COLLEGE OF MEDICINE AND HEALTH SCIENCE

INSTITUTE OF PUBLIC HEALTH

DEPARTMENT OF ENVIRONMENTAL HEALTH

CBTP PHASE: ONE

BY GROUP 2

TITLE: ASSESSMENT OF COMMUNITY HEALTH AND HEALTH

RELATED PROBLEMS IN GONDAR TOWN, KEBELE 15, NORTH WEST

AMHARA REGION, ETHIOPIA, 2022

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 Group Members

Name ID

1. Belay Mengesha ------------------------------------------------------------------GUR/01178/12

2. Freweyni Zerihun ---------------------------------------------------------------GUR/02082/12
3. Habtamu Birhanu ---------------------------------------------------------------GUR/171235/12
4. Habtamu Mengstu ----------------------------------------------------------------GUR/01945/12
5. MohammedJunaid Hassen ------------------------------------------------------GUR/00534/12
6. Mohammed Yasin ---------------------------------------------------------------GUR/02160/12
7. Mohammed Tesfaye ------------------------------------------------------------GUR/171641/12
8. Tekalgn Fantahun ---------------------------------------------------------------GUR /00427/12
9. Yordanos Shimels --------------------------------------------------------------GUR/170943/12

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Acknowledgement 

First; we would like to thank GOD the Almighty who gave to us healthy and assist us and as
well as with us in all our activities. Then, we would like to thanks University of Gondar
College of Medicine and Health Science(CHMS), Specially we appreciate our department;
Environmental Health for giving us such interesting and motivational program to observe and
identify as well as put down action plan for the future. Also we would like to express our
sincerely and humble gratitude to our supervisors: -Mrs Mastewal and Mr. Dawit forgiving us
constructive ideas which makes our work easier and we would like to explicit our  special
thanks of gratitude to Mr. Eshetu for giving as CBTP phase one course.. Secondly, we would
like to thank the environmental health Staff workers and UoG transportation services. Thirdly,
we would like to thank   my group members and all classmates who helped us in accomplishing
the program and finally, we have a pleasant and grateful appreciation for Gebreal community for
their helpful and willing to give us truthful information at the time of our journey and interview.

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Acknowledgement………………………………………………………………… i
List of tables…..………………………………………………………………. iii
Abbreviations and Acronyms……………………………………….………… .iv
Abstract…....……………………………………….……………… v
1. Background ……………………………………………………………….…… 1
1.1 Introduction to CBTP………………………………………………………….…1
1.2. Justification of the problem ………………………………….….….…… 1
1.3 Statement of the problem……………………………………………….……... 2
1.4 Limitation of this study……………………………………………………….. 2
1.5 Significance of CBTP phase –One…………………………………….…….... 3
2. Objectives…………………………………………………………………….…… 3
2.1. General objective……………………………………………………….…...… .3
2.2. Specific objective……………………………………………………….……… 3
3. Methodology………………………………………………………………………. 4
3.1 The study area …........................... 4
3.2 Data sources and types………………………………………………….......……5
3.3 Sampling Techniques and Procedures……………………………….……......…5
3.4 Methods of data Collection …………………………………………………......5
3.5 Materials used during the study…..…………………………………………… 5
3.6 Data Analysis and Interpretation …………………………………………………5
4. Result…………………………………………………...... ………………………… 6
5. Discussion…………………………………………………………………………… 21
6. Problems identification and prioritization……………………………………………21
7. Conclusion…………………………………………………………………… 22
8. Recommendation………………………………………………………………… 22
9. Action plan……………………………………………………………………………22
10. Reference …... ……………………………………………………………………… 24

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List of tables page

Table 1: Age, gender and marital status of respondents --------------------------------------------------- 7

Table 2: sources of family income -----------------------------------------------------------------9

Table 3: Vital statistics of households in Gebreal kebele ---------------------------------------10

Table 4: Food taboos, staple food, common language and prevailing types of marriage -----11

Table 5: Services giving institution & their estimated distance from the Gebrel kebele -------12

Table 6: social services in the Gebrel kebele ------------------------------------------------------------------------12

Table 7: educational facilities --------------------------------------------------------------------------------------------12

Table 8: Family income of households in Gebrel kebele ------------------------------------------------------------13

Table 9: sources of water supply, method of water purification and average daily consumption of
water ----------------------------------------------------------------------------------------------------------14

Table 10: ventilation, illumination , clean lines and need of maintenance of the households ---------------15

Table 11: sources of waste, latrine facility and waste disposal methods ----------------------------16

Table 12: Housing conditions of the households, type of flour, crack on the flour, type of kitchen
------------------------------------------------------------------------------------------------------------------17

Table 13: food sanitation and preservation method ----------------------------------------------------18

Table 14: insect control and rode infestation methods in Gebreal kebele ---------------------------18

Table 15: Access to Radio, private TV, telephone and postal services of the households in
Gebreal kebele ---------------------------------------------------------------------------------------------19

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Acronym/Abbreviation

ANC: Antenatal care

CBE: Community Based Education

CBTP: Community Based Training Program

CDI: Community Directed Intervention

EDHS: Ethiopia Demographic Health Survey

EPI: Expanded Program of Immunization

HEP: Health Extension Program

HC: Health Center

HP: Health Post

IUCD: Intrauterine Contraceptive Device

MCH: Maternal and Child Health

MDG: Millennium Development Goal

ORS: Oral Rehydration Salt

PAB: Prevention at Birth

PMTCT: Prevention of Mother to Child Transmission

PNC: Postnatal Care

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Abstract/Summary:

Introduction: Community Based Training is an on-site training program tailored to an

employer’s specific hiring needs. The training takes place in the actual work area in the
workplace, and a professionally trained job coach is located on-site to provide additional support
in training. The study was conducted in kebele 15 Gondar town found in Amhara region, which
is located 749 km far away from Addis Ababa and 172 km away from Bihar Dar town. The
Administration has 8 sefer the kebele has 8551 population of these 4447 were female and 4104
male, its climate condition, woyna dega and had 45 government and private health institution.
The aim of the study was to assess the community health status and health related condition in
keble 15 Gondar town, North West, Amara Region Ethiopia, 2022.

Method: - Community based cross sectional survey conducted from 25/11/2022-19/12/2022 by

using interviewer administrative questioner and observation. The study conducted in urban
population kebele 15 Gondar Town.

Result: - The cross sectional descriptive study, 96.3% of household in the kebele had latrine
facility among this 50% of house do not have hand washing facility connected with latrine. In
our finding shortage of water is the main problem in the households.

Conclusion:- Most of the house hold in the Kebele had latrine constructed but most of them had
no hand washing facility connected with latrine and low coverage of solid and liquid waste
disposal system. There were also different problems like low water supply coverage’s, low
sanitation facilities, not enough transportation facility and postal services.

Key words: Gondar, kebele, latrine, sanitation, community health,

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1|Page
 Background

1.1 INTRODUCTION

Community Based Training Program is an on-site training program tailored to an employer’s

specific hiring needs. The training takes place in the actual work area in the workplace, and a
professionally trained job coach is located on-site to provide additional support in training [1].

CBTP (community based training program) is one parts of community based education ( CBE)
which is designed to train health science students, about community diagnosis to identify the
problems related to health in the community, it provide health science students to apply the
theoretical knowledge in to practical application[2].

Sustaining a healthy community is the goal of every part of the world. However, achieving this
goal requires careful planning and organized community members, health organizations,
academic institutions, and various government agencies. Although, in terms of education,
technology, health resources, and per capita purchasing power are higher in United States, it fails
to deliver the best health care at a reasonable cost. About 45 million (15.6%) US population is
not covered by health insurance [2].

The United States, which spends 16% of its GDP on health care, spends more on health care per
capita than any other industrialized country. For example, Switzerland and Germany (which
spend a relatively high percentage of their GDP on health care) each spend 11% of their GDP on
health care. [1].

Neglected populations living under poverty throughout the developing world are often heavily
burdened by communicable and non-communicable diseases, and are highly marginalized by the
health sector due to their limited access to health and social support services [3].

The population density and diversity of urban communities offers formidable challenges for
healthcare delivery. The constant mobility (within urban areas, rural–urban–rural cycles) further
complicates the delivery of appropriate health interventions. The current approaches and systems
in urban areas are unable to reach agreed-upon goals and targets (e.g., the MDGs, RBM, national
targets) [4].

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Without improved delivery of health services, the present obstacles – accessibility, affordability
and utilization of the health systems – will perpetuate disparities and likely increase the risk
factors, incidence and prevalence of treatable and manageable health conditions as the size of
vulnerable and marginalized urban populations grows.

Reduction in disease burden would enable these communities and groups to become more
economically active and, thereby, further reduce the socio-economic factors contributing to
disease occurrence. Achieving reduction in disease burden lies in ensuring available health
interventions reach at risk. Many simple, affordable and effective disease control measures have
had limited impact due to poor access especially by the poorer populations (urban and rural) and
inadequate community participation [5].

'Community Directed Interventions (CDI) for major health problems in Africa’ was found to be
effective and efficient thus providing overwhelming evidence for its use as a strategy in
delivering multiple interventions at the community level in rural Africa should be mandatory [6].
There is thus a need to test the feasibility, acceptability and effectiveness of the CDI strategy.
During 2011–12, the World Health Organization’s Special Programme for Research and
Training in Tropical Diseases (TDR) sponsored a multi-country situation analysis in four large
and medium-sized urban settings throughout Africa – including Ghana (Bolgatanga, Wa),
Liberia (Monrovia), Nigeria (Ibadan) and the Democratic Republic of Congo (Kinshasa) – to
explore the feasibility of the CDI approach in addressing multiple disease intervention in urban
communities [7].

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 1.1 Statement of the Problem

Ethiopia is one of the developing country in which most of its population (85%) mainly depends
on agricultures [8]. Different factors like lack of professional committee members, population
awareness about the problems of waste disposal, adequate and necessary medical equipment, in
accessible health facility and low health seek behavior leads to the community to have low health
status. Communicable disease, nutritional problems, maternal and child health problems are the
major challenging health care related problems in Ethiopia. Even though the sanitary coverage of
this zonal town was relatively higher, there is still lack of proper utilization of latrine [9].

The town municipality has attempted to manage the solid and liquid waste by converting in to
compost for agricultural activities. Although the above measure has been taken, there is a
problem in collection, transportation, and disposal of wastes on time as a result this the
community is exposed to different communicable disease.

1.2 Justification of the Study

As most of health related problems in Ethiopia are preventable, community health assessment is
an important tool to identify health status, health related problems, and factors that could affect
the society’s health.

Governmental and non-governmental institutions to solve the community health related problems
could use the result of this survey. This study can also be used as a base line data for further
study.

1.4. Limitation of the study

There are many limitations & challenges during this program in the study area. We are
challenged in many ways during the time of our journey and at the time of work. These contests
influence us from the program perfect implementation are:

The study was limited on small number of household

Absence of homeowner from the surrounding or from the home
The residents or community house is far apart from the straight road
Shortage of resource and finance (this is critical things to the area)

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 In case of shortage of time we are unable to get enough and required information from
community as well as CTC (community training center).
Even if there is road (not constructed from asphalt and cement), it is not comfortable for
vehicles to move on and it is uncomfortable for human.

1.5. Significance of the CBTP phase -one

CBTP Phase - I involves Problem identification, analyzing, planning to eradicate the identified
problems, advocate possible solutions for intervention.

Both students and the community are benefited from this program. It helps to identify the
problems of the communities on sanitation facilities, water accessibilities and to jot down
something’s which is assumed as the solution. In addition, it helps the students to be a good
communicator and to be problem identifier and problem solver.

 It helps the communities: To tell their problems and they can ask solutions for their
problem, to get scientific knowledge from students in addition to their indigenous
knowledge on waste management activity.
 It helps the students in; identifying the problems related to water accessibility from
community, it helps to obtain preferable knowledge about theoretical session from
practical session, searching the ways to find the possible solution for the identified
problems.

2. Objective OF Study

2.1 General Objective;-

 To assess community health and health related problems in Keble 15 (Gebreal) Gondar town,
Amhara region, Ethiopia, 2022.

2.2 Specific objective;

To assess socioeconomic status of the community

To identify environmental health and sanitation condition of community
To determine water availability of community
To assess major morbidity statues of communicable disease .

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3. Methods and materials

3.1. The study area

The study was conducted at the selected Gebreal kebele of Gondar city. Gondar city is about 750
km far from the North West of Addis Ababa, the capital city of Ethiopia. According to the 2015
population projection of major cities in Ethiopia, the total population size of Gondar town was
estimated to be 323,900. The city is divided into 22 kebeles (the smallest administrative unit).
This city is among the ancient and largely populated in the country. Currently, Gondar city has
one Referral Hospital and Eight government Health Centers. Gebrel kebele has climatic
condition of Wayna Dega. Gondar is one of the city in the Amara Region of Ethiopia, part of the
Central Gondar zone. Gondar is bordered on the South by Debub Gondar Zone, on the West by
Dembia, on the North by Lay Armachho, on the North East by Wegera.

3.2. Study Period

The study was conducted from 25/11/2022-19/12/2022.

3.3 Study Design

A community based descriptive cross-sectional survey was conducted.

3.4 Population

3.4.1 Source population- our source of population was all people who live in Gondar town,

3.4.2 Study population- all population who live in kebele 15.

3.4.3 Study unit- The representative of household

3.4.4 Sampling unit- house holds

3.5 Inclusion and Exclusion Criteria

3.5.1. Inclusion criteria: The household of the study in kebele 15 Gondar town

3.5.2. Exclusion criteria: Individual who were seriously ill

3.6. Data sources and types

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3.6.1. Primary data sources

Primary data is used to collect the first hand information. This data had been collected from 54
households by interviewing by using questionnaire which was prepared by the department of
Environmental Health .In addition to this we use personal observation oral questions.

The primary data was collected from household’s interview and group discussion.

3.6 Sampling Techniques and Procedures

At the time of conducting this program we select 54 households as a sample. The data were
collected from primary data source 54 households were randomly selected and interviewed by
using the semi structured questionnaire.

3.7 Methods of data Collection

The study was performed by using questionnaire survey and observation of the different
activities of the community in the area of study.

Data was collected qualitatively (for example observation of the community status) and
quantitatively (for instance no of latrine per households) 
The data were collected through: 
Observation 
Questionnaire 
Personal Interview 
Data collected quantitatively or qualitatively

3.8. Materials used during the study

 Notebook including questionnaire 

Camera 
Pen

3.9. Data Analysis and Interpretation

After the data was collected qualitatively and quantitatively, all group member came together
and discussed with each other by giving comments, suggestion on the collected data; the
collected data implies that all information should recorded in numeric form as a raw data. After
that was done, the data was organized, analyzed, and presented through tables, words and etc.

3.10. Variables of the Study

Dependent variables

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  Hygiene and sanitation problems
 Maternal and neonatal, child health problems
 Major communicable disease and morbidity and mortality problems.

Independent variables

Health care delivery system

Socio economic states of the population
Educational status
Socio cultural factors
Demographic factors sex, age, religion.

4. RESULTS
I. Socio-Demographic Information and Educational Status
 According to the information obtained from the result of household interview
98.15% of respondents were found to be single married and 1.85% were
Divorced, all the respondent ethnicity is Amhara and among the respondent of 54
households 30 (55.56%) of them are males.
 Some of them are kindergarten, learned up to grade 1-8(primary school) and the

remains are secondary school and above (certificated).

 Nearly 70.37% of the family respondents were found in age group under 65 years

old while only about 29.63% of the family respondents had chance to live for
more than 64 and above years old. Almost 59.26% of family members were
between the ages of 15 to 64 years old and were productive (independent). From
this status we are conclude that independent were more than dependent which are
workforce.

Table 1: Age, gender and marital status of respondents

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Variable Category Frequency Percentage

Ethnicity Amhara 54 100

Sex Male 30 55.56

Female 24 44.44

Age 0-5 2 3.70

6-14 4 7.41

15-64 32 59.26

65+ 16 29.63

Marital Status Married 44 81.48

Single 9 16.67

Divorced 1 1.85

Widowed

Religion Orthodox 43 79.63

Islam 11 20.37

Other

Educational Status Kindergarten 2 3.7

Primary School 16 29.63

Secondary School 17 31.48

Above secondary school and 17 31.48

certificated

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II. Economy

According to the respondents, the major source of family income is based on family level
which includes Trading, Governmental organization ,private organization, mixed(Agriculture
and Animal husbandry) and other means of generating income such as Daily labor, handcraft,
selling fuel wood and charcoal and other sources of income respectively in order of their
importance.

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Table 2: sources of family income

Variable Category Frequency Percentage

Means of Trading Small scale/ cottage 18 33.33

livelihood
Medium Scale - -

Large scale 3 5.56

Animal husbandry 0 0

Mixed (Agriculture & animal husbandry) 7 12.96

Governmental organization 18 33.3

Private Organization 4 7.41

Other (specify) 12 22.22

Other means Handicraft 5 9.26

of generating
income Selling fuel wood & charcoal 2 3.7

Daily labor 9 16.67

Other 23 42.59

III. Morbidity Status

Diseases that occur in the last two weeks in Gondar town Gebrel kebele

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 Table 3: morbidity status of households in Gebreal kebele
Variable Category Frequency Percentage

Birth In The Last 12 Yes 19 35.18

Months In The Family
No 35 64.61

If Yes Sex of the Male 12 22.22

newborn
Female 7 12.96

Place of delivery Home 20 37.04

HI 17 31.48

Attendant of TTBA 18 33.33

delivery
Professional 19 35.19

Any Death In The Last Yes 12 22.22

12 Months In The
Family No 42 77.78

If Yes Sex Of The Male 5 9.26

Deceased
Female 7 12.96

Age At Death 0-5 2 3.70

6-14 3 5.55

15-64 1 38.88

65+ 6 11.11

Perceived Cause TB 2 3.7

Of Death
Malaria 1 1.85

Cancer 2 3.7

Other

IV.

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 Culture

1. Stable Food and Food taboo

Injera, (teff, wheat or barely injera) and, bread (kita) mainly made of wheat were found to
be some of the stable foods. The community in the study area also uses barely. In line
with Food Taboo, pork meat, camel milk and camel meat and any harem (bad) things was
not eaten by community because such foods were forbidden by their culture and religion.
Table 4: Food taboos, staple food, common language and prevailing types of
marriage.

Variable Category Frequency Percentage

Culture What is / are the Injera 64 66.66

staple diet?
Bread 36 33.3

Is / are there food Yes 32 59.26

taboos in the study
community? No 22 40.74

Common language Oromiffa - -

Amharic 54 100

others (specify)

Prevailing types of Polygamous 1 1.85

Marriage
Monogamous 51 94.44

Others 1 1.85

2. Access to Social Services

Hospital is far from the community as compared to other services and there is no any hospital in
the Kebele.

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Table 5: Services giving institution & their estimated distance from the Gebrel kebele.

Institutions Distance travel in m

<50 500-1000 1001-1500 >1500
0
Health Station X
Health Center X
Hospital X
Drug vendor shop X

3. social services

Table 6: social services in the Gebrel kebele

No Variable No
1 Literacy status (estimated
2 Number of Churches 2
3 Number of mosques 1
4 Other religious centers 1
5 Community health post: -

4. Educational Facilities
Table 7: educational facilities

Type Kindergarten Elementary Junior Senior Other

school secondary secondary educational
school school facilities
No 1 2 1 1 -

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V. Family Income of house holds

Table 8: Family income of households in Gebrel kebele

Variable Category Frequency Percentage

Average Annual Income of The <25000 5 9.26

Family
26000-50000 9 16.67

51000-750000 12 22.22

76000-10000 14 25.93

>100000 14 25.93

Additional Source Of Income Yes 11 20.37

No 43 69.63

VI. Environmental Health survey

Environmental Sanitation

All the studied houses had a roof that was made of sheet. 94.6% of the houses had smooth wall which is
not cracked and scratched while the remaining 5.4% were scratched. 50 % of studied houses had floor
made of soil, 40.74% is made from cement.

During visiting, 30 (60.6%) houses’ window was opened. Half of them have been opened daily and the
other 40.6% windows have opened occasionally. From the total selected houses, 57.78% of them have an
additional door to escape during emergency cases.

Most of the houses (91%) have enough light, from which 30.12% obtain morning light. Out of the studied
houses, 70.4% of them are separated from the neighboring house and the other 29.6% of them are joined
with the nearby houses. Most of the family members sleep on bed and the rest sleep on floor (`medeb`).
92.59% of the selected households have kitchen of which 55.55% of them are separated from the main
houses, and 37.03% are joined with the main houses.

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From 54 households only 2 (6.87%) of them have kitchen with windows. 49 (98%) households use wood,
charcoal, can dung & fuel gas for cooking. All households have electric supply.

Regarding latrine condition, 52(96.3%) households have latrine while most of them (59.6%) have uses pit
latrine. Only 29.63% households use flush latrine. 35(70.32%) households do not have cover for their
latrine. 22(44.5%) households have good sanitation condition.

Regarding water supply, main water sources of the households are tap water (88.89%) but only 52% are
suspired with the current water supply.

1. Water supply: sources of water

The population of kebele uses different water sources for different activities. Among water
resource used there:-

River/stream water,
Tap water, and
Well water and other sources

Are used for activity performed, majority of drinking water is from tap water.

Most of the respondent’s interviewee using Tap water as source of portable water for human
being. They have no access to water from other sources

About 51.85% of the community in Gebreal kebele are employed any method of water
purification such as boiling, standard filtration, traditional filtration and others.

Table 9: sources of water supply, method of water purification and average daily
consumption of water.

Variable Category Frequency Percentage

Source Of Your Water Supply Tap 48 88.89

Well 2 3.7

Stream/River 2 3.7

Others 2 3.7

Do you employ any method of Yes Boiling 28 51.85

water purification?
Traditional 2 3.7
filtration

Standard 7 12.96
filtration

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 Other 6 11.11

No 15 27.78

How much is your daily <50 41 75.93

consumption in liters?
51-100 9 16.67

101-200 4 7.41

>201 - -

2. Household
Table 10: ventilation, illumination, clean lines and need of maintenance of the households.

Variable Category Frequency Percentage

Ventilation Good 3 5.56

Fair 46 85.19

Bad 5 9.26

Adequate

Inadequate

Illumination Good 7 12.96

Fair 42 77.78

Bad 5 9.26

Adequate - -

Inadequate - -

Cleanliness Good 5 9.26

Fair 43 79.63

Bad 6 11.11

Adequate - -

Inadequate - -

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 Need of maintenance Good 10 18.52

Fair 39 72.22

Bad 5 9.26

3. Waste Disposal

Table 11: sources of waste, latrine facility and waste disposal methods.

Variable Category Frequency Percentage

Source Of Waste Residential/Domestic/ 46 85.19

Household

Commercial 4 7.41

Industrial - -

Other (specify) 4 7.41

Final Waste Disposal Method Sanitary land field 14 25.93

Dumping in the river 1 1.85

Burning 30 55.56

Composting 2 3.7

Others (specify) 7 12.96

Latrine Facility Yes 52 96.3

Pit 32 59.26

VIP 3 5.56

Flush 16 29.63

Other 1 1.85

No 2 3.7

Ownership Of Excreta Disposal Owned by the family 26 48.15

Shared or communal 24 44.44

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 Other 4 7.41

4. Housing Condition

Table 12: Housing conditions of the households, type of flour, crack on the flour, type of
kitchen.

Variable Category Frequency Percentage

Need of maintenance Good 10 18.52

Fair 39 72.22

Bad 5 9.26

Type of floor Cement 22 40.74

Soil 27 50

Wood 3 5.56

Others 2 3.7

Cracks On The Floor Yes 27 50

No 27 50

Livestock Around The House Yes living together with 8 14.81

people

they have separate 16 29.63

quarters

No 38 70.37

Type of kitchen Separate room attached to the main 20 37.03

house

Separate room but detached from 30 55.55

the main house

No kitchen at all 4 7.41

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5. Food Sanitation
Table 13: food sanitation and preservation method.

Variable Category Frequency Percentage

Which of the following Washing hands 40 74.07

procedures do you implement
during food preparation? Washing vegetables 2 3.7

Proper and adequate cooking 6 11.11

Material cleaning frequently 1 1.85

Preventing contamination 2 3.7

Other 3 5.56

Food Preservation Method Refrigerator 30 55.56

Drying 14 25.93

Others 10 18.52

VII. Vector and Insect control

Table 14: insect control and rode infestation methods in Gebreal kebele

Variable Category Frequency Percentage

Stagnant Water Yes 18 33.33

No 36 66.67

Insect Control Yes 49 90.74

Bed nets 17 31.48

Insecticides 22 40.74

Fumigation 5 9.26

Draining 2 3.7
stagnant water

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 Insect Repellant 3 5.56

Other

No 5 8.26

Rodent Infestation Yes 50 92.59

Poison 18 33.3

Mouse traps 11 20.37

Cats 20 37.04

Other 2 3.7

No 4 7.41

VIII. Means of communication

1. Access to Radio ,TV, Telephone , newspaper, and postal services

From the data collected most of the sampled households don`t use radio set but majority of the
households have private TV set.

Table 15: Access to Radio, private TV, telephone and postal services of the
households in Gebreal kebele.

Variable Category Frequency Percentage

Means Of Radio set Yes 14 25.93

Communication
No 40 74.07

private TV set Yes 41 75.93

No 13 24.07

telephone in your Yes 11 20.37

house
No 43 79.63

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 access to public Yes 4 7.41
telephone
No 43 79.63

access to newspaper Yes 15 27.78

No 39 72.22

access to postal Yes 5 9.26

service
No 49 90.74

IX. Means of Transport

Mostly they use transport system like bus and taxi and others. They use sometime horses and
mules to transport their goods up to the road as well as the market, while they walk on feet.

5. DISCUSSION

According to our study 96.3% of households had latrine, while EDHS 2011data showed
relatively lower number of households (62% of household) [8, 10, 11], but not appropriate latrine
utilization. This may be due to inadequate health education about latrine construction and

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utilization by co- coordinating health extension worker, health development army, and health
center and health office.

In our study 52% and 36%of of house hold had no solid and liquid waste disposal pit
respectively, but according to Amhara regional state health be roué 2012 annual reported slow
performance in inspection of solid and liquid waste disposal pit was 84%and 88% respectively
[9,12, 17].

According to our study, there is no maternal death related to pregnancy and delivery but the
maternal mortality rate of Ethiopia is 676 deaths from 100,000 live births according to EDHS
2011[8, 13]. The result may indicate that health extension worker, woreda health office, hospital
and other supporters of community create awareness on community health.

In our finding, TB fully immunization coverage was low (60%). This may be due to urban health
extension workers did not give immunization service, and low community awareness about
immunization default.

ANC follow-up was good (100%), on the contrary EDHS 2011report showed, it was 34 % [8,
14]. This may be due to increase awareness of the pregnant women.

In our study show, skill birth attendant is high/100%/ but in EDHS/2011/ it was 10% [8, 18].
This may be due to the cooperative work of health care professionals by giving information
regarding to mother and child health.

6. Problem identification and prioritization

Group proposal and action plan for intervention

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After identifying the problems of the society, the students must full fill their responsibility in
collaboration with the collage, governmental and non-governmental organization.

OBSERVATION

In addition to the above the following are also major problems:

Lack of water supply

Poor environmental sanitation
Poor family planning
Poor hygiene
Lack of hard work
The people are poorly organized and hence assisted by kebele administration.
Shortage of latrine construction land scarcity of clean water
There is no enough health services
Sufficient training is not given to the people
People and livestock live in single house

PRIOTIZATION RATING SCALE TABLE

Problems Magnitude Severity Feasibility Government Community Total Rank

Concern Concern
Solid waste 4 4 3 3 4 18 1
management
Lack of water 4 3 1 2 4 14 3
supply
Poor 4 4 2 2 3 15 2
environmental
sanitation
Poor family 4 3 1 3 2 13 4
planning
Personal 4 4 2 3 2 15 2
hygiene
Shortage of 2 3 3 3 2 13 4
latrine
construction

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land
No enough 4 3 1 2 2 12 5
health services

Prioritization scales

1= very low
2= low
3= medium
4= high
5= very high
A. problem that can be alleviated together with community and students
In the next phase we will try to give the following technical advice from our previous
noknowledge, by asking support from other knowledgeable people concerning this
solproblem or else by referring books related to this condition:
 How to store and collect solid and liquid wastes in a safe way.
 How to prevent and control various human and zoonotic diseases.
 Creating awareness on waste management and how they improve environmental
sanitation.
 Creating awareness on disease prevention and control method rather than treating.
 Advise to change the ideological background of some kebele workers on their
giving service for the community.
B. problems that need inputs from the college
Since some problems of the community are scarcity of service such as health services,
water supply, marketing, transportation services, clinic and other services, the college
must help to alleviate such problems of the society. In addition to this, the college may
advise a way to motivate community by giving award for those who show a better
management in the field of waste management, crop production and other activity
performed there.
C .Problems that needs external assistance
Nowadays there are a number of associations that provide fund to help economically
poor society. We can play a role in this regard:-

To direct a given institution to the society or-

To direct a society to the given institution

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As we asked the communities during the program they said that “Even if there are many services
like; health services, training on prevention of disease and waste management, financial services
and so on, in the kebele it doesn’t support all people equally and fairly.

7. CONCLUSION

CBTP help the students to gain practical knowledge other than the academic one. Community
based training program is one of the problem solving techniques that designed to benefit the
community and students.

CBTP phase I consists an important procedure, which is great input for CBTP phase II in
identification of the communities problem and ordering it. Most health extension packages were
not properly utilized.

CBTP have been developed for the purpose of improving communities problem by

Direct observation and collection of data from the farmers

Organize and analyze the collected data and
Presentation of the organized and analyzed data for future intervention Generally, CBTP
for its more important program carried out by preparation of training program for farmers
and demonstration site for new technologies in comfortable place and/or situation.

8. RECOMMENDATION

The following recommendations were forwarded.

 The town administration and woreda health office with concerned stakeholders should
work to improve the awareness of the community about proper placement and utilization
of liquid and solid waste burning materials, kitchen and latrine utilization, and alternate
energy source for cooking.
 The health office stakeholder should work to create awareness about immunization.
 Health care providers: - to teach hand washing.
 For those working in Family planning:-to teach the different forms of family planning.
 The government should alleviate health services and other extension center
 Policy of waste management system must be expanded
 The kebele should participate simultaneously for achievements of the program.

9. Action Plan

 From the problems identified before, shortage of water and lack of awareness toward the
technology is the most and that will be facilitated through motivating and giving training
for communities by students, DA, College or Universities,

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  Advise to change the ideological background of some kebele workers on their giving
service for the community.
 Creating awareness on human disease prevention and control methods.
The linkage b/n DA and other employers and community should strengthen through
governmental organization or nongovernmental organization (NGO) Motivation,
Technical support and supervision should be given to the community.
NGOS should be invited to kebele for motivation of sanitation activity and appropriate
use of latrine facilities. Since there is a lack of income and knowledge about saving,
creating means of credit, availability based on their interest for assistance of poor
community should be applied in the kebele.

Action plan for CBTP II

Problems that can be raised together with the community and students are:

 Give skill development training on modern practices in different aspects especially on

sanitation technology systems.
 Participate and facilitate in the control of different disease by constructing health center
in the community.
 Train the community on wise use of sanitary facilities.
 Training on simple water treatment.
 Train the community to change their thought on education
 Problems that need input from the university of Gondar:
 Research based on disease.
 Facilitate the involvement of community in the field work

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 10. REFERENCES

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contain CBTP done in previous years.
20. Inernet search for instance about back ground of CBTP.
21. Kebele workers and our coordinator instructors

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