This document summarizes a community entry and diagnosis conducted in Emanyinya Sub-Location, Vihiga County. A team of students and supervisors assessed the health determinants and status of the community. They found that the majority of households had good ventilation but poor sanitation. Common diseases affecting adults and children included malaria, respiratory infections, and intestinal worms. While vaccination rates were high, nutrition and family planning posed challenges. The team recommended organizing medical camps and ensuring tutors are well-prepared to support students during community placements.

1. PRESENTATION OF COMMUNITY ENTRY AND
DIAGNOSIS OF EMANYINYA SUB LOCATION,
VIHIGA COUNTY

2. EMUSIRE TEAM
STUDENTS SUPERVISORS
1. Dr. Benson Nyambega
2. Miss Indrah Ongwong’a
3. Dr. Bonuke Anyona
NAME ADMISSION NUMBER
OKOTH KEVIN TONY MS/00040/2013
WAKHU LESLEY MUKOYA MS/00035/2013
TIREN HILDA CHEMUTAI MS/00015/2013
KIPKIRUI NICHOLAS MS/00024/2013
ONUNGA ANTHONY
OTIENO
MS/00032/2013
KIMANI JOAN RUGURU MS/00007/2013

3. OBJECTIVES AND RESEARCH QUESTIONS
BROAD OBJECTIVES
To assess the health determinants and health
status of Emanyinya sub-location.
SPECIFIC OBJECTIVES
• To conduct a community entry and diagnosis
in Emanyinya Sub-Location.
• To give the health center and the community
feedback on the research done.
• To write and compile a report of the
community diagnosis.
RESEARCH QUESTIONS
• How does demography, housing,
HIV/AIDS, culture, nutrition, lifestyle,
sanitation, and environment in Emanyinya
community influence their health status?
• Do the study areas reveal a positive or
negative impact on health of the
community?
• If they reveal negative impacts, what can
be done to alleviate the same?

4. INTRODUCTION
EMUSIRE HEALTH CENTER
LOCATION: Emusire Sub-Location,
Vihiga County
CATCHMENT POPULATION: Central
Bunyore Ward
LEVEL: 2
DEPARTMENTS: Registration, MCH/FP,
ANC,CCC, Pharmacy
STAFF: 2 COs, 7 Nurses, 2 PHOs, Lab
Attendant & Support Staff.
COMMUNITY
Sub tribe: Abanyole of Luhya tribe
Historical events: Sabalala (famine),
livestock theft & jigger outbreak
Culture: Male circumcision, after
birth & death rituals and Wife
inheritance
HSB: rely on health center and
traditional healers.

5. METHODOLOGY AND SAMPLING
METHODOLOGY
Data source: interviews, observation, FGD
& questionnaires (Primary source),
Journals, Govt Sources, Books (Secondary
sources)
Data collection: semi-structured
questionnaires, interviewing, observation,
FGD.
Data analysis: Ms Excel and Word.
SAMPLING TECHNIQUES
• Convenience: selecting
households in the catchment area
• purposive: selecting households
with children under 5 years

6. DEMOGRAPHY & HOUSING
97.5% female
Household: 1-5 (60%), >10
(1.43%): family planning
effective
Death: 77.14% none: low
mortality rate
Education: 68.57% primary:
low literacy level
Ventilation: 54.29% good,
45.71% poor
Windows: 3 or less 78.57%:
Cooking place: 75.71% inside
Floor: 84.29% earthen
Risk of allergies & respiratory
infections (30% both children &
adults)

7. NUTRITION AND LIFESTYLE
Meals/day: 72.86% 3 meals/day
Fruits: 31.43% rarely took
Water: 44.29% thrice, 30%
randomly: depend on many factors
Food last 1 month: 100% carb,
1.43% proteins: need to balance diet
Supplements: 85.7% No: need to
provide
CONDITION NUM
BER
PERCE
NTAGE
Severe Acute Malnourished
(<11.0cm)
1 0.7
Moderate Acute Malnourished
(11.0-12.5 cm)
2 1.41
Growth Promotion
Monitoring (12.5-13.5 cm)
12 8.45
Well Nourished (>13.5 cm) 127 89.4
Breast feeding: 7.14% < 6 months
Weaning: 11.42% < 2 months, 52.86% 3-6
months: measures on infant nutrition

8. HIV AIDS & HEALTH SEEKING BEHAVIOURS
Awareness level: 34% good, 47% fair,
19% poor.
95.71 % tested, 12.86% infected
Drugs: 18.57% always get, 65.71%
often, 14.29% rarely.
Payment: 77.14% No, 22.86% Yes
Affordability: 12% yes, 11% No
Outreach: 60% yes
92.86% Health Center, 1.43%
pharmacy, 1.43% magicians, 1.43%
religious leaders.
Distance: 52.86% 1-2 km, 20% >3km,
4.29 <km
Service: 37.14% 30mins, 34.29% >1 hr.
HSB is influenced by availability of
drugs, affordability, distance & quality
of services.

9. ENVIRONMENT & SANITATION
Most of the households (84.3%) pour away
their liquid wastes. 15.7% pour liquid wastes
in pits.
HUMAN WASTE
• 64 households out of 70(91.4%) have pit
latrines
• 6 (8.6%) use alternatives. All people access
latrines.
0
10
20
30
40
50
Animal
feed,
Manure
Animal
feed
Burning Compst pit Dumping Manure Pit
Percentage
Axis Title
SOLID WASTE DISPOSAL
KITCHEN WASTE FARM WASTE GENERAL LITTER
1.4
7.1
15.7
75.7
0
10
20
30
40
50
60
70
80
5-10m 10-50 m 50-100 m >100 m
Percentage
Distance
DISTANCE FROM
WATER SOURCE TO LATRINE
5-10m 10-50 m 50-100 m >100 m

10. ENVIRONMENT AND WATER SUPPLY
• Most households get water from
springs.
• 43(61.4%) do not treat their water. 27
(38.6%) treat water with chlorination
the most common of treatment
methods. 29.6 among them boil their
water and 7.4
• 5 of them filter their water before
drinking.
POSITION OF LATRINE RELATIVE TO WATER SOURCE
• position of latrine relative to water
sources was uphill for 82.9% of the
households.
• It was downhill for 14.3% of the
households.
• 51.4% of the people have had ill oral
health and this relates to 38.6% of the
population who do not brush their
teeth at all and only 2.9% go for dental
checkup.

11. CULTURAL PRACTICES AND TRADITIONS
• Rite of passage: 100% circumcision
• Age groups for circumcision:
7.1% Below 5 years
50% between 5-10Years
42.9% between 11-15 Years
None above 15 years.
• Place of circumcision:
74.3% Health center
18.6% Home
7.1% Either home or health center
• Common marriage type:
75.4% Traditional
24.6% Religious.
• Practice of polygamy:
40% Monogamy
60% Polygamy.
• Wife inheritance: 41.4%No, 58.6% Yes
• How wife inheritance is done:
73.2% by members of husband’s family
14.6% by non-family
12.2% by anybody.
• Reasons for wife inheritance:
10% social stability,
10% Emotional support,
21.4% financial support,
20% both financial and emotional support,
38.6% no reason.
• Negative impacts of wife inheritance:
40% not aware,
30% disease transmission,
21.4% social instability,
8.6% economic exploitation.

12. CULTURAL PRACTICES AND TRADITIONS
• Are rituals performed at birth?
64.1% Yes, 38.6% No
• Ritual performed at birth:
81.4% Naming and shaving
11.6% Bathing child with herbal
drugs
7% Praying before leaving bedroom.
• Are rituals performed after death?
55.7% Yes, 44.3% No,
• Rituals performed after death:
65.2% Shaving head of family
members,
15.5% slaughtering chicken,
19.3% isolation, restriction movement
and praying for bereaved family

13. COMMON DISEASES AFFECTING THE COMMUNITY
DISEASE CHILDREN ADULTS BOTH NONE
Number % Number % Number % Number %
Diarrheal diseases 25 35.7 1 1.4 13 18.6 31 44.3
Malaria 8 10 2 2.9 56 80 5 7.1
Upper Respiratory Tract Infections (URTIs) 15 11.4 6 8.6 21 40 28 40
Eye infections 7 10 8 11.4 1 1.4 54 77.2
Tuberculosis 1 1.4 3 4.6 1 1.4 65 92.5
Common cold 1 1.4 8 11.4 43 61.4 18 25.8
Pneumonia 18 25.7 5 7.2 1 1.4 46 65.7
Skin Infections 22 31.4 6 8.6 3 4.3 39 55.7
Sexually Transmitted Infections(STIs) 0 0 15 10.4 0 0 41 69.6
Malnutrition 1 1.4 0 0 1 1.4 68 97.2
Intestinal worms 29 41.4 0 0 6 8.6 35 50

14. MATERNAL CHILD HEALTH (MCH) & FAMILY PLANNING
1st pregnancy: 12.86% 10-15 yrs,
61.43% 16-20 yrs, 24.29% 21-25 yrs,
1.43% >25 yrs.
ANC- 100% visit health center during
pregnancy, 52.86% 1st trimester,
24.29% 2nd trimester, 22.86% 1st
trimester.
Delivery place: 57.14% health center,
20% home with TBA, 20% home
without TBA, 2.86% others.
Vaccination: 100% BCG, Polio,
DPT1, DPT2. 92.71% DPT3, 81.25%
measles.
FP: 88.57% aware of it.
Type of FP: 32.86% Depo, 21.43%
none, 2.86% pills.
FP challenges: 54.29% side effects,
2.86% non approval by spouse

15. RECOMMENDATIONS
• Enough preparations before the main attachment date.
• Chose new centers wisely and avail tutors who are aggressive enough
during the first two weeks at the new center.
• Organize medical camps.
THANK YOU!
TO SCHOOL OF MEDICINE