ASSESSMETOFHEALTHANDHEALTHRELATEDPROBLEMSI

NKETENA03,
WOREDA
02,ASSOSATOWN.

WORKEDBY;
1.TEWACHEW ABEBE

2.BI
KILAABEBE

3.TAMI
RUDAGNEW

4.MULUALEM ASSGI
E

5.ZI
NASHETANA

6.MI
SRAKDESTAW

7.BI
NIAM TAMI
RAT

8.I
SRAELYEMANE

ACOMMUNITYBASEDTRAI
NINGPROGRAM RESEARCHTOBESUBMMI
TEDTOMCM
DEPARTMENTOFPUBLI
CHEALTH

SUPERVI
SORABNET.
K[BSc]
SUBMI
TEDTOMCM DEPARTMENTOF
PHO
ASSOSA,
ETHI
OPI
AJAN2022
2|Page
Acknowl
edgement
Wewoul
dli
ket
oexpr
essourdeepestgr
ati
tudeandt
hankst
opeopl
ewhohav
ehel
ped
wi
tht
hewhol
epr
ocessofourCBTPcour
seandmai
nlyi
nourdat
acol
l
ect
ionpr
ocess.I
n
par
ti
cul
ar,al
lAssosat
ownKet
ena03r
esi
dent
sfort
hei
rgoodhospi
tal
i
tyandki
nd
suppor
tforourmi
ssi
on,wewoul
dli
ket
othankKet
ena3admi
nist
rat
ionwhogav
eas
t
hei
rval
uabl
eti
mef
orpr
ovi
dinguswi
thal
lnecessar
ydat
aandsuppor
tingui
ding
l
ocat
ions.Andoursuper
visorMr
.Abnet

I|Page
Tabl
eofCont
ent
s
Acknowl
edgement I
LI
STOFTABLES I
II
LI
STOFFI
GURES I
V
ACCRONYMS/
ABRI
VATI
ON V
Abst
ract VI
CHAPTER1:I
NTRODUCTI
ON 1
1.
1Backgr
ound 1
1.
2STATEMENTOFTHEPROBLEM 2
1.
3Si
gni
fi
cantoft
hest
udy 3
CHAPTER2: LI
TERATUREREVI
EW 4
CHAPTERTHREE:
OBJECTI
VE 6
3.
1Gener
alobj
ect
ive: 6
3.
2Speci
fi
cobj
ect
ive 6
CHAPTERFOUR:METHODOLGYANDMATERI
ALS 7
4.
1St
udyar
eaandper
iod 7
4.
3Studydesi
gn
Communit
ybasedcr
osssect
ional
studywer
eappl
i
edf
romJanuar
y19-
26,
2014E.
C.7
4.
4Popul
ati
on 7
4.
4.1Sour
cepopul
ati
on 7
4.
4.2St
udypopul
ati
on 7
4.
5Incl
usi
onandExcl
usi
oncr
it
eri
a 8
4.
5.1.I
ncl
usi
oncr
it
eri
a: 8
4.
5.2.Excl
usi
oncr
it
eri
a: 8
4.
6Sampl
esi
zedet
ermi
nat
ionandsampl
ingt
echni
que 8
4.
6.1Sampl
esi
zedet
ermi
nat
ion 8
4.
5.2Sampl
ingt
echni
queandpr
ocedur
es 9
4.
6St
udyVar
iabl
es 9
4.
6.1.DependentVar
iabl
es: 9
4.
6.2.I
ndependentVar
iabl
es: 9
4.
7Oper
ati
onaldef
ini
ti
on: 10

I
I|Page
 4.
8.Dat
acol
lect
ionTool
: 11
4.
9.Dat
acol
lect
ionPr
ocedur
e: 11
4.
10.Dat
aqual
it
yassur
ance: 11
4.
11.Dat
apr
ocessi
ngandanal
yzi
ng: 11
4.
12.Et
hical
consi
der
ati
on: 12
4.
13.Di
ssemi
nat
ionofr
esul
ts 12
CHAPTERFI
VE:RESULTS 13
5.
1Soci
o-Demogr
aphi
cchar
act
eri
sti
cs: 13
5.
2Meansofcommuni
cat
ion 14
5.
3Fami
lyi
ncomes 15
5.
4Vi
talst
ati
sti
cs 15
5.
4.1Chi
ldBi
rt
h 15
5.
4.2DEATH 16
5.
4.3Mor
bidi
ty 17
5.
5Repr
oduct
ivehi
stor
yofr
espondent 18
5.
6Fami
l
ypl
anni
ng 20
5.
7Nut
ri
ti
onal
assessment 21
5.
7.2Chi
l
dnut
ri
ti
on 22
5.
8Env
ironment
alheal
thsur
vey 22
5.
8.1Wast
edi
sposal 22
5.
8.2Wat
ersuppl
y 24
5.
8.3Housi
ngcondi
ti
ons 24
6.DI
SCUSSI
ON 26
7.I
dent
if
iedpr
obl
ems andact
ionpl
an 27
7.1I
dent
if
iedpr
obl
ems 27
7.
2Act
ionpl
an 29
8.Concl
usi
onandr
ecommendat
ion 31
8.1.Concl
usi
on 31
8.
2Recommendat
ions 31
9.REFERENCE 33

I
II|Page
LI
STOFTABLES
Table1;
Socio-Demogr
aphi
cchar
acter
ist
icsofhousehol
dsofAssosatownwor
eda2
Ketena3Assosatown,
wester
nEthi
opi
a,2014…………………………. .page14
Tabl
e2:Chil
dbi
rthst
atusamonghousehol
dsofKet
ena03wor
eda2,Assosazone,
west
ernEthi
opi
a2014…………………………………………………………………. .page16
Table03;
thatshowsdeathoccur
rencesamongHHsi
nthel
ast12mont
hsofKet
ena3,
woreda2Assosatown,west
ernEthi
opia,
2014E.
C……………….
.page18
Tabl
es4;thatshowsmorbidi
tyamongHHsi
nthel
ast2weeksofKet
ena3,
wor
eda2
Assosat
own, wester
nEt
hiopia,
2014E.
C…………………………………………page19
Tabl
es05;thatshowsreproduct
ivehi
stor
yofr
espondent
sint
heKet
ena03wor
eda2
Assosatown,wester
nEt hi
opia,
2014E.C……………………………………………page21
Tables06;
thatshowsFPt r
endsofr
espondent
sint
heKet
ena03wor
eda2Assosa
town,wester
nEthiopi
a,2014E.
C…………………………………………………………page22
Table7thatshowHHSnutri
ti
oninthel
ast12mont
hsofKet
ena3,wor
eda2Assosa
zone,wester
nEthi
opi
a,2014E.C……………………………………………………………page23
Tabl
e08:Chi
ldnut
ri
ti
oni
nofKet
ena3,wor
eda2Assosazone,
west
ernEt
hiopi
a,
2014…………………………………………………………………………………page24
Tabl
e9:wast
edisposalcharact
eri
sti
csofhousehol
dsofKet
ena03i
nwor
eda02,
Assosat
own,wester
nEthiopia,
2014…………………………………………………………page25
Table10:Watersuppl
yofket
ene3househol
dsi
nwor
eda2,
Assosazone,
West
ern
Ethi
opia,2014…………………………………………………………………………………………page25
Tabl
e11:Housi
ngcondi
ti
onofket
ene3i
nwor
eda2,Assosazone,
West
ernEt
hiopi
a,
2014……………………………………………………………………………………………page26
Tabl
e12;
showi
ngPr
ior
it
izat
ionofi
dent
if
iedpr
obl
ems…………………page28
Tabl
e13;
showi
ngt
heAct
ionpl
andev
elopedf
orpr
ior
it
izedpr
obl
ems…page30

I
V|Page
LI
STOFFI
GURES
Fi
gur
e1mapofAssosawor
eda02Ket
ena03……………………………………….
.page8
Fi
gur
e2:
thatshowsmeanscommuni
cat
ioni
nKet
ena3……………………….
.page15
Fi
gur
e03;
annual
incomeoft
hehousehol
dsi
nKet
ena03………………………page16
Fi
gur
e04;
showsbi
rt
hat
tendanti
nKet
ena03……………………………………….page17

I
V|Page
ACCRONYMS/
ABRI
VATI
ON
CBE-Communi
tybasededucat
ion

CBTP-communi
tybasedt
rai
ningpr
ogr
am

AI
DS…………Acqui
redI
mmuneDef
ici
encySy
ndr
ome

ANC……….
Ant
eNat
alCar
e

EBF…………Excl
usi
veBr
eastFeedi
ng

EDHS………Et
hiopi
andemogr
aphi
cheal
thsur
vey
ing

FP……………Fami
l
yPl
anni
ng

HH……………HouseHol
ds

MCH……….
.Mat
ernal
andChi
l
dHeal
th

ORS……….
.Or
alRehy
drat
ionSol
uti
on

TBA……….
Tradi
ti
onal
Bir
thAt
tendant

TTBA……….
Trai
nedTr
adi
ti
onal
Bir
thAt
tendant

DHS-
Ethi
opi
aDemogr
aphi
candHeal
thsur
vey

MCM………….
.Mi
l
lenni
um col
l
egeofmedi
cine

V|Page
Abst
ract
Background: Communi tybasededucat i
onisawayofsuccessi onofeducat i
onal
rel
evancet otheneedsandwant soft hecommuni ty.I
twasinaugur atedt otheworldin
thelate1970st oachieveapopul arneedanddemandt hateducat i
onshoul drender
servi
cet ocommuni ti
es.Healthandheal threl
atedproblemsarewor seninggloball
y.The
problemsar emor epreval
entindev elopingnationsascompar edt othedev eloped
countri
es.Communi t
ybasedt rai
ningpr ogram (CBTP)isstudypr ogram itincl
udes
teachersandot hercoll
aborat
ingsect orwhi chenabletoextr
actandt hepossi bl
e
i
nterventi
onofcommuni tyhealthrelatedproblemssuchas; mat ernal andchildhealt
h
problem,nutri
ti
onalandgener al socio-demographics.
Object
ive:
Toident
if
ymaj orhealt
handheal
threl
atedcondi
ti
onsandprobl
emsi n
Assosatownresi
dentsthroughcommunit
ydiagnosi
sbythi
rdyearpubl
icheal
th
st
udentsonJanuary2014E. C.
Met hods:Acommuni tybasedcross-sect
ionalstudywasconductedtoi denti
fyhealt
h
andheal t
hrelatedpr oblemsi nAssosatownKet ena3,wester
nEt hi
opiaf r
om January
19-27,2014.Thesy stematicrandom samplingisusedtogetsampl ehousehol dfr
om
totalhouseholds.Sampl efr
acti
on(k=14).Datawasanalyzedanddescr ipti
vefrequency
withrespecti
veper cent agewasusedt opresentf i
ndi
ngsbyusingtables,chartsand
diagramsaccor dingly.
Result
:From t
hetot
al populat
ionmajor
it
yofthepeople270(50.
2%)iscomposedof
agegroupbelow15y earsandt hesexr
ati
ooffemaletomaleis1.11.Theaver
age
famil
ysizeoftheHHswer e5.4member s/househol
ds.Maj
ori
tyofpeoplear
eAmhara
andfoll
owersofort
hodoxr eli
gion.
Keywor
ds;
Stakehol
der
s,Needofmai
ntenance,
Il
lumi
nat
ion,
Vent
il
ati
on:

VI|
Page
CHAPTER1:I
NTRODUCTI
ON
1.
1Backgr
ound
Heal
thi
sthecor
eanddet
ermi
nantt
hingf
ort
hel
i
feofhumanbei
ng.Not
hinggr
eatcan
bedonei
fther
eisnowel
l
-bei
ngi
nuni
ver
se.Howev
er,t
hewor
ldi
sfaci
ngenor
mous
heal
thandheal
thr
elat
edpr
obl
ems.Thesi
tuat
ioni
nAf
ri
cancount
ri
es,
especi
all
yinsub-
Sahar
ancount
ri
esi
sst
il
lhugeandwor
seni
ng.
[1]

Communi
tybasedt
rai
ningpr
ogr
am i
sthest
udyt
hati
nvol
vesst
udent
,communi
ty,
t
eacher
sandot
hercol
l
abor
ati
ngsect
ors,
ital
soi
tal
l
owsst
udent
stocombi
neser
vicei
n
t
hecommuni
tywi
thacademi
cinqui
ryt
ransi
tsst
udent
sov
ert
imequest
ionoft
her
eal
set
ti
ngs.CBTPi
soneoft
hecomponent
sofCBE.I
twasst
art
edi
nlat
e1970sG.
Cand
Ji
mmaUni
ver
sit
ywast
hef
ir
stt
oadopti
tinEt
hiopi
a.[
1].

1|Page
1.
2STATEMENTOFTHEPROBLEM
Healthandhealthr elatedpr obl
emsar ewor seninggl
oball
y.Thepr obl
emsar emor e
preval
entindevelopi ngnat i
onsascompar edt othedevel
opedcount ri
es.Fori nstance
waterandsanitati
oni soneoft hepri
marydr iver
sofpubli
chealth.Oncewecansecur e
accesstocleanwat erandadequat esani
tationforall
people.Forexampl e1.8mi l
li
on
peopledieever
yy earf rom diar
rhealdi
sease, 90%areunder5most l
yindev eloping
countri
es.88%ofdi arrhealdiseasesareattri
butedtounsafewat ersupply,
inadequat e
sanit
ati
onandhy gi ene.Poorwat ersuppl
yandpoorsani t
ati
onincreasediarrheal
morbidit
yby21%, 37. 5%respect i
vel
y.(1)
Bettermanagementofwat erresourcereducetransmissi
onofmal ari
aandotherv ector
bornedisease.Forinstance1.2mi l
l
ionpeopl edieofmalari
aeachy ear
,90%ofwhom
arechil
drenunder5.Ther eare396epi sodesofmal ari
aeveryyear
, mostoft
hedi sease
burdenisinsubSahar anAf r
icancount r
ies.Whenwecomet oseeaccesstowat er
supplyandsanitati
on,in2000, 2.
4bill
ionpeoplelackedaccesstoimprovedsani
tat i
on.
81%oft hesewer einruralar
eas.Similarl
y1.1bill
ionpeopl
elackedaccesstoimpr oved
watersource.(1)
Whenwecomet oseet heurgeoffamilyplanni
nginAsi
a,Lati
nAmer icaandCari
bbean
countr
ieswi
threl
ati
velyhighpreval
enceofcont r
acept
ive,
thelevelofunmetneedare
10.9%and10.4%respectivel
y.I
nAfrica23.2%ofwomenofr eproducti
veagehave
unmetneedofmoder ncont r
acepti
ve.(2)
I
thasbeenesti
matedthatever
ymi nut
e8underf i
vechi
lddieinsub-
Sahar
aAfri
caoft
he
46count
ri
esintheAfri
canregi
on,36hav eunderfi
vemort
ali
tyrat
eof100per1000l
iv
e
bi
rt
hs.2/
3ofunder-f
ivedeathi
ntheAfricanregi
onduetoprevent
abl
ecauses.(
3)
Themedianunderfivecasef
atali
tyr
ateforSAM typi
cal
l
yr angesf
rom 30%to50%.The
cur
rentgl
obalfi
guresofSAM burdenproducedbyWHO, UNICEFandWorldBank(2013)
est
imatethat17.
6mi l
li
onchi
ldrencoul
dbecl assi
fi
edwit
hSAM atanypointinti
me.(4)
SinceEthiopiaisoneofdev elopingnat i
onsthesepr oblem al
soexi sther e.Tostartup
from somephy si
calchar acteri
sti
csofhousehol ds, t
heenv i
ronmenti si mportant
deter
mi nantofheal t
hst atusofhousehol dmember s,especiall
ychildr en.Amongt hose
servi
cesincreasingaccesst oimpr ov
eddr inki
ngwat erisoneofmi llenni um
development .Accordingt o2011EDHS11%ofr uralhousehol dhav eaccesst odri
nking
waterfrom pr ot
ectedspr ingand8%hav eaccesst odrinki
ngwat erf rom pr ot
ectedwel l
.
Simil
arlythenumberofpopul ati
onusi ngnowat ertreatmenti s90.2%.Thesedat ashow
theprevalenceofwat erbor ndiseasei sextremelyhigh.Forexampl e, accordingto2011
EDHS13%ofchi l
drenl essthanf iv
ey earswerer eportedtohav ehaddi arr
hea.(5)
Whenwecompar ethecontracepti
veprev
alencerateforallEt
hiopi
anage15-49is20%.
Thisshowsthathowapr evalencerat
eofSTIandot herSTDsl i
keHIVandincreasi
ng
numberofpopulati
on.Accordingto2011EDHS10%ofbi r
thinEthi
opi
aaredeliver
edat
healt
hfaci
l
ity
,9%i npubl
icfacili
tyand1%inprivat
ef aci
l
ity
.Thatmeans9womeni n

2|Page
everytendeli
veryathome.Especi
all
yinSNNPRper centageofbirt
hsdeli
ver edinheal
th
i
nstit
utioni
slessthan10%.Inordertoover
comet heseandot herheal
threlatedprobl
em,
di
fferenti
nterv
enti
onshavebeenimplement ed.Amongt heseCBTPisbelievedto
contri
butefortheachi
evementofint
ervent
ionmechanism.( 5)

1.
3Si
gni
fi
cantoft
hest
udy
Si
nceCBTP assessesal
lheal
th and heat
hrel
ated pr
obl
ems,i
tcont
ri
but
esapar
amountofr
olesi
nthecommuni
ty,especi
all
ytoAssosat
ownKet
ena3wor
eda2i
nthe
pr
ocessofi
dent
if
yingandaddr
essi
ngt
hecommuni
tyHeal
thpr
obl
ems.I
tal
sopr
ovi
des
a base l
i
ne dat
aforgov
ernment
alor
gani
zat
ion t
hati
nter
estt
oint
erv
ene i
nthe
communi
typr
obl
em aswel
lasf
indi
ngoutt
hepossi
blesol
uti
onf
ort
hepr
omi
nent
pr
obl
em oft
hesoci
ety
.Ital
sopr
ovi
desagoodknowl
edgef
orust
oident
if
y,i
nter
vene
andsol
vet
hecommuni
tyheal
thandheal
thr
elat
edpr
obl
ems,notonl
ybutal
sopr
ovi
de
i
mpor
tantski
l
landknowl
edget
owr
it
egr
aduat
ionr
esear
chpr
oposalandr
esear
ch
r
epor
t.

3|Page
CHAPTER2: LI
TERATUREREVI
EW
Thecr
udebi
rt
hrat
einEt
hiopi
ais34.
5bi
rt
hsper1,
000popul
ati
on.Asi
sthecasewi
th
ot
herf
ert
il
it
ymeasur
es,t
her
eisasubst
ant
ialdi
ff
erent
iali
ntheCBRbyur
ban-
rur
al
r
esi
dence.TheCBRi
s37per
centhi
gheri
nrur
alar
eas(
36per1,
000popul
ati
on)t
hani
n
ur
banar
eas(
26per1,
000popul
ati
on)
.TheGFRi
nEt
hiopi
ais161l
i
vebi
rt
hsper1,
000
womenofr
epr
oduct
iveage.Ther
atei
sconsi
der
abl
yhi
gheri
nrur
alar
eas(
184)t
hani
n
ur
banar
eas(
89)[
1].

Just34%ofEt
hiopi
anwomenr
ecei
vesomeant
enat
alcar
efr
om ski
l
ledpr
ovi
der
s.Most
commonl
yfr
om anur
seormi
dwi
fe(
28%)onl
y11%ofwomen’
shadanANCv
isi
tbef
ore

4|Page
t
hei
rfour
thmont
hofpr
egnancyasr
ecommendedand19%r
ecei
vet
her
ecommended
f
ourormor
eANCv
isi
t,
17%ofwoment
ooki
ronsuppl
ementdur
ingpr
egnancy
,6%t
ook
i
ntest
inalpar
asi
tedr
ug.Onei
nfi
vewomeni
nfor
medofsi
gnofpr
egnantcompl
i
cat
ion
dur
ingANCf
oll
owup.Lesst
hanhal
f48%ofwomenmostr
ecentbi
rt
hwer
epr
otect
ed
agai
nstneonat
alt
etanus(
EDHS2011)
.10%ofbi
rt
hoccur
sinheal
thf
aci
l
ity
,pr
imar
yin
publ
i
csect
orf
aci
l
ity
.Homebi
rt
har
eal
mostt
wiceascommonasr
uralar
ea(
95%)asi
n
ur
banar
ea(
50%)onei
n10bi
rt
hsar
e assi
stedbyt
radi
ti
onalbi
rt
hat
tendantand57%by
unt
rai
nedr
elat
iveorf
ri
ends.post
nat
alcar
ehel
pst
opr
eventcompl
i
cat
ionaf
terchi
l
d
bi
rt
h.Just7%ofwomenr
ecei
ved post
nat
alcheckupwi
thi
ntwoday
sofdel
i
ver
y.The
v
astmaj
ori
ty(
92%)womendonothav
epost
nat
alcheckup(
EDHS2011)
.

The2011 EDHS asked women aboutdeat

h oft
hei
rsi
stert
o det
ermi
nemat
ernal
mor
tal
i
ty,deat
hassoci
atedwi
thpr
egnantandchi
l
dbear
ing.Themat
ernalmor
tal
i
ty
r
ati
oforEt
hiopi
ais676per100,
000l
i
vebi
rt
hs.I
mmuni
zat
ioncov
eragei
soneoft
he
i
ndi
cat
orsusedt
omoni
torpr
ogr
esst
owar
dst
heachi
evementofMDGandt
her
educt
ion
ofchi
l
dmor
bidi
tyandmor
tal
i
ty,asi
tisoneoft
hemostcost
-ef
fect
ivepubl
i
cheal
th
i
nter
vent
ionsf
orr
eachi
ngt
hesegoal
s.I
nEt
hiopi
aov
eral
l
,24% ofchi
l
drenage12-
23
mont
hswer
eful
l
yvacci
nat
edatt
het
imeoft
hesur
vey
sforcov
eragef
orspeci
fi
c
v
acci
nes,66% ofchi
l
drenhadr
ecei
vedt
heBCG v
acci
ne,and56% hadr
ecei
vedt
he
measl
esv
acci
ne.Ar
elat
ivel
yhi
ghper
cent
ageofchi
l
drenr
ecei
vedt
hef
ir
stDPTdose
(
64%)
.Howev
er,
onl
y37%wentont
orecei
vet
het
hir
ddoseofDPTr
efl
ect
ingadr
opout
r
ateof43%.Mor
ethanei
ghtchi
l
drenofev
eryt
en(
82%)r
ecei
vedt
hef
ir
stdoseofpol
i
o,
butonl
yaboutf
ouri
nten(
44%)r
ecei
vedt
het
hir
ddose,
ref
lect
ingadr
opoutr
ateof46%.
Ev
ent
houghDPTandpol
i
ovacci
nesar
eof
tenr
out
inel
yadmi
nist
eredatt
hesamet
ime,
pol
i
ocov
eragei
shi
ghert
hanDPTcov
erage.Thi
sispr
imar
il
yduet
othesuccessoft
he
nat
ional
immuni
zat
iondaycampai
gns,
dur
ingwhi
chpol
i
ovacci
nesar
eadmi
nist
ered[
1].

I
nthet
woy
ear
sbef
oret
hesur
veyshows7%chi
l
drenunder5wasi
l
lwi
thcoughand
f
astbr
eat
hingsy
mpt
om ofanacut
erespi
rat
oryi
nfect
ion(
ARI
)oft
hosechi
l
dren27%
wast
akent
oheal
thf
aci
l
ityand13%ofEt
hiopi
anchi
l
drenunderage5haddi
arr
hea.Thi
s
r
atewashi
ghest(
25%)amongchi
l
dren6-
11mont
hol
d,32%ofchi
l
drenwi
thdi
arr
hea
was t
aken t
o heal
thf
aci
l
ity4 i
n 10 chi
l
dren wi
th di
arr
hea wer
etr
eat
ed byor
al

5|Page
r
ehy
drat
ionsol
uti
on(
ORS)accor
dingt
o2011EDHSt
hev
acci
necov
eragei
nBGwas24%.

Br
eastf
eedi
ngi
scommoni
nEt
hiopi
awi
th98%ofchi
l
drenev
erbr
eastf
ed.Ov
erhal
fof
chi
l
dren(
52%)ofchi
l
drenunder6mont
hinEt
hiopi
aar
eexcl
usi
vebr
eastf
eedand10%
ofi
nfantunder6mont
hrecei
vecompl
i
ment
aryf
ood.Onav
eragechi
l
drenbr
eastf
eed
unt
ilageof25mont
handar
eexcl
usi
vebr
eastf
eed(
EBF)f
or2.
3mont
h.TheEDHS
measur
est
hechi
l
drennut
ri
ti
onalst
atusbycompar
inghei
ghtandwei
ghtmeasur
ement
agai
nstani
nter
nat
ionalr
efer
encest
andar
d.Accor
ding2011EDHS44% ofchi
l
dren
under5ar
est
unt
edort
ooshor
tfort
hei
rage.St
unt
ingi
smostcommoni
nchi
l
drenaged
24-
35mont
handi
sleastcommonamongchi
l
drenofmor
eeducat
edmot
herand
weal
thi
erf
ami
l
ies.29%ofEt
hiopi
anchi
l
drenar
eunderwei
ghtoft
oot
hinf
ort
hei
rage,
44%ofchi
l
drenar
est
unt
edi
nBG.

Accor
dingt
o2011EDHS27% ofEt
hiopi
anwomenar
eov
erwei
ght(
obese)
.Women
l
i
vingi
nrur
alar
eaar
emor
eli
kel
ytobet
hint
hanl
i
vingi
nur
banar
ea(
29%v
ersus20%)
.
Lesst
han1%ofwoment
ooki
ront
abul
atef
oratl
i
st90day
sdur
ingt
hei
rlastpr
egnancy
.

Knowl
edgeoff
ami
l
ypl
anni
ngi
nEt
hiopi
aisnear
lyuni
ver
sal
,97%ofal
lwomenand98%
ofal
lmenaged15-
49knowsatl
eastonemet
hodoff
ami
l
ypl
anni
ng.Mor
ethanonei
n
f
ourmar
ri
edwomen’
s(27%)cur
rent
lyusemoder
nmet
hodsoff
ami
l
ypl
anni
ng.Publ
i
c
sour
ces such as heal
th cent
erand gov
ernment
alheal
th postcur
rent
ly pr
ovi
de
cont
racept
ivet
o5%ofcur
rentuse.Thepr
ivat
emedi
calcent
ersuppl
i
escont
racept
ivet
o
13%ofuser
’s.Condomsar
emostcommonl
yobt
ainedatshops(
51%)whi
l
emostot
her
met
hodsar
eobt
ainedatgov
ernment
alheal
thcent
er.Fami
l
ypl
anni
nguser
shasal
most
doubl
edsi
nce2005,
whenonl
y14%ofmar
ri
edwomenwer
eusi
ngmoder
nmet
hod.Thi
s
i
spr
imar
il
yduet
oacont
inuedi
ncr
easei
ntheuseofi
nject
abl
einBG.Cur
rent
ly25%of
mar
ri
edwomenaged15-
49whoar
eusi
ngmoder
nmet
hodofFP.

CHAPTERTHREE:
OBJECTI
VE
3.
1Gener
alobj
ect
ive:
Toassessmaj
orheal
thandheal
thr
elat
edcondi
ti
onsandpr
obl
emsi
nAssosat
own
wor
eda2Ket
ena3,
Assosat
own,
BGf
rom Januar
y19-
27,
2014E.
C.

6|Page
3.
2Speci
fi
cobj
ect
ive
 Todescr
ibet
heSoci
o-demogr
aphi
ccondi
ti
onofpopul
ati
on

 Toi
dent
if
yheal
thandheal
thpr
obl
emsofKet
ena03

 Topr
ior
it
izei
dent
if
iedpr
obl
ems

 Todev
elopanact
ionpl
anf
orpr
ior
it
ized

7|Page
 .

CHAPTERFOUR:METHODOLGYANDMATERI
ALS
4.
1St
udyar
eaandper
iod
Thest
udywasconduct
edi
nKet
ena3,
wor
eda2f
rom Januar
y19-
30,
2014E.
C

Fi
g1mapofAssosawor
eda02Ket
ena03

8|Page
4.
3St
udydesi
gn
Communi
tybasedcr
osssect
ional
studywer
eappl
i
edf
romJanuar
y19-
26,
2014E.
C.

4.
4Popul
ati
on
4.
4.1Sour
cepopul
ati
on
Al
lhousehol
dofKet
ena03

4.
4.2St
udypopul
ati
on
Ourst
udypopul
ati
onwassel
ect
edhousehol
dsi
nwor
eda2Ket
ena3

4.
5Incl
usi
onandExcl
usi
oncr
it
eri
a
4.
5.1.I
ncl
usi
oncr
it
eri
a:
Al
lhousehol
dswhol
i
vesi
nwor
eda2Ket
ena3f
ormor
ethan06mont
hs

4.
5.2.Excl
usi
oncr
it
eri
a:
 Whor
efuset
hei
nter
view
 Cl
osehousehol
ds
 Whocan’
tresponse(
languagebar
ri
er)

4.
6Sampl
esi
zedet
ermi
nat
ionandsampl
ingt
echni
que
4.
6.1Sampl
esi
zedet
ermi
nat
ion
Thesampl
esi
zewascal
cul
atedbyusi
ngasi
ngl
epopul
ati
onpr
opor
ti
onsampl
esi
ze
2
cal
cul
ati
onf
ormul
a(n=[
Zα/
2] p(
1-p)
/d2)consi
der
ingt
hef
oll
owi
ngassumpt
ions:

Wher
e,

P=50% (
assumi
ngpr
opor
ti
onofr
espondent
swhoar
esuf
fer
ingwi
thheal
thr
elat
ed
pr
obl
ems.
)d=mar
ginal
err
orof5%=0.
005.

Z=conf
idencei
nter
valof95%andZα/
2ist
hev
alueoft
hest
andar
dnor
maldi
str
ibut
ion
cor
respondi
ngt
oasi
gni
fi
cantl
evel
ofal
pha(
α)0.
05,
whi
chi
s1.
96.

ni
=ther
equi
redsampl
esi
zewhent
het
argetpopul
ati
ongr
eat
ert
han10,
000.

n=Z2* d2
pq/

9|Page
 2 2
=(
1.96)*0.
5*0.
5/(
0.005)

=384

Thi
syi
eldsasampl
esi
zeof384.Si
ncet
hesour
cepopul
ati
oni
slesst
han10,
000,an
adj
ust
mentf
ormul
a

Wher
e,

N=Sour
cepopul
ati
on1552HHS-i
nthest
udyper
iod

nf
=ther
equi
redsampl
esi
zewhent
het
argetpopul
ati
onl
esst
han10,
000.

nf
=n/
1+n/
N

=384/
1+384/
1552=308

Al
though,
oursampl
ewas308wet
ookonl
y108whi
chwasgi
venbyoursuper
visordue
t
oshor
tageoft
imeandcost
.

So,
K=n/
N=14

4.
5.2Sampl
ingt
echni
queandpr
ocedur
es
Sy
stemat
icr
andom sampl
i
ngwasusedt
ogetsampl
edhousehol
dsf
rom t
het
otal
households.Usingsamplingfr
acti
on(K=14).Beforeenter
ingtodatacol
l
ecti
onwe
appli
edsurveyoft heKetenatogetthesamplingframe.Afterget
ti
ngthesampl
ing
framethef i
rsthousewasobtainedbylott
erymet hodthenweappl i
edsyst
emat
ic
random sampl i
ngmet hodtogeteachhousehold.

4.
6St
udyVar
iabl
es
4.
6.1.DependentVar
iabl
es:
 Pl
aceofdel
i
ver
y

 Ut
il
izat
ionofANC

 Knowl
edgeofANC

 Ut
il
izat
ionoff
ami
l
ypl
anni
ng

10|Page
  Knowl
edgeoff
ami
l
ypl
anni
ng

 Br
eastf
eedi
ngdur
ati
on

 Nut
ri
ti
onal
stat
us

4.
6.2.I
ndependentVar
iabl
es:
 Sex

 Age

 Et
hni
ci
ty

 Rel
i
gion

 Sour
ceofi
nfor
mat
ion

 Fami
l
yincome

 Educat
ionst
atus

 Occupat
ional
stat
us

 Fami
l
ysi
ze

4.
7Oper
ati
onal
def
ini
ti
on:
Heal
thr
elat
edpr
obl
ems:Thepr
obl
em t
hatar
isesandaf
fectt
hecommuni
ty.

Adequat
e:Repr
oduct
iveagedWomengetatl
eastt
woheal
thser
vicesf
rom heal
th
i
nst
it
uti
onwhi
chi
sneart
othesoci
etysuchas(
fami
l
ypl
anni
ngser
vices,
ant
enat
alcar
e
ser
vices,post
par
tum car
eser
vices,TTandchi
l
dimmuni
zat
ion,t
est
ingandcounsel
i
ng
aboutHI
Vandl
i
ke)

I
nadequat
e:get
ti
ngoneornoneoft
heheal
thser
vicessuchas(
fami
l
ypl
anni
ngser
vices,
ant
enat
alcar
eser
vices,post
par
tum car
eser
vices,TTandchi
l
dimmuni
zat
ion,t
est
ing
andcounsel
i
ngaboutHI
Vandl
i
ke

 Monthl
yincome-donebasedonEthiopi
angovernmentempl
oyermonthl
ysal
ary
st
andar
dandt hi
siscalcul
atedbychangi
ngthei
rit
em ofpr
oduct
ioni
nt omoney

11|Page
 accor
dingt
ocur
rentmar
ketpr
ice.

 Vent
il
ati
on:

 Good-ahousewhi
chhasoneormor
ewi
ndowsf
orr
oom whi
char
e
funct
ional
.

 Fai
r-
ahousei
nwhi
chhasonewi
ndowbutf
unct
ionpar
ti
all
y

 Bad-nowi
ndoworcl
osedal
lthet
ime/
nonf
unct
ional
.

 I
ll
umi
nat
ion

 Good–ahouseinwhi
chl
ead/
penci
lwr
it
tenmat
eri
alscanber
ead
bynat
ural
li
ght
.

 Fair
-ahousei
nwhi
chi
nkwr
it
tenmat
eri
alscanber
eadbynat
ural
l
ight.

 Bad-
inkwr
it
tenmat
eri
ali
sil
l
egi
ble

 Needofmai
ntenance

 Good-
nosi
gnofdet
eri
orat
ionandt
hehousei
ser
ect
.

 Fai
r-
signofdet
eri
orat
ionbuter
ect
.

 Bad–det
eri
orat
edandnoter
ect
.

 Stakehol
ders:areindivi
dualswho ar
eaccept edaswellasrespect
edi
nthe
communi t
yliker
eli
giousleader
s,admi
nist
rat
ivebodi
es,
andel
der
s.

4.
8.Dat
acol
lect
ionTool
:
Dat
awer
ecol
l
ect
edusi
ngsemi
-st
ruct
uredandani
nter
viewergui
dedquest
ionnai
reand
i
ncl
udi
ngobser
vat
iont
oident
if
yheal
thandheal
thr
elat
edpr
obl
emsamongr
esi
dent
sof
Ket
ena03.
Thei
nst
rumentwaspr
epar
edi
nEngl
i
shandt
ransl
atedi
ntoAmhar
ic.The
i
nst
rument
scompr
isesoci
odemogr
aphi
cchar
act
eri
sti
cs(
age,sex,educat
ionall
evel
,
et
hni
cit
y,r
eli
gion,i
ncome,andoccupat
ion)
,mor
tal
i
tyandmor
bidi
tyf
act
ors,nut
ri
ti
on
r
elat
edf
act
ors,
mat
ernal
andchi
l
drel
atedf
act
orsheal
thser
vicer
elat
edf
act
ors.

4.
8.1Mat
eri
alused
 Quest
ioner

 Penci
l

12|Page
  Shar
pener

 Pen

 Chal
k

 Rul
er

 Cal
cul
ator

 Paper
s

 Lapt
op

4.
9.Dat
acol
lect
ionPr
ocedur
e:
Thedatawascol l
ect
edbyteam membershav
ingstandardi
zedandstr
uctur
ed
questi
oner
,team membersusedint
erv
iew,
guidedquesti
onersandobser
vati
onal
techni
quetogatheri
nfor
mati
onfrom t
hecommunityofKetena03.

4.
10.Dat
aqual
it
yassur
ance:
Tokeepqual
i
tyofdat
a,t
het
eam member
sdi
scussedoneachandev
eryi
temsoft
he
quest
ionnai
res. Sel
ect
ion of househol
ds dur
ing sampl
i
ng was t
ri
ed t
o keep
r
andomi
zat
ion.Dur
ing dat
a col
l
ect
ion super
visi
on by assi
gned super
visor was
under
takeni
nor
dert
osol
veanypr
obl
em t
hatmi
ghtar
isedur
ingdat
acol
l
ect
ion.Af
ter
dat
acol
l
ect
iondat
awasseenf
orcompl
etenessandedi
tedbef
orei
tisbei
ngt
all
i
ed.

4.
11.Dat
apr
ocessi
ngandanal
yzi
ng:
Thecompl etedquestionnair
eswer echeckedforcompl etenessandconsi stency.Data
cl
eaningwasper f
ormedt ocheckf oraccuracy
,andconsi stenci
esstarti
ngf rom t
heday
ofdatacoll
ect i
on.Dataanaly siswasper f
ormedusi ngdescr i
pti
vestati
sticsand
fr
equencyt ables(tal
ly,or
gani ze,andcategori
ze)aftercl
eaning,edi
ting,andcodi ng.The
hi
ghestproblem wasi dentif
iedbyr ankingthehigherpercentageasdueconsi derati
on
andconsideringdescripti
vest ati
sti
cs.Datawasanal yzedbygr oupmember s,by
prepar
ingtallysheet,
conv er
tingittofrequencythent opercentage,
scient i
fi
ccalculator
andwor
dExcel
wer
eal
sousedt
oanal
yzeanddr aphs.
awgr

4.
12.Et
hicalconsi
der
ati
on:
Forl
egal
i
tyoft
hest
udy
,of
fi
ciall
ett
erwassecur
edf
rom MCM whi
chcancl
ari
fyt
he

13|Page
st
udypur
poset
oconcer
nedaut
hor
it
ies.Respondent
swer
eint
roducedaboutt
hest
udy
bydat
acol
l
ect
orsbef
oret
heywer
erecr
uit
edi
nthest
udy
.Inf
ormedconsentwassought
bef
orecl
i
ent
sar
eassur
edt
opar
ti
cipat
ioni
nthest
udy
.Dur
ingdat
acol
l
ect
ionpr
ivacyof
r
espondent
swaskeptt
opossi
bleext
entt
opr
eventanyassumpt
ionofr
espondent
sthat
hi
s/herpr
ivacyi
sbei
ngv
iol
ated.

4.
13.Di
ssemi
nat
ionofr
esul
ts
Thi
sCBTPwor kwil
lbepresent
edusingPower
Pointandeveryi
nter
est
edpeopl
ewil
lbe
i
nvit
edonpr esent
ati
on.Alsothedocumentwil
lbesubmi t
tedtoMCM depart
mentof
publ
icheal
thandKetena03admini
str
ati
onandhealt
hoffi
ceoftheAssosat
own.

CHAPTERFIVE:RESULTS
5.
1Socio-
Demographi
cchar
act
eri
sti
cs:
Thest
udywasconduct
edon108HHsand92.
4%(100)wast
her
esponser
ate.The
r
easonf
ornoner
esponsewer
ecl
osedhousesdur
ingt
hreev
isi
t[4]
,l
anguagebar
ri
er[
3]
andduet
oref
usal
[1]
.Ther
ear
e538peopl
einoursampl
edhousehol
ds,
from t
he
sampl
edhousehol
ds(
255)47.
4%wer
emal
es,
(283)52.
6%wer
efemal
es.Outof538
househol
dspopul
ati
on(
47)8.
7%wer
eunderf
iveage,
(195)36.
2%wer
eaged5-
14,
(247)

14|Page
45.
9%wer
eage15-
59,
(21)15.
12%wer
eage>50.

Table1 Soci o-Demogr

aphicchar
act
eri
sti
csofhousehol
dsofAssosat
ownwor
eda2
Ketena3Assosatown,west
ernEthi
opi
a,2014
Var
iabl
es Opt
ions No % Remar
k

Sex Mal
e 255 47.
4

Femal
e 283 52.
6

Tot
al 538 100

Age <1m 3 0.
56

<1y
r 25 4.
6

<5y
r 47 8.
7

5-
14y
r 195 36.
2

15 122 22.
7
-
49y
r Mal
e

Femal
e 125 23.
2

>50y
r 21 3.
9

Et
hni
cit
y Amhar
a 42 42

Or
omo 32 32

Shi
nasha 8 8

Ber
ta 9 9

Ot
her
s 9 9

Rel
i
gion Or
thodox 45 45

Pr
otest
ant 20 20

Musl
i
m 34 30

Ot
her
s 5 5

15|Page
Educat
ionst
atus Can’
treadandwr
it
e 20 20

Canr
eadonl
y 22 22

Pr
imar
y 23 23

Secondar
yandabov
e 35 35

Mar
it
alst
atus Mar
ri
ed 78 78

Si
ngl
e 9 9

Di
vor
ced 8 8

Wi
dowed 5 5

Far
mer 0 0
Occupat
ional
stat
us
Housewi
fe’
s 33 33

St
udent
s 15 15

Gov
ernmentempl
oyer 22 22

Mer
chant
s 13 13

Tel
l
asel
l
er 7 7

Car
pent
er 0 0

Unempl
oyed 0 0

Ot
her
s 10 10

5.
2Meansofcommuni
cat
ion
Among100househol
ds,
themaj
ori
tyof49(
49%)oft
hesampl
edhousehol
dst
endt
o
possesst
elephonewhi
l
e20(
20%)t
endt
opossessr
adi
oand31%possesst
endst
oT

16|Page
Fi
gur
e2:
thatshowsmeanscommuni
cat
ioni
nKet
ena3

5.
3Fami
lyi
ncomes
Among100households5(5%)househol
dsear
nlesst
han4000bi
rri
nay ear
,and8(8%)
househol
dsearnbet
weentheinter
val
s4000and8000and87(
87%)householdsf
amily
haveannual
incomeabove8000Birr.

Fi
g03annual
incomeoft
hehousehol
dsi
nKet
ena03.

5.
4Vital
stat
ist
ics
5.
4.1Chi
ldBi
rth
Among100HHs,t
her
ewasbi
rt
hin28(
28%)HHsi
nthel
ast12mont
hsf
rom whi
ch12

17|Page
(
42.
85%)and16(
57.
14%)oft
hem wer
emal
eandf
emal
eli
vebi
rt
hrespect
ivel
y.Among
t
otalof28bi
rt
hs,96.
428%(27)and3.
57% (
1)ofwomengav
ebi
rt
hatHIandhome
r
espect
ivel
yfr
om whi
ch3.
57%(1)and96.
42%(27)wer
eat
tendedbyTTBAsand
pr
ofessi
onal
srespect
ivel
y.

Tabl
e2:Chi
ldbi
rthst
atusamonghousehol
dsofKet
ena03wor
eda2,
Assosazone,
west
ernEt
hiopi
a2014

Var
iabl
es Opt
ions Number % Remar
k

Was t
her
e Bi
rt
hin Yes 28 28
t
hel
ast12mont
hs?
No 72 72

St
atusoft
hebi
rt
h Al
i
ve 28 100

dead 0 0

Sexoft
henewbor
n Mal
e 12 42.
85

Femal
e 16 57.
14

Pl
aceofdel
i
ver
y Home 1 3.
57

HI 27 96.
428

At
tendant of t
he TTBA 1 3.
57
del
i
ver
y
HP 27 96.
428

18|Page
Fi
gur
e04showsbi
rt
hat
tendanti
nKet
ena03

5.
4.2DEATH
Outof100househol
ds,
ther
ewasdeat
hin5(
5%)househol
ds.Fr
om t
otalof3deat
h,60
%)wer
emal
esand40%(
2)wer
efemal
es.

Table03thatshowsdeathoccurrencesamongHHsi
nthel
ast12mont
hsofKet
ena3,
wor
eda2
Assosatown,wester
nEthiopi
a,2014E.C

Deat
h Opt
ions Number % Remar
k

Yes 5 5

No 95 95

Sex at Mal
e 3 60
deat
h
Femal
e 2 40

Age at <5y
ear
s 2 40
deat
h
5-
14y
ear
s 0 0

15-
49y
ear
s 2 40

19|Page
 >50y
ear
s 1 20

5.
4.3Mor
bidi
ty
Fr
om among100HHsst
udi
ed,t
her
ewer
emor
bidi
tyi
n22(
22%)HHsi
nthel
astt
wo
weeks;amongt
hose14(
63.
6%)and8(
46.
4%)wer
emal
eandf
emal
erespect
ivel
y.
Accor
dingt
othest
udyatagegr
oupwhof
acedmor
bidi
tywer
eagegr
oupof15-
49,
(
52.
63%)
.

Tables4thatshowmorbidi
tyamongHHsi
nthel
ast2weeksofKet
ena3,
wor
eda2Assosa
town,wester
nEthi
opi
a,2014E.C

Var
iabl
es Opt
ions Number % Remar
k

Mor
bidi
ty Yes 22 22

No 78 78

Sexofsi
ck M 14 63.
6

F 8 46.
4

<5y
ear 5 22.
7
Age
5-
14 4 18.
18

15-
49 10 45.
45

>50 3 13.
6

Ai
l
ment
s Fev
er 8 36.
36

Di
arr
hea 4 18.18

Cough 7 31.
8

Ot
her 3 13.
6

Day
slost <7day
s 13 59.
1

20|Page
 7-
14day
s 9 40.
9

Seekhel
p? Yes 15 68.
2

No 7 31.
8

HI 15 68.
2

Seekhel
pwher
e? Tr
adi
ti
onal 3 13.
6

Home 4 18.
18

5.
5Repr
oduct
ivehi
stor
yofr
espondent
Fr
om 100HHS,maj
ori
tyofthem concei
vedi
nthepast88%[
88]andAgeatf
ir
st
pr
egnancy15-
24ar
e62[62%].
Tabl
es05t
hatshowsr
epr
oduct
ivehi
stor
yofr
espondent
s

Var
iabl
es Opt
ion Number % Remar
k

Concei
vedi
npast Yes 88 88

No 12 12

Ageatfi
rst 15-
24 62 62
pr
egnancy
25-
34 38 38

Numberof One 22 25
gr
avi
dit
y
Two 24 27.
3

Threeand 42 47.
7
above
I
sthelast Yes 80 90.
9
pr
egnancyis

21|Page
pl
anned No 8 9.
1

Di
dyougi
vebi
rt
h Yes 85 96.
6
i
napast
No 3 3.
4

Numberofchi
l
d One 20 22.
7
Two 23 26.
1

Threeand 42 47.
7
above
None 3 3.
4
Numberofal
i
ve Zer
o 3 3.
4
chi
l
d
One 20 22.
7

Two 23 26.
1

Threeand 42 47.
7
above
St
il
lbi
rt
h Yes 2 2.
3
No 86 97.
7
Hearaboutbr
east Yes 72 72
cancer
No 28 28

Didyouknow Yes 32 44.

44
aboutbreast
cancerprevent
ion
No 40 65.
6

Didyouhearabout Yes 82 82
cerv
ical
cancer
No 18 18

Didyouknowri
sk Unsaf esexual 19 21.
5
fact
orsf
orcer
vical i
ntercourse
CA
Multi
plesexual 24 29.
3
part
ner

22|Page
 Ot
her 39 47.
6
Didy ounow Yes 60 73.
2
screeningtestfor
cervi
cal cancer No 22 26.
8

5.6Fami
l
yplanni
ng
Among100househol
ds,
(89)89%househol
dsknowaboutf
ami
l
ypl
anni
ng
and(
11)11%househol
dsdonotknowaboutf
ami
l
ypl
anni
ng.

Tabl
es06;thatshowsFP t
rendsofr
espondent
sint
heKet
ena03,wor
eda2Assosat
own,
west
ernEthi
opia,
2014E.
C

Var
iabl
e Opt
ions No % Remar
k

Hear about Yes 89 89

f
ami
l
y pl
anni
ng
No 11 11
met
hod

Sour
ce of Heal
thcar
ePr
ovi
der 60 67.
4
i
nfor
mat
ion

Massmedi
a 18 20.
22

Fr
iends 9 10.
1

Ot
her
/speci
fy 0 0

Notknow wher
ethey 2 2.
24
hear

Knowi
ngt
ypeof Pi
l
ls(
COCt
abl
et 43 48.
3
f
ami
l
y pl
anni
ng
met
hod
Depot 20 22.
5

I
mpl
ant 9 10.
11

Condom 2 2.
25

23|Page
 I
UCD 6 6.
7

Ot
her 9 10.
11

Women usi
ng Yes 80 80
cur
rent
ly
No 20 20
cont
racept
ive

Fami
l
y pl
anni
ng Pi
l
ls 38 42.
7
met
hodt
heyar
e
Depot
/i
nject
abl
e 18 22.
5
cur
rent
lyusi
ng
I
mpl
ant 9 11.
25

Condom 2 2.
5

I
UCD 4 5

Ot
her 9 11.
25

Wher
e do y
ou Heal
thf
aci
l
ity 75 93.
75
getf
rom
Pr
ivat
ecl
i
nic 5 6.
25

5.
7Nut
ri
ti
onal
assessment
Fr
om t
het
otalof100HHs,
inal
lsampl
edHHSI
njer
aisusedasst
apl
efood.Outof100
HHs,Br
ead95%(95)
.Maj
ori
tyofHHs,82%(
82)eatt
hreet
imesdai
l
yandi
nal
lHHs
t
her
ewasnodeat
hduet
olackoff
ood.

Tabl
e7thatshowHHSnut
ri
ti
oni
nthel
ast12mont
hsofKet
ena3,
wor
eda2Assosazone,
west
ernEt
hiopi
a,2014

Var
iabl
es Opt
ions Number %

St
apl
efood I
njer
a 100 100

Br
ead 95 95

Veget
abl
esandf
rui
ts 88 88

Ot
her 30 30

24|Page
 Do y
ou get di
ary Yes 80 80
f
ood
No 20 20

Doyouget Yes 100 100

car
bohy
drat
e
No 0 0

Dai
l
ynumberof Onet
imes 0 0
meal
Twot
imes 8 8

Thr
eet
imes 82 82

Fourt
imes 6 6

Ot
her 4 4

Deat
hduet
olackof Yes 0 0
f
ood
No 100 100

5.
7.2Chi
l
dnut
ri
ti
on
Amongt
het
otalof88HHs,
85(
96.
6%)hadbr
eastf
edt
hechi
l
d.82(
93.
18%)and3(
3.4%)
wer
ethechi
l
dwhi
chr
ecei
vedandnotr
ecei
vedsuppl
ement
aryf
oodi
nbr
eastf
eedchi
l
d
r
espect
ivel
y.

Tabl
e08:
Chi
l
dnut
ri
ti
oni
nofKet
ena3,
wor
eda2Assosazone,
west
ernEt
hiopi
a,2014

Var
iabl
es Opt
ions No % Remar
k

Br
eastf
eedt
hechi
l
d Yes 85 96.
6

No 3 3.
4

Child r
eceiv
e Yes 82 93.
18
supplement
aryfood
No 6 6.
82

Age atwhi ch t
hey <4mont
hs 4 4.
9
startsuppl
ementar
y
feeding 4-
6months 56 68.
3

7-
12mont
hs 13 15.
9

Af
ter12mont
hs 7 8.
54

Dur
ati
ont
hekeepon <6mont
hs 9 10.
9

25|Page
br
eastf
eedi
ng 6-
12mont
hs 66 77.
64

>12mont
hs 8 9.
4

Ot
her
s 4 4.
7

Fr
equencyt
hey Whenthechi
l
dwant 20 76.
5
br
eastfeed
Gr
eatert
han8ti
mes 65 23.
5

Combinat
ionoff
ood Foodmadeofcer
eal
onl
y 2 2.
44
they use to f
eed
chil
d Mil
kal
one 10 12.
2

Mi
l
kandcer
ealcombi
ned 70 85.
4

5.
8Envi
ronmentalheal
thsur
vey
5.
8.1Wastedi
sposal
Among100HHs,foral
mostal
lHHsmaj
orsour
ceofwast
ewasdomest
ic,
25(
25%)had
schedul
edpr
ogr
am tocol
l
ect.
Table10:wastedisposalchar
act
eri
sti
csofhousehol
dsofKet
ena03i
nwor
eda02,
Assosa
town,westernEthiopi
a,2014

Var
iabl
es Opt
ions No % Remar
k
(
n=100HH)
Sour
ceofwast
e Resi
dent
ial 95 95
Commer
cial 5 5
Schedul
epr
ogr
am t
ocol
l
ect Yes 25 25
waste
No 75 75
Di
sposal
met
hod Compost
ing 5 5
Bur
ning 45 45
Opendumpi
ng 42 42
Sani
tar
y 8 8
Tot
al 100 100
Pr
esenceofl
atr
ine Yes 88 88
No 12 12

26|Page
 Tot
al 100 100
Dist
anceofl
atr
inef
rom t
he <10m 45 51.
13
house
11-
15m 25 28.
4
>15 10 11.
4
Tot
al 88 88
Owner
shi
pst
atusoft
hel
atr
ine Owned 24 24
Shar
ed 64 64
Tot
al 88 88
Fornon-
lat
ri
neuser
s(n=7) Yes 12 80
Avai
l
abili
tyofadequat
e No 3 20
spaceforconstr
ucti
on
Tot
al 15 100
Aff
ordabi
li
tyofl
atr
ine Yes 3 25
const
ruct
ion
No 9 75
Tot
al 12 100
Wastedi
sposal
syst
em of Cl
osed 59 100
l
atr
ine

5.
8.2Wat
ersuppl
y
From 100HHs, 95(95%)ofthem gotthei
rwat ersuppl
yfrom t
apwaterand5( 5)gotthei
r
wat ersuppl
yfrom stream.From tapwaterusersnooneempl oyanymet hodofwat er
purifi
cati
on,f
rom st r
eam waterusersonl
y1( 20%)employtradi
ti
onalf
il
tr
at i
onmet hods
ofwat erpur
ifi
cationand4(80%)di dn’
temployanymet hodofwaterpuri
ficat
ionofthe
total59%HHsconsumed20- 40and41%consumedmor ethan40lit
erperday .

Table11:
Wat
ersuppl
yofket
ene3househol
dsi
nwor
eda2,
Assosazone,
West
ernEt
hiopi
a,
2014.

Var
iabl
es Opt
ions No % Remar
k
Sour
ceofwat
ersuppl
y Tap 95 95
St
ream 5 5

27|Page
 Tot
al 100 100
Wat
erpur
if
icat
ion Yes 1 1
No 4 4
Tot
al 100 100
I
fyes(n=1)methodof Tradi
ti
onal 1 100
waterpur
if
icat
ion fi
l
trat
ion
Tot
al 1 100
Dail
ywater 20-
40l
i
t 65 65
consumpti
onperl
i
tter
>40 35 35
perHHs
Tot
al 100 100
.

5.
8.3Housi
ngcondi
ti
ons
Outof100HHs,(
30%),(30%)and(45%)househadgodv
ent
il
ated,
cleanedand
adequat
elyi
l
lumi
natedhouserespect
ivel
y.
Tabl
e12:
Housi
ngcondi
ti
onofket
ene3i
nwor
eda2,
Assosazone,
West
ernEt
hiopi
a,2014.

Var
iabl
es Opt
ion No % Remar
k
Noofr
ooms 1 50 50
2 30 30
3 20 20
Vent
il
ati
on Good 30 30
Fai
r 50 50
Bad 20 20
I
ll
umi
nat
ion Adequat
e 45 45
I
nadequat
e 55 55
Cl
eanness Good 30 30
Fai
r 50 50
Bad 20 20
Ty
peoff
loor Cement 75 75

28|Page
 Soi
l 25 25
Cr
ackont
hef
loor Yes 25 25
No 75 75
Ty
peofki
tchen Separat
edroom butat
tached 35 35
totheli
vi
ngroom
Separatedki
tchenbut 55 55
detachedtotheli
vi
ngroom
Noki
tchenatal
l 10 10

6.DI
SCUSSI
ON
Thet
otalpopul
ati
oni
nthi
sst
udywer
e538andf
rom,
thosepopul
ati
on255(
47.
4%)and
283(
52.
6%)ar
e mal
es and f
emal
es r
espect
ivel
y.The mean f
ami
l
y si
ze oft
he
househol
dsi
s538/
100=5.
4member
sHHswhi
chi
sgr
eat
ert
hant
her
egi
onalmean
f
ami
l
ysi
ze(
4.9member
/HH)
.Fr
om 100HHsmember
sonav
erage270(
50.
2%)ar
e
chi
l
dren age bel
l
ow 15y
rs whi
ch i
sless when compar
ed t
o Et
hiopi
an househol
d
consi
stsofanav
erage46%oft
hepeopl
ear
echi
l
dren.

Onnut
ri
ti
onalassessmentourf
indi
ngshowst
hatf
rom 88HHs,85(
96.
6%)oft
he
mot
her
shadbr
east
feedt
hei
rchi
l
dwher
easEDHs2011showst
hati
nEt
hiopi
a98%of
chi
l
drenev
erbr
eastf
eed.Fr
om t
hose82(
93.
2%)st
art
ssuppl
ement
aryf
eedi
ngandf
rom
t
hosechi
l
dwhost
art
ssuppl
ement
aryf
eedi
ng56(
68.
2%)st
art
sbet
ween4-
6mont
hst
his
i
sgr
eat
ert
hant
hatofEDHs2011showst
hat10%ofi
nfantunder6th mont
hs’r
ecei
ve
suppl
ement
aryf
eedi
ng .
Great
ert
han hal
fmot
her
skeepst
hei
rchi
l
dren on br
east
-
f
eedi
nggr
eat
ert
han12mont
hs’
andt
heyf
eedmor
ethan8xaday
,wher
easEDHs2011
showst
hatonav
eragechi
l
drenBr
estf
eedunt
ilageof25mont
hs.

29|Page
Ourf
indi
ngonknowl
edgeofFPshowst
hat89(
89.
%)ofwomenknow atl
eastone
moder
nFPmet
hodsandwhi
chi
slow whencompar
edt
o EDHS2011f
oundst
hati
n
Et
hiopi
aknowl
edge’
sofFPi
snear
lyuni
ver
sal
,97%ofal
lwomenage15-
49knowsat
l
eastonemoder
n met
hodsofFP.Thesour
ceoft
hei
r knowl
edgear
eheal
thcar
e
pr
ovi
der
sandmedi
athi
sissi
mil
arwhencompar
edwi
thEDHs2011showst
hatHeal
th
car
epr
ovi
der
s,medi
aandot
hersour
ceofi
nfor
mat
ioni
ncr
easet
heawar
enessoft
he
publ
i
caboutFPmet
hods.WomenwhouseFPMet
hodscur
rent
lyaccount
s80(
80%)of
womencur
rent
lyut
il
izemoder
n FPmet
hodswhi
chi
shi
ghwhencompar
edt
oEDHs
2011showst
hat27%ofwomencur
rent
lyi
nEt
hiopi
ausemoder
nmet
hodsofFP.

7.I
denti
fi
edproblems andact
ionpl
an
7.1Identi
fi
edproblems
1.Lackofawar
enessaboutbr
eastcancerandcer
vical
cancer

2.I
nappr
opr
iat
eti
meofst
art
ingsuppl
ement
aryf
eed

3.Awar
enessofut
il
izat
ionoff
ami
l
ypl
anni
ng

4.Pooraccessofwat
er

5.Poorki
tchen

6.Lackofl
atr
inef
aci
l
ity

7.Opendumpi
ngasf
inal
wast
edi
sposal
met
hod

Tabl
e13showi
ngPr
ior
it
izat
ionofi
dent
if
iedpr
obl
ems

30|Page
No Pr
obl
em Magni
tud Sev
eri
ty Feasi
bil
i
t Communi
t Gov
ernme Tot
al Rank
e y yconcer
n ntconcer
n

1 Lack of 4 3 4 4 5 20 2
awar
eness
about
br
east
cancer and
cer
vical
cancer

2. Poor 3 4 1 5 2 15 4
access of
wat
er

3. I
nappr
opr
iat 5 5 3 2 5 20 2
e t
ime of
st
art
ing
suppl
ement
ar
yfeed.

4. Awar
eness 4 3 4 3 5 19 3
of
ut
il
izat
ion
of f
ami
l
y
pl
anni
ng

5. Poor 4 5 3 1 1 14 5
ki
tchen

6. Lack of 2 2 4 1 4 13 6
l
atr
ine
f
aci
l
ity

31|Page
7. Open 3 3 2 2 2 12 7
dumpi
ngas
f
inal wast
e
di
sposal
met
hod

Pr
ior
it
izedpr
obl
ems

1.Lackofawar
enessaboutbr
eastcancerandcer
vical
cancer

2.I
nappr
opr
iat
eti
meofst
art
ingsuppl
ement
aryf
eed

3. Awar
enessofut
il
izat
ionoff
ami
l
ypl
anni
ng

4.Pooraccessofwat
er

7.
2Act
ionpl
an
Tabl
e14;
showi
ngt
heAct
ionpl
andev
elopedf
orpr
ior
it
izedpr
obl
ems

No. Pr
ior
it
ized Obj
ect
ives Act
ivi
ti
es St
rat
egi
es Tar
get Responsi
ble
pr
obl
em popul
ati
on body

1. Lack of i
ncr
ease of Di
scussi
ng Teachi
ng Al
l -
wor
eda
awar
eness awar
eness of t
he about women about r
epr
oduct
ive admi
n. And
about br
east women about br
eastcancer br
eastcancer age women heal
thof
fi
ce
cancer and br
eastcancer and cer
vical and cer
vical ofKet
ena03
-
ket
ena
cer
vical and cer
vical cancer cancer
3heal
th
cancer cancer pr
event
ion
cent
er,
& head

32|Page
 met
hods and of
fi
ce
gener
al
3th y
earMCM
i
mpacti
fnot
HOst
udent
s
pr
event
ed

2. I
nappr
opr
iat
e To cr
eat
e Heal
th To gat
her Women of 3th y
ear HO
t
ime of awar
eness educat
ion women r
epr
oduct
ive st
udent
s &
st
art
ing among about ar
ound heal
th age gr
oup Heal
th
suppl
ement
ar women about suppl
ement
ar post and especi
all
y ext
ensi
on
yf
eedi
ng appr
opr
iat
e yf
eedi
ng t
eachi
ngt
hem who hav
e wor
ker
s
suppl
ement
ar about chi
l
dren
y f
ood suppl
ement
ar bel
owone.
i
nit
iat
ion yf
eedi
ng

3. Awar
enessof To i
ncr
ease Cr
eat
ing Gi
vi
ng heal
th Al
l Ket
ena3
ut
il
iz
ati
on of t
he ut
il
izat
ion awar
eness educat
ion t
o r
epr
oduct
ive Wor
eda2
f
ami
l
y of f
ami
l
y about t
he al
l agewomen’
s admi
nist
rat
ion
pl
anni
ng pl
anni
ngf
rom i
mpor
tanceof r
epr
oduct
ive andmen’
s.
-
heal
th cent
er
80%t
o95%. f
ami
l
y age women’
s
& heal
th post
pl
anni
ng, andmen’
s.
of
fi
ce
especi
all
y
l
ong act
ing -
Ket
ena 3
f
ami
l
y wor
eda 2
pl
anni
ng headof
fi
ce.
met
hod.

4 Poor wat
er To ensur
e Di
scussi
ng Di
scussi
ng Ket
ena 3rd y
earPHO
access sust
ainabl
e bout pur
e bout t
he admi
nist
rat
iv St
udent
s,
access t
o wat
eraccess gener
al e, r
esi
dent
s, Ket
ena
pur
ewat
er benef
it of NGOs admi
nist
rat
ive
get
ti
ng pur
e , r
esi
dent
s,
wat
er wi
th NGOs
di
ff
erent

33|Page
 st
ake hol
der
s
i
ncl
udi
ng
NGOs and
wi
th t
he
soci
ety

8.Concl
usi
onandr
ecommendat
ion
8.1.Concl
usi
on
From thetot
alpopulati
onmajori
tyoft
hepeople270(50.
2%)iscomposedofagegroup
below15y earsandthesexrati
ooffemalet
omal ei
s1.11.Theaver
agefamil
ysizeof
theHHswer e5. 4members/househol
ds.Major
it
yofpeopl
eareAmharaandfoll
owers
oforthodoxrel
igion.
General
lybasedonourst udy,l
ackofawarenessonbr eastcancerandcervi
calcancer,
i
nappropri
atetimeofstarti
ngsupplementar
yf eed,
Awar enessofuti
li
zat
ionoffamily
pl
anning,Pooraccessofwat er
.Theref
ore,i
tisworthytoprior
it
izeandtacklet
hese
pr
oblemssi ncetheyhavesigni
fi
canteff
ectunlesstheyaresolvedasearlyaspossibl
e
bycoll
aborati
ngwi t
htheconcernedbodies.

34|Page
Pr
obl
emsencount
ered
Languagebar
ri
er
Absent
eei
sm ofHHs
Shor
tageoft
ime
Nonpunct
ual
i
tyofgover
nmentwor
ker
soft
hest
udyar
ea

Sol
uti
onsat
tempt
ed
Tr
ansl
atori
nvi
ted
Rev
isi
ti
ng

8.
2Recommendat
ions
Togov
ernmentof
fi
cial
s

 I
tisbet
teri
f,wor
koni
mpr
ovi
ngmat
ernaleducat
ion,ext
ensi
veheal
theducat
ion
onMat
ernal
andchi
l
dheal
th

 Toest
abl
i
shaf
for
dabl
eheal
thser
vice

 Towor
konel
i
minat
ebar
ri
erf
ornotusi
ngFPmet
hodsuchasf
ear
,si
deef
fect
andot
her

 Toi
ncr
easeori
mpr
ovenumberofv
isi
tdur
ingANC

 Toi
ncr
easeknowl
edgeconcer
ningsaf
erorpr
efer
abl
epl
acet
ogi
vebi
rt
h

ToMCM

 I
tisbet
teri
f;

 Tomakef
urt
heri
nvest
igat
ioni
nket
ene3

 Towor
kincol
l
abor
ati
onwi
tht
hecommuni
ty.

Tot
hecommuni
ty;

Par
ti
cipat
ingandcooper
ati
oni
nact
ioni
mpl
ement
edbyadmi
nist
rat
orsbycont
ri
but
ing
money
,knowl
edge,
andl
abor
.

35|Page
9.REFERENCE

1. Et
hiopi
aDemogr
aphi
candHeal
thSur
vey2011Cent
ral
Stat
ist
ical
AgencyAddi
s
Ababa,
Ethi
opi
aICFi
nter
nat
ional
Cal
ver
ton,
Mar
yland,
USAMar
ch2012

36|Page
2. Wor
kuAwoke,
Jemal
Muhammed,
Gedef
awAbej
e,I
nst
it
uti
onal
Del
i
ver
ySer
vice
Ut
il
izat
ioni
nWor
ldi
a,2014

3. Gel
awBK,
TegegneGT,
Bizuy
eYA,
AssessmentofCommuni
tyHeal
thandHeal
th
Rel
atedPr
obl
emsi
nDebr
eMar
kosTown,
EastGoj
j
am,
Ethi
opi
a,2013.

4. ht
tp;
//sapi
ens.
rev
es.
org/
130#.

5. Det
ermi
nant
sofmat
ernal
heal
thcar
eut
il
izat
ioni
nHol
etat
own,
cent
ral
Ethi
opi
a
Sci
enceJour
nal
ofPubl
i
cHeal
th.Vol
.1,
No.2Ki
distBi
rmet
a*,
Yohannes
Di
babaandDesal
egnWol
dey
ohannes

6.Et
hiopi
aDemogr
aphi
candHeal
thSur
vey2011Cent
ral
Stat
ist
ical
AgencyAddi
s
Ababa, Et
hiopi
aICFi
nter
nat
ional
Cal
ver
ton,
Mar
yland,
USA2014

7.St
ati
sti
cal
dat
arepor
tsofKet
ena03,
2014

37|Page