Full summary of community diagnosis in Nakasongola District

1. INVESTIGATORS;
AKELLO FAITH, KALUNGI JONATHAN, MUGALU DENIS
EDWARD, BALUKU ANDREW, KUNIHIRA CATHERINE,
NABUKALU SSENTONGO ANGELA, NDAGIRE REGINA
NABIKINDU, ORIBA DAN LANGOYA, TUMWESIGIRE
SAMUEL,

2. ABSTRACT
 The study was done to carry out a community diagnosis of Nakasongola subcounty,
Nakasongola district a catchment area of Nakasongola HC IV.
 Methods used included both quantitative & qualitative.these were
questionnaires,interviews,documents review etc.
 key informants; LCI, VHT.
 Sampling: Household sampling-simple randomized sampling, sample size-120 households,
Sample area; Kalubanga, Matuugo and Buruuli villages.
 Demography: 81%- female respondents, 57% of households-mother headed, majority of
household members-below 5 yrs(45.2%), 6-18 (40.5%). Religion; anglicans, Catholics,
Muslims, others – 47.6%, 21.4% 14.3% ,16.7% respectively.
Occupation; peasants(69%), civil savants(11.9%)
 Nutrition and food security: Food source; from own garden(61.1%), rest from market.
Availability(meals per day); 3-64.3%, 2-26.2%, 1- 7.1%. Diet-mostly carbohydrates(root tubers,
maize & its products.), proteins(animal products).

3. ABSTRACT CONT’D
 Sanitation and hygiene: Water source; Tap water(50%),
borehole(40.5%), wells (4.8%). Water treatment; Boiling(54.8%),
Chemicals(9.5%). Other aspects; kitchen compound cleanliness
rubbish pits.
 Health seeking Behavior: Majority from the health facility.
 The above results were analyzed using Microsoft Excel spread sheet
and presented in form of tables, bar graphs and Pie charts.

4. INTRODUCTION
 Community diagnosis is the comprehensive assessment of the health state of an entire
community in relationship to its social, physical and biological environment
 This assessment was carried out in Nakasongola sub-county , Nakasongola District.
 Political hierarchy included;district level-Nakasongola District; county-Nakasongola
(originally called Buluuli);subcounty-nakasongola; parish-nakasongola town council;
villages - buluuli, matuugo, kalubanga.
 Economically; the people were mainly dependant on agriculture and a few others
indulge in trade & commercial activities and others –transport & communication
services.
 Socio-culturally;people generally fall among two established kingdoms which include ;
the baganda and the baluuli. Originally these were the same kingdom people established
in buganda kingdom but a segment of some people broke off as the a Baluuli people in
the name of need to have a separate political structure & region demarcation.
 During the assessment, we used questionnaires and a checklist to obtain information on
social demographic factors, nutrition, hygiene, and health seeking behavior. The data
collected was then analyzed to come up with a report.
 Biggest health challenges were ; Malaria, Upper respiratory tract infections, and
diarrheal diseases.
 The major economic activity was farming.
 The results were analyzed using Microsoft excel and presented in form of tables, bar
graphs, and pie charts

5. Objectives
General objective.
 To carry out the community diagnosis of nakasongola subcounty.
Specific objectives.
 To determine social demographic characteristics of the community.
 To assess the nutrition status of the community
 To assess the sanitation and hygiene.
 To identify the commonest diseases.
 To assess the health seeking behavior of the people in the community.
 To assess the health service delivery system in this community

6. Methods and tools
 Study design:- The study design was a non interventional,
descriptive cross sectional survey.
 Study population:- The target group was the community and
local leaders.
 Sample size:- 120 participants from different villages of
nakasongola subcounty.
 Sampling technique:- Simple random sampling.
 Data collection techniques:-
Primary data:- questionnaires and Checklist. Households were
selected at random and interviewed using close ended
questionnaires.
-Key informants included VHT and LCI chairperson;
Secondary data:- Documents used included District records,
Hospital records.

7. Methods and tools cont’d
 Data processing and analysis: Data processing was done
manually by researchers with the help of calculators and
computers. The analysis was done by microsoft excel and
presented in form of tables, Bargraphs and pie charts.

8. Results and Discussion
 Socio-demography;
The study showed that the majority of the respondents were females(81%) & the
rest being males-as men were out for work by the time the surveys were carried out.
Also, most families were mother headed (57.1%) implying a heavy burden loaded
onto the females financially, that in a long run greatly impacted onto the maternal
health.
Households were established in a nuclear setting mainly(80%) with the most age
distribution below 18yrs as follows;<5yrs-(45.2%) & 6-18yrs-(40.5%). This shows the
economical burden laid onto the breadwinners of the households as it was
implicated in the poor standard of living evident with general source of income
being peasant farming(69%) generating below $3 @ day.
Majority of household members were anglicans(47.6%) by religion & a significant
others being;catholics(21.4%),moslems(14.3%).this shows majority were christians
with spiritual faith that influences their health seeking behaviour as seen in
indulging spiritual healing as part of their ways of managing different health
aspects

9.  Nutrition & food security;
Majority of households obtain food from their own gardens (61.9%),
others bought food from the market.
64.3% of the households would afford three meals a day, 26.2% had
two meals a day, and 7.1% had only one meal per day.
Most of the meals were served with root tubers(81%), others being:-
maize and its products(57.1%), matooke(38.1%) and animal products
(31%).
The results above depicted that most families had an unbalanced diet
in their nutrition. Their meals were majorly protein deficient as shown
by the few animal products consumed. They was as a significant
Vitamin deficient in their diet shown by absence of vegetables in their
diet.
However they had a strong food security depicted by the availability
and accessibility (grew their own food and even had stores for it.)
Cassava and sweet potatoes were dried and preserved as “kasedde” in
preparation for the dry season

10. Sanitation and Hygiene:
 Majority of the sampled households use tap water (about 50%),
others obtained it from boreholes (40.5%) and wells (4.8%) especially
when there was water shortages. This was a good indicator water safety.
However, they were affected by the long distance from the water
sources.
Water was mainly boiled for consumption (54.8%) and 9.5% used
chemicals like water guard tablets. The rest had no means of treatment
at all.
 The water safety accounts for the low prevalence of water borne
diseases like Bilharzia and Typhoid as recorded at the health facility.
As regards waste management, most households disposed off their
rubbish safely in rubbish pits and in their gardens for manure,
accounting for the high percentage of observed clean compounds.
Human waste was disposed off in regularly cleaned pit latrines
accounting for the low prevalence of communicable diseases like
cholera, Dysentery, e.t.c

11.  Health Seeking Behavior:
The study showed that the majority of people in the area (83%)
sought health attention from the health facility.
A significant number however, sought health attention from
traditionalists (14%) and a few from spiritual healers and churches
(3%).
This implies good health seeking behavior shown by the high
numbers of people attending health facility. However, none of these
people were found to go for routine medical check ups.
Also, this good health seeking behavior is attributed to the short
distance to health facilities, therefore easy accessibility to medical
services and awareness about the health services provided at the
facility such as immunization, safe male circumcision, e.t.c

12.  Disease burden:
Among the most common diseases affecting people in the area
included Respiratory tract infections( 46.2%), and Malaria (44.6%).
The prevalence of diarrheal diseases was low ( 0.05%), mainly due to
the good general sanitation and hygiene as shown by; Clean
compounds, regularly cleaned pit latrines and good waste disposal.
The frequency of these endemic diseases esp. malaria was almost
every month with a registered highest percentage(57.1%). This is
attributed to a variety of factors such as breeding places and bushy
areas around their compounds.

13. Conclusions
Community strengths include :-
 Easy access to medical and social services
 Good political leadership and communication with the community.
 Good Health seeking behavior.
 Good Sanitary conditions of the community.
 Good food security.
 Good road networks and communication.

14. Weakness of the community:
 Low levels of income.
 Poor nutrition
 Long distance from distance from reliable water sources.
 Poor housing facilities; Overcrowded and poor ventilated.
 Inadequate mosquito nets and bushes around homes.
 Ignorance about some essential health practices like routine medical
check ups and water treatment

15. Recommendations
 Health promotion and preventive activities ( like continuous health
education on usage of mosquito nets) should be implemented.
 A number of outreaches should be done to create more awareness on
the essence of routine medical check ups.
 In order to decongest the households, Family planning methods should
be emphasized.
 Diversification of the economy to improve on economic status of the
community.
 Provide Nutrition education to the community about the
imperativeness of the consumption of a balanced diet.

16. References
 DHO offices. Higher local government statistical abstract, Nakasongola
district; 2008
 http/en.wikipedia.org/w/index.php?title=nakasongola_district.downlo
aded at 20th April 2013
 UBOS(2002), Uganda population and Housing census report, Uganda
bureau of statistics, Kampala Uganda.
 WHO; World health report (2002,2004)