilkinson, social determinants of Health, 2005
4. Ju.edu.et
5. World malaria manual report, 2002
6. Ethiopian mini demographic health survey, 2019(EDMHS 2019)
7. Jimma University Publication and Extension Office: Guidelines and procedures for
community based education, jimma, 2013