JINKA UNIVERSITY CMHS

Department of Nursing
Course title:-CBTP
Community Diagnosis Of Pilla Keble, South Ari Woreda, Gazer Town, South Ethiopia Regional State
Complied by:-Group 1 student
Submitted to CBE office of Jinka University
Advisor:-CBE of Jinka University.

Jinka, Ethiopia
May, 2024
ACKNOWLEDGMENT
This work is the result of the total effort of different concerned bodies. Without their sincere supports we
wouldn’t be able to accomplish our task in this manner. Therefore, we are deeply grateful Jinka
University College of Medicine and Health Science for providing us with an opportunity to toil the Task
and interact with Community. This proves that," we are from the community to the community.''
We are also greatly indebted to the Community Based Education (CBE) Office for letting us to have an
access to important apparatus needed for our study. What is more, it is important to forward our deepest
gratitude to our supervisors and advisors for guiding and helping us throughout our work.
Eventually, we want our acknowledgement to be extended to pilla Keble administration office and all the
community members of pilla Keble for their positivity and open mindedness. Individuals of our group are
also appreciated for their fair contribution towards this study.

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Table of Contents
ACKNOWLEDGMENT........................................................................................................................................................i
INTRODUCTION.................................................................................................................................................................1
1.2 STATEMENT OF PROBLEM........................................................................................................................................2
1.3 SIGNIFICANCE OF STUDY.........................................................................................................................................3
2. LITERATURE REVIEW..................................................................................................................................................4
2. 1 Housing and Environmental Hygiene...................................................................................4
2.1.1 Housing Condition...............................................................................................................................................4
2.1.2 Water supply........................................................................................................................................................ 5
2.1.3 Family Planning...................................................................................................................................................5
2.1.3.1 Pregnancy and child birth..................................................................................................................................5
2.1.3.2 Child Health and Nutrition................................................................................................................................6
2 .1.3.3 Related to Vaccination.....................................................................................................................................6
2.3.3.4 Diarrhea.............................................................................................................................................................7
2.2 Liquid and Solid Waste Disposal...........................................................................................7
2.2.1 Latrine Availability and Utilization......................................................................................................................7
2.2.2 SOLID WASTE DISPOSAL...............................................................................................................................7
2.3 Rational Utilization Of Medication.......................................................................................8
3, OBJECTIVES OF THE STUDY.......................................................................................................................................8
4. Method and materials........................................................................................................................................................ 9
4.1 Study Area and Period...........................................................................................................9
4.2 Study Design........................................................................................................................10
4.3 Population............................................................................................................................10
4.3.1 Source Population...............................................................................................................................................10
4.3.2 Study Population................................................................................................................................................10
4.3.3 STUDY UNIT....................................................................................................................................................10
4.4 Inclusion and Exclusion Criteria..........................................................................................10
4.4.1 Inclusion Criteria................................................................................................................................................10
4.4.2 Exclusion Criteria...............................................................................................................................................10
4.4.3. Sample Size Determination...............................................................................................................................10
4.6 Variables of the Study..........................................................................................................11
4.7 .Operational Definitions.......................................................................................................12
4.8 Sampling Procedure.............................................................................................................13

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 4.9. Data Collection Technique.................................................................................................14
4.10. Data Collection Tool and Procedure.................................................................................15
4.11 Data Quality Control...........................................................................................................................................15
4.12 Data Processing and Analysis............................................................................................15
4.13 Ethical Consideration.........................................................................................................15
5. RESULT..........................................................................................................................................................................16
5.1. Socio Demographic Characteristics....................................................................................16
5.1.1 Marital Status....................................................................................................................16
5.1.2 Occupational status...........................................................................................................17
5.1.3 Educational status (level)..................................................................................................17
5.1.4. Source of Information and Income..................................................................................18
5.1.5. Vital Statics................................................................................................................................................................19
5.2. Housing Condition and Environmental Hygiene..........................................................................................................20
5.2.1 Housing Condition............................................................................................................20
5.2.2 Water Supply....................................................................................................................22
5.3. Liquid and Solid Waste Disposal..................................................................................................................................24
5.3.1. Latrine Availability and Utilization.................................................................................24
5.3.2. Solid waste disposal.........................................................................................................25
5. 4. MATERNAL HEALTH....................................................................................................26
5.4.1 Family Planning.................................................................................................................................................26
5.4.2 Pregnancy and Delivery Service.........................................................................................................................28
5.4.3. Breast and Complimentary Feeding................................................................................................................29
5. 4.4. Child Health..................................................................................................................................................... 32
5.4.4.1, Under Five Diarrheal Diseases and Treatment...............................................................................................32
5.4.4.2. Immunization..................................................................................................................................................33
5.5. Rational Medication Utilization..........................................................................................34
7. Conclusion and Recommendation...................................................................................................................................38
7.1 Conclusion...........................................................................................................................38
7.2. Recommendation................................................................................................................38
LIMITATIONS................................................................................................................................................................... 45
Reference.............................................................................................................................................................................46

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INTRODUCTION
Health is "a state of complete physical, mental and social wellbeing and not merely the absence of disease
and infirmity". WHO 1948. The enjoyment of the highest attainable standard of health is one of the
fundamental rights of every human being without distinction of race, religion, and political belief,
economic or social condition. Health is significant in all sectors of the community be it social, economic
or political. It is when the health of the community is addressed that the society can involve and
participate in socioeconomic activities with maximum capacity and create sustainable economic
development of the country. According to the World Health Organization, the main determinants of health
include the social and economic environment, the physical environment, and the person's individual
characteristics and behaviors. Community is a group of people living in the same place or having a
particular characteristic in common way. Community health is a branch of public health that cares for the
well-being of people in a specific area. it involves initiatives to prevent diseases, promote healthy
behaviors, and respond to emergencies. Community health refers to non-clinical approaches for improving
health, preventing disease and reducing health disparities through addressing social, behavioral,
environmental, economic and medical determinants of health in a geographically defined population.
Community based training program is a program that deals with identifying, prioritizing, planning, and
intervening health and health related problem of the community. 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.
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 governments.
Objectives of CBTP:
Define demographic socio-economic, political and environmental aspects of a given
community ( determinants of socio- economic status).Make community diagnosis and draw an action
plan which would enable students to suggest appropriate intervention measures. Organize intervention
utilizing the concept components and strategies of community participation and multi -sect oral
approach Plan and conduct problem -oriented research

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What is Community Diagnosis?
According to WHO definition, it is “a quantitative and qualitative description of the health of citizens
and the factors which influence their health. It identifies problems, proposes areas for improvement
and stimulates action”. Community diagnosis can also be defined as the identification and
quantification of health problems in a given population using health indicators to define those at risk
oroooooooooooooooo

those in need of care and the opportunities and resources available to address these factors
Aims of Community Diagnosis:
 Analyze health status
 Evaluate the health resources, services, and system of care
 Assesses attitudes toward community health services and issues

1.2 STATEMENT OF PROBLEM

Healthcare problems in developing countries are multifaceted and result from a combination of factors,
socio-cultural, economic, political as well as poor planning and/or poor implementation of health policies
and program. Also, there is the problem of availability, accessibility, affordability, sustainability that
affects the heath condition in developing condition. Maternal and child health depends on different
factors. Short birth intervals (of less than 24 months) are associated with harmful outcomes for both
newborns and their mothers, such as preterm birth, low birth weight, and death. Childbearing at a very
young age is linked to an increased risk of complications during pregnancy and childbirth and higher rates
of neonatal mortality. The developing country in which most of its population (85%) mainly depends on
agricultures. Different factors like lack of awareness about the problems of waste disposal, adequate and
necessary medical equipment, inaccessible health facility and low health seek behavior leads 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 is relatively bad, there is still lack of proper utilization of latrine. Although the
towns’ municipalities and rural peoples cannot attempting to manage the solid and liquid waste, there is a

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problem in collection, transportation, and disposal of wastes on time as a result this the community is
exposed to different communicable diseases. Pneumonia, diarrhea and Malaria are major communicable
disease in Ethiopia .
Pneumonia affects 65% of children under five years, diarrhea affects 50% of children under 5years and
Malaria affect 60% of children under five years. In Ethiopia Communicable diseases, nutritional
problems, maternal and child health problems are the major challenging health care related problems.
The most common nutritional situation are under nutrition , which causes decreased physical and mental
development, compromised immune system, and increased susceptibility infectious diseases.
Environmental conditions are a major direct and indirect determinant of human health. Inadequate water,
sanitation and hygiene account for a large part of the causes of illness and death in the world, especially in
developing countries where about 80 per cent of illnesses are linked to inadequate water and sanitation.
According to central statistics agency (CSA) from urban dwellers of Ethiopia about 84% of households
have to travel up to an hour to obtain water; in which it complicate health related problems .A cross
sectional study conducted in Ethiopia indicate 80% of population get water from unimproved source .
Maternal and child health includes the promotive, preventive, curative, and rehabilitative healthcare for
mothers and children. Inadequate access to clean water, toilet and sanitation are among the factors for
increasing preventable disease like diarrheal disease. Health indicators maternal , infant and under
5mortality which can be minimized by utilization of health service ,like family planning, ANC ,Delivery ,
PNC ,TT vaccination , nutrition and immunization, are significantly high in Ethiopia

1.3 SIGNIFICANCE OF STUDY

This study will provide relevant information on health and health related problems in Pilla Keble and
serve as an input to prioritize, plan and properly execute appropriate, feasible, timely and cost effective
public health interventions and evaluation of the continuity of the intervention.
It also provides the platform for concerned bodies to intervene, create awareness and mobilize the
community for maximum and sustainable results.
The study will also serve as a baseline to perform further study on the subject by an individual,
governmental and non-governmental organization in the future. This study helps us to gain practical
knowledge other than the academic one.
As most of the health related problems in Ethiopia are preventable and minimized by good health services
management and strong political commitment as well as community participation, community health

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 assessment is an important tool to identify health status, health related problems, and factors that could
affect the society’s health. The result of this survey will be used by governmental and non-governmental
institutions to solve the community health related problems

2. LITERATURE REVIEW

2. 1 Housing and Environmental Hygiene

2.1.1 Housing Condition
The majority of house in Ethiopia are susceptible to easily collapse due to their poor construction. The
majority of Ethiopia people which means 70% of the population according to EDHS report of 2011 have 1
room for sleeping, 25% of the household have 2 rooms and 5% of the population got 3 or more for
sleeping Most Ethiopians lived, are still living in rural areas: large villages or small homesteads. The
majority of today’s Ethiopian urban centers were established in the past 200 years. In terms of quality of
construction material and quality, over 50% of the housing units are categories as sub ‐standard and poor
quality Construction materials in urban centers (CSA 2007 and 2011):
Wall:-70.8% of the housing units are made of china wood plastered with mud) and in 5 years the
reduction in only 2.2%
Roofing:-93.5% of the houses have corrugated iron sheet (CSI) and In 5 years the use of CIS increased
by 1.7
Floors:-Over 57.7% of the existing housing units have earthen dusty floors and in 5 years it dropped to
49%
Ceiling፡-Housing units without ceiling 52% and In 5 years it dropped to 35%
Addis Ababa:• more than 30% are single room units ,close to 15% have no private or shared toilets, and
around 20% have no access to kitchen
Factors behind the current housing conditions in Ethiopia:
 Poverty
 high cost of standard construction materials
 Development history (urbanization trend)

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  Construction permit guidelines and areas earmarked for renewal by master plans
Overcrowding
 On average 44.9% are single room units
 Over 44% of the housing units have an average number of persons per housing unit of 3.8
(more than 3 – slum)
 The percentage of single roomed houses ranges from the lowest in Dilla (32%) to the highest
in Gambela (64%).

2.1.2 Water supply

According to WHO survey 80% of all illness in developing countries are water associated.
Water coverage in Ethiopia is 68.5% depending on source and definition. In SNNPR the water coverage is
52% in zonal level. A community based cross sectional study was done on Gouansolo of Mali shows only
74% urban and 61% rural population has access to safe water.
A community based cross sectional study was done on Nigeria shows only 58% population on
Rural area has access to safe water. A community based cross sectional study which was done in sidama
Zone Ethiopia shows about 49% of population has access to safe water.
According to information we obtained from pilla kebele administrative office and the survey we made in
community there are 15 pipes in pilla .without having any trained water professional.

2.1.3 Family Planning

According to EDHS 2016 report 19.6% is current use of contraceptive for any method, 18.7% modern
type, 14% inject able in Ethiopia which is comparable to that of 25.8% current used contraceptive for any
method, 24.4%modern method, 19.5% IUD in SNNPR.A community based cross sectional study was
done in Afar region shows 8.5% of women use contraceptives and among those 92.2% uses injectable.
A community based cross sectional study was done in done on Jimma Ethiopia 43% of women uses
contraceptives. A community based cross sectional study was done on Debere Birhan and 21 % of the
population used any method of contraceptives.

2.1.3.1 Pregnancy and child birth

globally while 86%of pregnant women access antenatal care with skilled health personal at least once,
only two in three 65% for antenatal care visit Dec 11, 2023 — The study found that 92.3% of women
attended at least one antenatal care visit; 28.8% attended at least four visits; and none attended eight.

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The study, published in PLOS Global Public Health in November, aimed to accurately estimate antenatal
care coverage in rural Ethiopia, using data collected from Birhan’s on-going study of cross-sectional more
than 2,000 pregnant women. Between December 2018 and April 2020, HaSET researchers tracked the
cross-sectional antenatal care visits using prospective observations and health facility records. The study
found that 92.3% of women attended at least one antenatal care visit; 28.8% attended at least four visits;
and none attended eight or more visits. (Eight visits is the World Health Organization’s global target for
antenatal care.)

2.1.3.2 Child Health and Nutrition

UNICEF and WHO recommend that children be exclusively breastfed during the first 6 months of life and
those children be given solid or semi-solid complementary food in addition to continued breastfeeding
from age 6 months until 24 months or more, when the child is fully weaned. Appropriate infant and young
child feeding (IYCF) practices include early initiation of breastfeeding(within the first hour of life),
exclusive breastfeeding for the first 6 months of life, continued breastfeeding for 2 years or more, and
introduction of safe, appropriate, and adequate complementary foods at age 6 months.In Ethiopia, 58
percent of infants lower than 6 months are exclusively breastfed. Contrary to recommendation by WHO
those children under age 6 months should be exclusively breastfed, 17 percent of infants 0-5 months
consume plain water, 5 percent, each, consume no milk liquids or other milk, and 11 percent consume
complementary foods in addition to breast milk. Five percent of infants under age 6 months are not
breastfed at all.The study conducted show that 38% of children under five are considered short for their
age or stunted, and 18% are severely stunted in Ethiopia. Stunting ranges from a high of 46% in the
Amhara region to low of 15% in Addis Ababa. Overall, 10 of children in Ethiopia are wasted and3% are
severely wasted. Regional variation exists with Somali and Afar having the highest percentages of
children who are wasted, 23% and 18% respectively.

2 .1.3.3 Related to Vaccination

Globally, 116.5 million children’s received DTP3 in 2010 compared with 24.4 million in 1980.In 2016,
DTP3 coverage ranged from 74% in the WHO Africa region to 97% in the western pacific region.
In Ethiopia 39% of children aged 12-23 months have received all basic vaccination in 2016. 16%of
children in this age group haven’t received any vaccination. There is little difference in the vaccination
coverage rate between male and female children. Fully vaccinated coverage is much higher in urban than
rural area (65% to 35%). Fully vaccinated coverage is highest in Addis Ababa 89% and lowest in Afar

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15%. While immunization is one of the most successful public health interventions, coverage has
plateaued over the last decade. The Corona virus disease (COVID-19) pandemic and associated
disruptions have strained health systems, with 23 million children missing out on vaccination in 2020, 3.7
million more than in 2019 and highest number since 2009.During 2020, about 83% of infants worldwide
(113 million infants) received 3 doses of diphtheria-tetanus-pertussis (DTP3) vaccine, protecting them
against infectious diseases that can cause serious illness and disability or be fatal.

2.3.3.4 Diarrhea
Is the second leading cause of child mortality and morbidity, especially in developing countries? It is
estimated that there are 2.5 billion episode and 1.5 billion deaths throughout the world among under 5
years of age. This accounts for 21% of all the deaths in developing countries.
Educational status
Education is one of the primary tools which are getting consideration for the government as FDRE central
statically agency reveals. According to EDHS conducted census in 2016, 33% of the population never
attend school, 56% some primary,2.4% complete primary, 3.9% some secondary, 0.6% complete to
secondary and 3.5% more than secondary, in SNNP Literacy population aged 10 years and older female in
2007 is 34.9% in SNNP which is similar to that of 34.6% in Ethiopia. A community based cross sectional
was done on Muketuri , Oromiya Ethiopia 41% of population never attend school .59% of population can
read and write.

2.2 Liquid and Solid Waste Disposal

2.2.1 Latrine Availability and Utilization
Generally 20% of Ethiopian households use improved toilet facilities 42% in urban areas and 10% in
rural areas).The 56% of rural households use unimproved toilet facilities and 27% households has no toilet
facility. By region, the percentage of households with an improved sanitation facility ranges from a low of
10% in SNNPR to a high of 82% in Addis Ababa. Open defecation is most prevalent in Afar 70% and
least prevalent in Addis Ababa 2 % [20].The pooled prevalence of latrine utilization level in Ethiopia was
50.02%. The highest level 67.4% of latrine utilization was from southern nation’s nationality and people
regional state, followed by Amhara regional state 50.1% [36]. Study conducted in Bahirdar zuria district
reveled 58.4% had pit latrines and only 62.0% were functional and 56.9% latrines required maintenance
[35].

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 2.2.2 SOLID WASTE DISPOSAL
In developing countries significant portion of population does not have access to a waste collection service
and only a fraction of the generated waste is actually collected. Most of the solid waste is disposed in open
dumps due to its simplicity and low cost (Nas and Bayram, 2008; WHO, 1996). The most problematic
functional elements of poor Solid Waste Management (SWM) identified in developing countries include
absence of proper disposal of solid waste, non-existence of separation of the solid waste into its
constituents at the sources, absence of the timely information about the generation rate and characteristics
and lack of reliable database on SWM (Bhat et al., 2014; Buenrostro et al., 2001; Gomez et al., 2008;
Jansen, 2010; Mbuligwe, 2002; WHO, 1996). The lack of knowledge, financial and technological
deficiencies has also contributed to the poor management of solid wastes (Mbuligwe, 2002).In Ethiopia
large amount of solid waste remains unmanaged and it affected the public health and the environment
significantly(Cheever, 2011; Haylamicheal et al., 2011).

2.3 Rational Utilization Of Medication

Rational utilization of medication is essential for ensuring optimal patient outcome and minimizing
adverse effect. By adhering to the principles of rational medication use and implementing effective
strategies, health care providers, patients, and policymakers can improve medication safety and
effectiveness. In some reported the lack of trust in physicians the patient uses self-medication .and also the
high costs of physician visits and overcrowded health facilities. According to the literature, respiratory
conditions such as sore throat 34%, common cold with fever47%, and cough 40%,along with the belief
that antibiotics can reduce the duration of acute respiratory infections and the ease with which they can be
obtained without prescription. A study conducted in southern part of Ethiopia showed that 15% of the
persons with perceived illnesses performed self-medication (26). In another study conducted in Addis
Ababa and central Ethiopia the magnitude of self-care was as high as 50%

3, OBJECTIVES OF THE STUDY

3.1 General objectives

The main objective of this study was to assess the health and health related problems of
Pilla Keble, Gazer town, south ari, south Ethiopia regional state of Ethiopia from May 7 -15,2016 E. C
3.2 Specific objectives

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  To assess the health problems of Pilla Keble, Gazer town, south ari, south Ethiopia regional state
of Ethiopia from May 7 -15,2016 E. C

 To identify health related problems of Pilla Keble, Gazer town , south ari , south Ethiopia regional
state of Ethiopia from May 7 -15,2016 E. C

4. Method and materials

4.1 Study Area and Period

The study was conducted in pilla Keble having estimated total population of 3706 out of 560 household
from May 7-15, 2016 E/C. among these 1852 were male and 1854 were female. From those female 273
are between 15_49 and 128 are pregnant. Of this total population 194 were under five years old with 99 of
them being female and 95 of them male. There are 1 health post in pilla kebele gazer chamet village.
Regarding to water supply there are 15 water pipe with some of them being supported by NGO
( world vision). Unfortunately there are no water professional in pilla. Pilla is a Keble which is found in
Gazer sub-city, in Jinka town, South Ethiopia regional State of Ethiopia and contain 11 villages. Namely
bodosonkot(37hh), bonat(44hh),cashet(24hh),dosi(56hh), keytser(40hh), karunga(24hh),gazer
chamet(71hh), sulafet(46hh),shelma(58hh),negamer(65hh) and gangat ( 95house hold) totally 560
household.. pilla locates gazer to south east and is found to north of Jinka city. pilla is surrounded by
Shepi in south ,Gazer in north, Gazer in west and Gedir in east. Since pilla is rural and agriculturally
productive the community mostly dwells on agriculture as livelihood. We have prepared the health profile
of this Keble and the health profile defined as a set of indicators of basic demographic and socioeconomic
characteristics, health status, health risk factors and health resource use of a community.

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Figure 1 ; Map of Gazer town, Pilla kebele .May, 2024

4.2 Study Design

 A community based descriptive cross-sectional study was conducted to assess community health and
health related problems and to provide possible community mobilization in Pilla Keble.

4.3 Population
4.3.1 Source Population
 The source populations were all households in Pilla Keble.

4.3.2 Study Population

 All randomly selected households in Pilla Keble fulfill our inclusion criteria.

4.3.3 STUDY UNIT

 The study unit was households that were selected at every 1.3 Households with systematic selection
who live in Pilla kebele.

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 4.4 Inclusion and Exclusion Criteria
4.4.1 Inclusion Criteria
 Households that had been selected by systemic sampling method were included during the time of data
collection and permanent residence

4.4.2 Exclusion Criteria

 A house without person
 business centers
 Governmental and nongovernmental organization.
 People who residence less than 6 months

4.4.3. Sample Size Determination

 A single population proportion sample size determination was carried out with proportion (p) value of
50%, precession (d), margin of error of 5% and 95% confidence interval.
 Hence, the estimated sample size was calculated as follows

Where, n=desired sample size

 p= since there were different variables and to get maximum possible sample size, assumed proportion
is 50% (0.5).

 Margin of error between the sample and the proportion i.e. 5% (0.05)

 By adding 10% of non-respondent rate;

NO = 384 + 38 =422

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 4.6 Variables of the Study
 Socio demographic factors
1) Age
2) Sex
3) Marital status head
4) Religion
5) Educational status
6) Income
7) Ethnicity
8) Family size
9) Occupation of household head
 Environmental factors
1) Housing condition
2) Water supply coverage and quality
3) Availability of latrine
4) Waste disposal facility
5) Prevalence of communicable diseases
6) Diarrheal diseases
7) Immunization coverage
8) Kitchen and latrine condition
9) Solid waste management

4.7 .Operational Definitions

1) House hold:
 A social unit living together in the same dwelling
2) Fully vaccinated:
 individuals that took all scheduled vaccines timely
3) Up-to-date –
 children who are on immunization schedule program
4) Health problems:

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 Specific health problems that households are facing in the community including diseases and
infirmities (, malaria, diarrheal disease MCH utilizations…etc.)

Figure2.A, child with diarrhea in pilla may,2024 Figure2 B, elder with malarria case in pilla 2024

5. Health related problems:

 Any phenomena that can predispose the members of households to disease and infirmities.
6. Housing condition

 Illumination
1) Good: house with at least two windows, at least two door and sunlight position is infront
of window and door.
2) Fair: house with at least two windows, at least two door and sunlight position is infront
of window and door.
3) bad: house with no window , at least one door and sunlight position is behind window
and door
 Ventilation
1) Good: house with at least three window
2) Fair: house with two window
3) Poor: house one or without window
 Cleanliness of the room
1. Good: If floors have concrete.

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 2. Fair: If floors are free of desity, derty, stains, derbs and vacuum or mop
marks.
3. bad: if the floor have dusty and there is no attractive

4.8 Sampling Procedure.

 The data were collected using systematic random sampling. From total of 560 counted and
coded households in Pilla kebele 422 samples were selected as sample unit using systematic
random sampling method by using sampling interval (k = 1.3).
 By dividing total population size (N=560) with sample size (n = 384).The starting point had
been selected randomly from 1-1.3 house1holds by using lottery method.
 K=housing interval, n=sample size, N = total house hold
Proportional allocation of households for each ketena
 NK=Number of households in each ketena, PA=Proportional allocation, PA=NK/N × n
Kashet (k1) = NK1/N ×n bodosonkot (K2) = NK2/N × n
=24/560 × 422 = 37/560 × 422
= 18 = 28
Sulaft (k3) = NK/N × n keytser (k4) =NK/N × n Dosi = (k5) = NK/Nxn
=46/560 × 422 =40/560 × 422 56/560x422
=35 =30 = 42
Ganget (k6) = NK/Nxn Gazer chamet (K7) = NK/Nxn Negahamer (K8) = NK/Nxn
96/560x422 72/560x422 65/560x422
= 72 = 54 = 49
Shelima(K9) = NK/Nxn Bonate (K10) = NK/Nxn Karunga(K11) = NK/Nxn
57/560x422 44/560x422 24/560x422
= 43 = 33 = 18

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Figure 2 ; Sampling technique procedure of Pilla kebele, 2024 G, .C

4.9. Data Collection Technique

The data for the study were collected by second year nursing students using structured interviewer
administered questionnaire with a total number of 27 students 2 supervisors. The questionnaire focuses on
(socio-economic conditions, vital event conditions, house hold and environmental health, maternal and
child health, diarrheal diseases and its treatment, other childhood related diseases, programmed
vaccinations as well as drug and medication .The data collection process will take 10 days. The data will
be collected every 5th household by using systematic random sampling method.

4.10. Data Collection Tool and Procedure

The data were collected by using structured interviewer administered questionnaire, observation and
secondary data like cards (Like- EPI card). The questionnaire tool includes socio demographic
characteristics, contraceptive use, vaccine coverage, MCH, housing condition, waste disposal and hygiene
practice and other related problems in the community. During data collection preferably Female
respondents or both (husband and wife) if they will available at the same time was considered as a
respondent.

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 4.11 Data Quality Control
The collected data were checked for completeness, accuracy, clarity and consistency by selected group
members. Data coding, cleaning and verification were performed to assure the quality of data. Incomplete
questionnaire were returned to the data collector to recheck it again in the data collection area with
revisits. The data was collected with close assistance of CBTP advisors. We had daily review meeting at
11:00 – 11:30 in gas station of gazer town to cross check the daily activity and to assure the consistency
and completeness of the data in order to control the data quality.

4.12 Data Processing and Analysis

After data collection completed, data was tallied, processed & analyzed through SPSS statics 26 and
summarized using frequencies, mean, percentage, and the data was presented in the form of tables, pie-
chart & graphs. Finally, relevant discussion, conclusion and recommendation made based on the result
from the study using tally sheet, pen, paper, ruler and chalk. Scientific calculator and computer using
descriptive statics.

4.13 Ethical Consideration

An official supportive letter was obtained from Jinka University College of health science and
department of nursing CBE office to communicate with South Ari woreda Health office to get permission
to enter in to the community and for their collaboration during our stay in the community. The necessary
explanation about the purpose of the study and its procedure was provided to them. Verbal consent was
taken, and personal identifiers had not been included in the data set to insure confidentiality.

16
 5. RESULT

5.1. Socio Demographic Characteristics

According recorded to study we conducted a total of 560 households were their in south ari woreda, Pilla
Keble having total population of 3706, from those 1852 (49.97%) male and 1854(50.03%) female. We
included 422 house hold in our survey, where respondent rate were 100%, from them 59(14.0%) were
female and 363(86.0%) male. The mean age of our respondent were 41.45.In 422 households there was a
total 2039 thus on average 4.83 individual lives in a single house hold

sex distribution
Male Female

50.3% 49.97%

Figure 1: sex distribution in pilla in pilla kebele, gazer town, south ari zone, SEPR regional state, Ethiopia, May 2024.

5.1.1 Marital Status

According to our study 85.1% are married, 2.8 %are single, 4.5 %are divorced and 7.6 %are windowed
Martial status for age >18.

5% 8%
3%

married
single
divorced
windowed

85%

Figure 2: Marital Status in pilla kebele May 2024.

17
 5.1.2 Occupational status
According to our study 8 (1.9%) are daily labourer, 363 (86%) are farmers, 24 (5.7%) are government
employee, 8(1.9%) are house wife, 10 (2.4%) are merchants and 9 (2.1%) are other specify like motor
driver, hair cutter and religious lieders etc.

Table 1; occupational status in pilla kebele, gazer town, south ari zone, SEPR regional state, Ethiopia, May 2024.

No Occupation Frequency Percent %

1 Farmer 363 86.0
2 Daily labour 8 1.9
3 Govt.employee 24 5.7
4 Merchant 10 2.4
5 Other 9 2.1
6 Total 422 100.0

5.1.3 Educational status (level)

Literacy rate in our study we conducted in pilla is 51.9%which is better compared to national figures
which is 46.8% for rural according to EDSH, 2016.among 422 hh head we studied 19(4.5%) have higher
education,203(48.1%) have no formal education,152(36%0)have primary education 48(11.4%) have
secondary education

Figure 3: educational status of house hold head women’s in pilla Kebele in pilla kebele, gazer town, south ari zone, SEPR
regional state, Ethiopia, May 2024

18
Figure 4: educational status of total women’s in pilla kebele, gazer town, south ari zone, SEPR regional state, Ethiopia, May
2024.

5.1.4. Source of Information and Income

Means of communication

Exposure to information on television, Radio and print media can increase knowledge and attitude to new
ideas, social change and opportunities and can affect individual’s perception and behaviour including
those about health. Our survey assed exposure to media by asking respondents whether they have radio
seat, private TV, phone (fixed or mobile). From our survey 66(15.6%) are radio user, 64 (15.2%) are TV
user 288 (68.2%) are mobile phone user, 2 (0.5%) are landline user, 8 (1.9%) are newspaper user and
11(2.6%) are postal serves user.

Table 2: means of communication in pilla kebele, may 2024

Frequency Percent %

Radio Yes 66 15.6

No 356 84.4
TV Yes 64 15.2
No 358 84.8
Landline Yes 2 0.5
No 420 99.5
News paper Yes 8 1.9
No 414 98.1
Postal service Yes 11 2.6
No 411 97.4
Mobile phone Yes 288 68.4
No 134 31.8

19
5.1.5. Vital Statics
From 422 house hold there were 27 females and 27 males. There were 54 newborns in the past 12
month and all of them were live births. 46 deliveries at health facility and attained by health professional,
8 were delivered at home. And attained by traditional birth attendants. . There were 12 death reports in the
past1 year. By the disease like chronic disease, diarrheal disease, malaria, malnutrition, respiratory
disease and other specify. In the past 1 year.

Table 3:case of death in the last 12 months in pilla kebele, gazer town, south ari zone, SEPR regional state, Ethiopia, May
2024.

Case of death Frequency

chronic disease 1
diarrheal disease 2
malaria 3
malnutrition 1
respiratory disease 4
other specify 1
Total 12
Table 4: place of birth in the last 12 months Keble in pilla kebele, gazer town, south ari zone, SEPR regional state, Ethiopia,
May 2024.

Birth in the last 12 month

Frequency Per cent

Not birth 368 87.2

Birth at Health institution 46 10.9

Birth at Home 8 1.9

Total 422 100.0

From 422 households 19(4.5%) females and 13(3.1%) males totally 32(7.6%) are married in past 12
months. And the age of 5 5 partners are <18 years from this 32 married partners. And one partner’s
marriage is polygamy. From 422 households 7(1.7%) females and 4(0.9%) males totally 11(2.6%) are

20
divorced in the past 12 months. And explain different reason for the case of divorce like economic reason,
religious reason, cheating etc.

5.2. Housing Condition and Environmental Hygiene

5.2.1 Housing Condition

Among all households 350(82.5%) of them have window and 72(17.5%) have no window. On the other
hand 312(73.6%) of houses have two door and the other 110(25.9%) have one door and 199(47.2%)
households have good ventilation, 193(45.7%) households have fair ventilation and 30(7.1%) households
have bad ventilations. The 180(42.5%) households were good and 220(51.9%) households were fair and
22(5.2%) households were bad. floors of the households of 16 (3.8%) was concrete, floor of,404(95.7%)
was earth and floor of 1(2%) was made of wood and adding other materials like muds.

Table 5: Housing condition of households in pilla kebele, south ari zone, Gazer town, SNNPR, Ethiopia,
may 2024.

Housing condition Frequency Percentage

Ownership Private(own) 417 98.8
of the House Rent 5 1.2
Others 0 0
Availability of Yes 350 82.9
Window No 72 17.1
Dual Door NO 110 26.1
Yes 312 73.9
Ventilation of the Good 199 47.2
house Fair 193 45.7
Bad 30 7.1
Cleanness of the Good 180 42.5
room Fair 222 52.3
Bad 22 5.2
Illumination of the Good 49.7
room
Fair 178 42.2
Bad 34 8.1
Type of floor Concrete 16 3.8

21
 Earth 404 95.8
Wood 1 0.2
Other specify 1 0.2
Type of roof Corrugated iron 286 67.7
sheet
Thatch/straw 121 28.7
Other specify 15 3.6

Table6: No of peoples live in the same house in pilla kebele, south ari zone, Gazer town, SNNPR, Ethiopia, may 2024.

No of people live in the same house frequency percent

1 20 4.7
2 54 12.8
3 86 20.4
4 65 15.4
5 59 14
6 46 10.9
7 37 8.8
8 28 6.6
9 10 2.4
10 8 1.9
11 7 1.7
12 2 0.5
Total 422 100

Based on the data collected from total sample households in pilla kebele 325(77%) were found to have
separated kitchen from the main house, 28(6.6%) are attached with the main house and the rest 69(16.4%)
of the house hold have no kitchen. Regarding to the presence of domestic animals 270(64%) of the
households have no domestic animals and 152(36%) of the households have domestic animals.

22
 no
attached kitchen;
with the 16.4
main
house;
6.6

separated kitchen; 77

Figure 5: Kitchen status in pilla kebele, gazer town, south ari zone, SEPR regional state, Ethiopia, May 2024.

Table7: No of peoples live in the same house in pilla kebele, south ari zone, Gazer town, SNNPR, Ethiopia, may 2024.

No room for stores frequency per cent

0 69 16.4%
1 329 78%
2 17 4%
3 4 0.9%
4 2 0.5%
6 1 0.2%
Total 422 100%

5.2.2 Water Supply

Regarding to the source of water in pilla kebele of gazer town majority of the respondents 237(55.9%)
gets their water from spring, pipe water 101(23.8%), public stand point hand pump 53(12.5%), stream or
river 32(7.5%) and 1(0.2%) gets from well. Of the respondents 99.8% of them have spent less than or
equal to 30 minutes to fetch water where as 0.2% of the respondents spent greater than 60 minute to fetch
water. From our study of pilla kebelle 180 (42.7%) of households were use a dipper to fetch water, most
of the households of these water dippers were clean that is 158(37.4%) from these 174(41.2%) had a cover
and the rest had no cover the water container when considering water safer of these 141 (33.4%) of
households tried to make water safer by using boiling 67(15.9%), draining through a cloth 31( 7.3%),
using chemicals 38(9%) and 5(1.2%) using other specify that is water filter and No knowledge about safe

23
of water but the other 22(5.2%) of water dipper were not clean because the community thought that
already treated by government(29.4%), expensive(15.9%), not in our culture to do so(15.4%) and other
specify(5.9%) like no facility to use the chemical for clean water, Lack of knowledge about safe of water,
They thought spring water was very clear and safe for drink, had No treat and the rest 242(57.3%) of
households were not use a dipper to fetch water. In our study from type of drinking water contain, most of
the community that is 412(97.6%) of households were uses Jerri can and the remaining 10(2.4%) of
households were uses pot.

450
400
350
300
250
jerrican
200 pot
150
100
50
0
Frequency Percent

Figure 6: Type of drinking water container in pilla kebele, may2 024

Fig 7: source of water supply Keble in pilla kebele, gazer town, south ari zone, SEPR regional state, Ethiopia, May 2024.

24
Table 8: Distance of water source from toilet of household in pilla Keble Gazer Town, South ari Zone, SEPR, Ethiopia, May
2024.

Distance in meters Number of HHs Percent

Less than or equal to 400 373 88.4%
401 to 800 17 4.1%
801 to 1200 24 5.7%
1201 to 1600 1 0.2%
1601 to 2000 6 1.4%
2001 to 2400 1 0.2%
Total 422 100%

Table 9: Time taken to fetch water in pilla Keble Gazer Town, South ari Zone, SEPR, Ethiopia, may 2024 .

Time in minutes Number of HHs Percent

Less than or equal to 100 423 99.8%
101 to 200 0 0%
201 to 300 0 0%
301 to 400 0 0%
401 to 500 1 0.2%
Total 422 100%

5.3. Liquid and Solid Waste Disposal

5.3.1. Latrine Availability and Utilization

 Among 422 respondents, 385(91.2%) of them have toilet, while the remaining37 (8.8%) have no
toilet.
 From 422 visted latrine 377(89.3%) is functional and 8(1.9%) is not functional.The remaining
37(8.8%) house holds have no latrine.
 In pilla Keble 23.7% of the house hold segregate the waste before disposal in the container while
76.3 % of the hose hold not segregate the waste before disposal in the container
 Frome 422 Hose hold 54.7% have enough area to disposal solid waste , in other side 45.3% have
not enough area to disposal the waste
 In total 422 households 241(57.1%) the waste dispose to the open field , 161(38.2%) it has
private pit , the remaining 1.2 % it has communal container ,the other are it has specify area
(3.6%)

25
 Table10: Kinds of latrine Keble in pilla kebele, gazer town, south ari zone, SEPR regional state, Ethiopia, May 2024.

Frequency per cent

Valid 37 8.8
Pit latrine with structures, door and Slab 170 40.3
Pit latrine without structures 202 47.9
Pour flush water carriage 2 .5
Ventilated improved pit 11 2.6
Total 422 100.0

Figure 8: Kinds of toilet in pilla kebele, Gazer town, South Ari zone, SEPR, Ethiopia, May 2024.

Table 11: The reason of nonfunctional latrine in pilla kebele, Gazer town, South Ari zone, SEPR, Ethiopia, May 2024.

Frequency Percent Valid Percent Cumulative

Percent
Valid 414 98.1 98.1 98.1
Filled 2 5 5 98.6
HH do not like to use it 2 5 5 99.1
Structures damage and dangerous 2 5 5 99.5
Surrounding is unsightly dirty 2 5 5 100
Total 422 100 100

5.3.2. Solid waste disposal

From a total of 422 households, 241 (57.1%) of them dispose solid wastes via open field within outside
the community, private pit 161(38.2%), communal container 5(1.2%) while 15(3.6%) of them collect
wastes in others specify.

26
 Solid waste disposal
1.2% 3.6%

open field
private pit
communal container
38.2% others specify
57.1

Figure 9: Solid waste disposal in pilla kebele, South ari zone, SSNPR, Ethiopia, may 2024.

Among 422 house hold 385(91.2%) house hold do not have access to municipality provided waste
disposal container, while 37(8.8%) house hold are user of municipality provided waste disposal container.

5. 4. MATERNAL HEALTH
5.4.1 Family Planning
In our survey we found 273 women who are in the age between 15_49 having the mean age of 27.26,
almost 252 of them married with 9, 150,93, 21. Women having higher, no formal, primary and secondary
educational status respectively. The husband of 3,197,17,18,8,9 women are daily labourer ,farmer,
governmental employee, house wife ,merchant and other specific respectively(2 driver,1 hair cutter,2
student,1 religious leader 2 motor driver). With 14,115,86,37 husband having higher, no formal, primary
and secondary educational statues .concerning with occupational status of women 1,119,9,126,10,8 are
daily labourer, farmer,government employee,house wife, merchant, other specific(18 students).
Knowledge of family planning is a prerequisite to obtain access and use a suitable contraceptive method in
a timely and an effectively manner. Among women respondents who are age group from 15 to 49,
412(97.6%) of them know about contraceptive methods (pill 139,implant 206,iucd 6, condom 35,
injectable 228 and ) and 10(2.4%) of women did not know the reason of this like not allowed husband,
didn’t use it before and others. From those who have knowledge about contraceptive 232 women (55%)
uses contraceptive (23, 124, 3, 123 women use pill, implant, condom and injectable respectively), whereas
190 women (45%) does not use. Of those who have knowledge about contraceptive and did not use is due
to fearing side effects 9(2.1%), familial disapproval 10(2.4%), and other specify 22(5.2%). We have asked
many of the women about the measure they will take if they want to prolong the next pregnancy six of
them responded that they will take contraceptive,15 know nothing,3 of them choose natural

27
method(calendar), 2 mentioned abstaining from sex and the rest told as that they want to give birth but
some factor as being infertile 1women, being out of marriage 4 aborted their wish ,whereas 2 of the told as
that giving birth as grace and only age will limit it.From contraceptive user women majority of their
husband has a positive feeling toward contraceptive usage (46.7%
Table 12; Husband feeling toward his wife contraception usage Pilla kebele ,Gazer town, South ari ,SEPR,Ethiopia ,May 2024.

Frequency Percent
Valid 170 40.3
He feels positive about them 197 46.7
He has no any feeling 35 8.3
He is indifferent about them 1 .2
I don t know 19 4.5
Total
422 100.0

Figure 10; knowledge about method of contraception in pilla 2024

28
 5.4.2 Pregnancy and Delivery Service
From 252 reproductive age women majority of them 137(54.3%) married by age greater than 18 and
the remaining 115(45.7%) married below age of 18 years. Regarding to first pregnancy and birth, 176
(41.4%) of them gets their first birth by age greater than 18 years and the rest are below age 18. During
our study, Among 234 respondent mothers who have under five children, 173(41%) were delivered in the
health institution, 50(11.8%) were delivered in the home and attended by non-trained Traditional birth
attendants, and 11(2.6%) were delivered in other specify. 38 women suffer health problem during
pregnancy out of 236 women we interviewed of these 38 women 4,1,1,18 ,12 and 2 are suffering from
blurred vision, high body temperature, other specific(hypertension), severe abdominal pain, vomiting and
vaginal bleeding respectively. 36 woman had problem during delivery among these 3 experience high
body temperature,10 of them prolonged labor, 15 vaginal bleeding, 5 seizure and 3 of them other specific
problem (1 of them breast abscess, pain and has undergone surgery,1 of them hypertension and 1 high
blood pressure). and 36 women were faced problem after delivery.8 of them suffer from vaginal
bleeding,16 of them from sever abdominal pain,5 of them from seizure, 5 of them from blurred
vision,1fromHNT and1 from other specific problem such as breast pain. Out of 236 women 178 of them
has gone to nearby health institution when they are pregnant. Of these 178 women 162 where visited
health institution for regular checkup ,15 due to illness and 1 for other specific problem that is for both
regular checkup and due to sickness. Of 236 women 113 were taken precaution during pregnancy in the
kind of work they do but 123. 200 take precaution in personal hygiene during pregnancy but not 36 of
them.117 of them take precaution In nutrition when they are pregnant than other days of life but the
remaining 119. Regarding to food prohibition during pregnancy almost more than 75% of the mentioned
alcohol, raw foods ,smoking and coffee as forbidden also some of them narrated that chat, honey , chat,
liver, seet potato and cabbage and so on as forbidden during pregnancy and they reasoned that those food
will cross placenta and result in both parental and child health impact and also their potential to cause
growth retardation on the child. On our survey most of mother told us that they decrease work load, avoid
alcohol, tobacco, abstain from labor work and walk with precaution when they are pregnant. And 156 of
them reported that they make special preparation on the way to delivery. 136,121 ,87, 51, 58,55 Of them
make food, money , place of birth, birth attendant supporter and house keeper and child cloth and towel
preparation respectively.

29
 5.4.3. Breast and Complimentary Feeding
From 232 under two year’s children, 157 (37.2%) initiated breast feeding within one hour and 75
(17.8%) greater than 1 hour( 49, 13, 3, 8, 2, 1, 1) initiate breast feeding at 2,3,4,6,24,30 and 192 hours
respectively. On average the child feed on their mother breast for 19.63 months. Among 234 mothers,
157(37.2%) started complementary feeding at six month while 65(15.3%) after 6 month, 158 (37.4%)
mother use bottle feeding and some mother exercised traditional practices like uvula cutting by 31
mother and extraction of milk teeth by 86 mother. 136 women believe that there were forbidden food for
infant and they mention that cow milk until 6 month, honey unpasteurized milk , under cooked
meat ,egg ,nut, alcohol,amicho and goder as forbidden for infant by reasoning out that their impact on
child health and growth retardation. Almost more than 75% of them recommend fruits and vegetables,
breast milk and dairy products for child health and development.

Table 13: Time of complementary feeding starting month in less than two years age

year Frequency

At 6 month 65

Start of Complementary >6 month 158

total 223

Age at first pregnancy

Among 252 ever married women in our study 100% were married below age of 30. with 115 (38.4%)
women being married below age 18 and 137(61.6%) women married between 18_30 years of age. In our
survey we found age at first pregnancy in 236 ever pregnant women is 25.4% in < 18 years, 19.1% in 18
years and 55.4% in >18 years. With 3.02 average number of pregnancy.in 811 pregnancy registered there
were 22 still birth 17 ,32 abortion from 24 and 641 live birth from195 women.Among 811pregnancy
recorded from 236 women 60(25.4%) women were pregnant age 17 and below,45(19.1%) at 18 and
131(44.5) women being pregnant at age of 19 and above.

30
 Age at first pregnancy

25%
<18
18
>18
55%

19%

Figure 11: Age at first pregnancy in ever pregnant women in Pilla kebele, gazer, south Ari, Ethiopia May 2024

Total number of pregnancies

There are 811 pregnancy by 236 women with 57 mothers being pregnant once,37 women 2times,35
women 3 times,38 women 4 times,24 women 5times 21 women 6 times 12 women 7 times,7 women 8
times,2 women 9 times and 1 women 10,11 1nd 12 times.

figure 12:
total No of pregnancies in pilla kebele, gazer, south Ari Ethiopia may 2024 Live birth.

Among 236 fertile women we interviewed we found 234 of them had been live birth.among these
(56,42,38,36,23,20,11,4,2,1,1,) mothers give (1,2,3,4,5,6,7,8,9,10,11) live birth respectively.

31
 Figure 13: Number of live birth in pilla kebele ,gazer , south Ari Ethiopia may 2024 Live birth.

Total Number of abortions; There were 32 abortion with (20,1,2,1) mothers experiencing
(1,2,3,4) times respectively. Therefore 5.6% of total pregnancies were aborted.

Figure 14: total No abortions pilla kebele ,gazer , south Ari Ethiopia may 2024 Live birth

Total Number of still births

In our survey there were 236 fertile women of these there were 17 mothers (3.9%) have experienced still
birth once and more times. with 14 mother being aborted once and and one mother aborting two times as
do for three times and four times still birth.so,22(3.9) pregnancy is still birth.

32
 Figure 15: total
No still births pilla kebele ,gazer , south Ari Ethiopia may 2024 Live birth.

5. 4.4. Child Health

There are 241 under five year’s old children in pilla kebele.in 194 hh with (1,2,3) childes in (150,41,3) hh
respectively. A among 194 randomly selected child 99 were female while the rest 95 is male. Among them
86 were subjected to extraction of milk teeth and 31for uvula cutting.139 of them have not exposed for
such harmful practice.

5.4.4.1, Under Five Diarrheal Diseases and Treatment

From the total 241 under 5 children, 9 children sick with diarrhea. Of these 8 are suffering from watery
diarrhea, while one of them from bloody diarrhea. Thus (2,2,2,2,2,) child suffer diarrhea for (1,2,3,4,5,7)
day respectively. All the sick children seek for care; 2 of them get care from heath center, 6 from hospital
and 1 of them were not get treatment at the health institution. I.e. they get the treatment at home. Among
the 9 children who sick’s diarrheal 7 of them was got oral rehydration salt (ORS) from health institution.6
of them continue treatment with ORS but the one. Six of the Childs parent think that ORS can treat
diarrhea but the one.7 of the parent modify their child fluid intake and feeding during diarrheal illness than
ever before. Only4 of them know sign of dehydration, they mentioned dry mouth, sinking of eye, fatigue
and weight loss as it’s manifestation.

33
 oral rehydration salt (ors)
1.7%
no treatment given
0.5%

98%

Figure 16: treatment of under 5 children with dihedral disease in pilla kebele, gazer, south Ari Ethiopia may 2024.
Under Five with other Diseases and Treatment
Among those 241 under five child we found in our survey 7 of them have fever with skin rash with
length of (1,2,3,,7,10) days respectively for (1,2,1,1,2,) child’s. Of these 7 chid 6 of them were sought
treatments. Two of them from traditional healer while 4 of them sought it from health institution. health
institution Of 5 Childs who have chronic cough 2 of them sought treatment from health institution. 5 child
had weight loss (1, 1, 2, 1) child suffer it for (1, 6, 7,240) days respectively. ( 1,3,2,1,1,1)child had
paroxysmal and whooping cough for (2,3,4,5,7,) days respectively. Among 9 child who have paroxysmal
and whooping cough 7 of them seek treatment. Of these 6 from health institution ,1 from home and 1 seek
no treatment.5 childs have acute cough 4 of them sought treatment from health institution but 1. We
found not locked jaw. one chid have eye illness with discharge from here eye for length of 3 days and he
was sought treatment from health institution. All of the 6 child who suffer from intestinal illness were
visited health institution. Among 4 child who have difficulty of swallowing 3 were visited health
institutions. Among 3 children who had accidental injuries 2 were visited health institution, we found not
accidental burns, joint pain. On average childes had 12.547MUAC, with no bilateral pitting edema.

5.4.4.2. Immunization
There were 194 children eligible for expanded program of immunization. From this age group 129[30.6%]
are fully vaccinated, 69% have partial or incomplete vaccination, [4] 0.9% have not vaccinated at all,
30.1% (127) of the vaccinated children have immunization card. From 63 child who have not shown
vaccination card 42 were lost and 21 compline that they have not recievd.Not all those who compete
vaccination shows cards. Among 190 child vaccinated 89 child from health center, 76 from health post
and 25 from hospital.

34
Table 14: vaccination coverage for eligible infant in pilla kebele, Gazer town, South Ari zone, SEPR, Ethiopia, May 2024.

Immunization YES NO
BCG 172 18
OPV0 171 19
OPV1 174 9
HPBV 130 60
Penta1 175 9
Penta2 170 11
Penta3 170 12
Pcv1 175 9
Pcv2 172 10
Pcv3 170 12
Rota1 175 9
Rota2 174 8
Measles1 152 25
Measles2 124 42
Vitamin A 139 39
IPV 171 12
In survey we made on 194 mother 143 mother have ever taken TT vaccination with (21, 6, 24, 37, 55)
mothers received (5, 4, 1, 3, 2,) respectively. But the remaing 51. 72 mothers out of 194 were received
HPV vaccine but the rest 122, from these 16 were received once and 56 two times.

5.5. Rational Medication Utilization

Among 422 hh we interviewed 32 sick person we found of these 10 were female but 22 of them were
male, with (7, 3 ,12 ,10) of them suffering from cough,diarrhea,fever and other specific(malaria,
vomiting ,abdominal pain DM breast pain,,, )respectively. Among these (26 ,4 ,1 ,1) seeking treatment
from (health institution, home self-treatment, other specificity and traditional healer respectively). Totally
out of 422 hh head 212 have ever taken medication but not the rest 210. Of these medication users 208 are
modern medicine user and the remaing 4 are traditional medication user. Out of those modern medicine
user 111, 88, 2, 1,2,4,4 get it from governmental health institution, governmental health institution private
pharmacy, governmental health institution red cross pharmacy, merchant shop ,private pharmacy and
private pharmacy governmental health institution respectively.

35
In general 206 of them get modern drug from governmental health institution,98 from private pharmacy,3
from red cross,2 from merchant shop and the rest from other specific. And of these 189 prefer
governmental health institiution,2 merchant shop and 21 private pharmacy. They prefer the source on the
base of their view concerning quality, accessibility and cost. Apart from modern medicine 88 hh use
complimentary treatment,15,7,66 hh herbs, other specific and religious therapy respectively. 45 hh prefer
complimentary treatment and they reason out it is cheap(1) easily accessible(20),effective(23) and other
specific(1) over governmental health institution.26 of them believe that there are problem that
complimentary treatment can teat but modern medicine. and 6 of them mention common cold,3 of them
evil sprite,12 of them evil eye(human eye),stress, fracture and so on. From 422 households 205(50.2%)
households utilize medication as prescribed and the rest 210(49.8%) utilize improperly. From 211
improper medication users, the reason are: 0,2% is due to ambiguity during dispensing, 1.4% is due to
unclear information about utilization From the improper medication utilizers 98.3% reasoned for getting
rapid relief. There were 352 respondents who share medication their major reason for utilization were
when common and known symptoms appear. It found that 186 households have information about drugs
in which 54 of them knows about drug toxicity and 78 knows about food drug interaction, 142 about drug
storage and 59 about drug expiry date. And they also played as that they know about the advantage and
proper usage of drug that are using. From 63 respondents who administer drug for themselves 28 of them
utilize self-medication for minor illness, 29 of them for cough, 6 of them helminthic, 17 0f them
antimalarial ,19 of them for small wound and 2 for other specify(joint fracture, DM). And they
informed us that anthelminthic, anti-pain and antibiotic as the most common drug used for self-
medication. They tailored that 36,4,1,5,17 of them get governmental institution,merchant shop,neighbors
friends,other specific and private pharmacy respectively. From drugs that used for self-medication are
more than half was NSAID. Respondents say that the most common source of described drug was
neighborhood (4.7%).
Table 15: Drug usage in accordance with prescription in pilla kebele, Gazer town, South Ari zone, SEPR, Ethiopia, May
2024.

Frequency per cent

Valid
210 49.8
No 7 1.7
Yes 205 48.6
Total 422 100.0

36
Fig 17: The reasons for improper usage of treatment in Pilla kebele , Gazer town ,South ari ,SERP ,Ethiopia ,May 2024

Among improper drug user 4 hh take extra dose to hasten healing,70 hh share drug for most common
symptom,40 keep it on open area but 172 in a locked cabinet,34 stock drug in house for emergency
case(12),for relapse case(18) and 4 of them due to lack of knowledge

Fig 18: Awareness of information about drug in Pilla, kebele, Gazer town, South ari, SERP, Ethiopia, May 2024.

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44, 332, 18, 28 of them most commonly use alcohol, coffee, other specific and tea respectively. 2 of hh
head informed us that he most often smoke cigarette, 18 hh head use alcohol often and 88 hh
sometimes, and we found 6 hh who chew khat sometimes

6. Discussion

In the study a total of422 households were selected for the sample and all was successfully interviewed,
yielding response rate of 100%. In 422 households there were a total 2039 individuals, In this study from
422 households, 98.8% are private, 1.2% rented. According to 2019 EMDHS report regarding household
ownership status, Among the 8,663 households surveyed in Ethiopia, 80% are private, 15% are rented,
and 5% are free or subsidized. The difference in rented house may be due to easily accessibility of rented
house in our study area and big difference in sample size. The study showed that, 55.9% gets their water
from spring, 23.7% pipe water, 12.6% gets their water from puplic pump and the remaining percent gets
from stream and well. In our study, we found that 77% of households use separate room and which is
detached to main house, 6.6% separate but attached to the main house, while 16.4% does not have
separate kitchen. Regarding place of cooking, Ethiopia Mini-DHS 2019 report that conducted in the urban
showed that, 28.8% cook in the house, 49.9% in the separate building, 18.6% of kitchen located out of
door and 2.6% no food cooked in household. The latrine coverage of the pilla kebele 91.2%, 47.9% of the
latrines are pit latrines with out structure, 2.6% are VIP, 40.3% pit latrine with structure and 5% pour flush
water carriage.From the total household of 422, 8.8% used municipal disposal method and 57.1% are used
open filed, 38.2% are used private pit,3.6% are used other specify areas and 1.2% are used container for
solid and liquid waste disposal. In this study from 422 house hold, 194 have <5 years child out of this 98% child
are vaccinated and 2% child are not vaccinated. . While EDHS 2016 report that the prevalence of fully immunized
children was (39%) ,the wide discrepancy is maybe due to our study area have much better educational status and
our sample population is much smaller than that of EDHIS. The study indicates 149 (35.3%) house hold 15-49 age
women’s are were not found and the other 273(64.7%) house hold 15-49 age women’s are found .

38
7. Conclusion and Recommendation

7.1 Conclusion
The female respondents have greater proportion and majority of respondents were house wife
(29.9%)and farmer(28.2%) and the rest were merchant(2.4%),daily labourer(2%),government
employee(2.1%) and other specify(1.9%) .In respect to educational status of house hold was, majority of
house were no formal education (48.1%) ,(36%) primary education,(4.5%)higher education and (11.4%)
of were secondary education. The study of households in the pilla kebele shows (47.2%) good
ventilation, (45.7%) fair and the remaining (7.1%) had bad ventilation and majority of house hold had
good illumination. Regarding kitchen condition (77%) of them were separated room detached from the
main house and the other (6.6%) separate room but attached to the main house,(16.4%) were no kitchen.
Above 55% of households get water from spring and for most only takes less than 60 minutes to fetches
water. Only 8.8% of house hold lack latrine facility and pit is the commonest type of latrine.in case of dry
waste disposal 57.1 % households use open field outside the community,38.2% use private pit,1.2% use
communal container and the rest 3.6% uses other specify to dispose their waste. Almost all female
respondents with in reproductive age 97.6% know some kind of contraceptive method and from them 55%
utilize, implant and injectable are the preferred method of contraceptives in pilla kebelle. Most women use
health facility for delivery services and from them 37% of them initiated breast feeding within 1 hour.
According to our finding chronic cough, intestinal worm, fever with skin rash and diarrheal are common
causes of under 5 children. The study indicates that only 40.8% of respondents keep the prescribed drug in
the locked cabinet 48.6% utilize medication according to their prescription.

7.2. Recommendation
We recommend to Community leaders Should mobilize the community with health extension workers,
kebele administration to solve problems like open field dry waste disposal, taking vaccination, water
supply Lack of awareness about recommended food for an infant, Poor ventilation of some houses,
Presence of domestic animals living with people in the room, Absence of fully functional toilet in some
houses, Early marriage of women and in improving house hold sanitation status.

39
  Primary Health Care Unit
 Primary health care unit should insure HE and health information dissemination on self-
medication administration, breast feeding, ANC, ORS utilization, and on timely imitation
of breast feeding.
 Primary health care unit and health extension workers should work on preventing and
reducing prevalent communicable child hood illness.
 Regional and local government officials should work on improving accessibility of
drinking water.
 Absence of fully functional toilet in some houses
 Poor TT vaccination practice.
 Early marriage of women
 Woreda health office:
 The health office of the Woreda should work hard to provide safe environment for
community through continuous and programmed health education and mass
communication.
 The South Ari Woreda health office should work hard to achieve proper solid and liquid
waste management in community.

ACTION PLAN
Problem identified
 Improper solid waste disposal(80.6)
 Unimproved latrine facility (10.7%)
 Poor utilization of family planning (45%)
 Early marriage of women(45.7%)
 Overcrowding of people living in single house (33.4%)
 Poor ventilations status, cleanness and illumination of house (20.4%)
 No clinical checkup of children under 5 years of age (21.3%)
 Home delivery practice (11.8)
 Lack of awareness about ANC follows up (38%)
 Poor awareness of precaution during pregnancy in work, nutrition and hygiene(29.1)
 Usage of polluted water (55.9%)

40
  Partial or incomplete vaccination (69%)
 Lack of awareness about recommended food for an infant(23.2)
 CRITERIA FOR PRIORITIZATION
  Severity
  Magnitude
  Community concern
  Government concern
  Feasibility

Magnitude: Severity: Feasibility: Community Governmen

concern: t concern:
<10% = 1 fatal= 5 extremely feasible Extremely felt = extremely
=5 5 supported = 5
10%-20% = 2 very sever = very feasible = 4 Very felt = 4 very supported
4 =4
21%-30% = 3 sever = 3 feasible = 3 Felt = 3 supported =3
31%-49% = 4 moderate = 2 not very feasible= 2 Not very felt =2 not very
supported = 2
>50% = 5 mild = 1 not feasible at all Not felt at all = not supported at
=1 1 all = 1

No Problem Magnitud Severity Feasibili Communi Governm Total Rank

e ty ty ent
concern concern
1 Improper solid waste 5 3 4 3 4 19 4
disposal
2 Unimproved latrine 2 3 3 2 4 14 9
facility
3 Poor utilization of 4 2 4 3 5 18 5
family planning
4 Early marriage of 4 4 1 3 4 16 7
women
5 Overcrowding of 3 2 2 1 4 12 11
people living in single
house
6 Poor ventilations 2 2 2 1 3 10 13
status, cleanness and

41
 illumination of house
7 No clinical checkup of 3 3 2 1 4 13 10
children under 5 years
of age
8 Home delivery 2 5 4 4 5 20 3
practice
9 Poor awareness of 3 4 2 2 4 15 8
precaution during
pregnancy in work,
nutrition and hygiene
10 Usage of polluted 5 4 4 4 5 22 1
water
11 Partial or incomplete 5 4 4 3 5 21 2
vaccination
12 Lack of awareness 3 2 1 1 4 11 12
about recommended
food for an infant
13 Lack of awareness 4 4 3 2 4 17 6
about ANC follows up

TOP 10 Problems
1. Usage of polluted water
2. Partial or incomplete vaccination
3. Home delivery practice
4. Improper solid waste disposal
5. Poor utilization of family planning
6. Lack of awareness about ANC follows up
7. Early marriage of women
8. Poor awareness of precaution during pregnancy in work, nutrition and hygiene
9. Unimproved latrine facility
10. No clinical checkup of children under 5 years of age

ACTION PLAN
No Prioritize objective Activities strategy Target plan Responsible person Time
Problem group fram
e
1 Usage of To decrease 1, Creating Collaboratin Communi Woreda water office in from
polluted proportion awareness g with ty who collaboration with May2
water of on cleaning water use health office, community 6 to
[spring(55. community of water professional polluted and kebele July
9%) , who try not and , health water administrative office. 01 EC
stream or to make 2, founding professional from
River water safe new water kebele spring,
(7.6%) and from 66.6% pipe and stake river,

42
 well to 50% and public holder, stream,
(0.2%) and spring user pump community well and
(no trial to from and other do not
make (55.9%) to concerned practice
water safe (40%). body. water
(66.6%)] cleaning.
2 Partial or To increase 1, provide Work with Under Health May
incomplete full easy access healthcare five department,hospitals,co 28 up
vaccinatio vaccination to provider, children mmunity health centers to
n (69%) from 30.1% vaccination. schools and and and NGO June
and no to 40.1% 2, community communit 10
vaccinatio conducting organizatio y which
n at all outreach n to educate practice
(0.9%) and partners poor child
education. and vaccinatio
caregivers. n.
Workshops,
and
information
al sessions.
3 Home To reduce 1. Create 1. Provide People Secure Health extensions, May
delivery home awareness health live in the funding for woreda health offices 26 –
practice delivery for the education communit the July2
and home community by home to y training 6
delivery by giving home vest. program
related health 2. Work through
problem education with health gerents
from 11.8% about risk profftionals and
to 5%. of home and pill partnershi
delivery. Keble p
2.Collaborat communitie
e with the s.
low
enforcemen
t and local
government
agencies to
address any
criminal
activity
related to
home
delivery
4 Improper Reduce the To done the By communit Publicize Health extension and May
solid amount of activity by collecting y the each members of the 27 to
waste solid waste the disposal increased community Jun
disposal accumulatin community. waste and enforceme 27
g in the burning this nt effort
public area solid waste. through
from 80.6% local media
to 50% and social
media.
5 Poor Increase Giving Provide communit Giving Health extension, May
utilization utilization health health y health woreda health office and 26 to

43
 of family of family education education education group of members July
planning planning about by home to two times 01
from 45 % contracepti home visit. a week.
to 60%. ve methods.
6 Lack of Create Giving clear Work Woman’s TO prepare Woreda health office, 1 to 2
awareness strongly who are them to go mont
awareness information women and hasbands
about ANC with health lack of to health hs
follows up about the about the center, awarenes center for themselves, regional
health s about check up
purpose of benefit of health sector,
organizatio ANC
ANC in the ANC and n, Kebele follows up government health
stake and even
community persuasion sector and Keble
holders, the
especially them by community husbands administration must
leader, also must
pregnant showing work communally for
religious get excess
women and different leader, even informati preserving women’s life
discus with on about
decrease figure i.e and to improve the life
womans ANC.
lack how the who expectancy of the baby.
pregnant
awareness ANC
and pre
about ANC completing pregnant
woman.
follows up mother’s
from 38% baby is
to 20%. healthier
and
happier.

7 Early To reduce Advocate Collaborate Women Government, family and May

marriage Early for the with under 18 community. 26-
of women marriage developmen government age July
from 45.7% t and al agency 26
to 37% implementa NGO and
tion of internation
policy and al
law to organizatio
prevent n.
early
marriage.
8 Lack To decrease Creating Health Pregnant Communit ANC,health office of
precaution lack of awareness education women y training woreda and health
during precaution about need every 10 institution
pregnancy during of days
in pregnancy precaution
nutrition in nutrition during
and kind of and work pregnancy.
work from
(28.65%) average of
on average 28.65 to 18
per cent.

44
9 Unimprov Decreasing Disseminat Discuss communit Per weak Household ,Group May2
ed latrine unimprove ing latrine y for one 6-
with members
facility(10 d latrine associated hour Septe
.7%) facility informatio municipaliti Health extension mber
from n to 25
es, health Workers,
1o.7% to community
5% offices,kebe Municipalities, health
offices,
le stake
holder,
community
leader
community
sanitation
campaign

10 No clinical 1. To 1.Give Collaborate Communi Three Woreda health office, May

checkup of decrease health with ty sessions Keble administration, 27-
children absence of education Keble stake per week health extension worker, july
under 5 clinical to increase holders, health professionals and 12
years of check-up Community health group members.
age under 5 awareness extension
years of age about the workers,
from 21.3% importance local
to 10%. of regular community
Give health clinical organizatio
education check-up ns, schools
to increase 2.Conductin and
Community g home visit religions
awareness To educate institutions
about the parent abut to spread
importance important awareness
of regular of regular about the
clinical clinical importance
check-up check-up. of regular
2.Conductin 3. Providing clinical
g home visit rewards for check-up
To educate family who for children
parent abut constantly
important bring their
of regular children for
clinical regular
check-up. check-up.
3.Providing
rewards for
family who
constantly
bring their
children for
regular
check-up.

45
 SWOT ANALYSIS
Strength
 Efficacious communication among all participants and the leader.
 Having good relationship with Keble leader and volunteer.
 Strong coordination among group members and community.
 Obtaining responsibility of group members on what they delegated to do.
 Presence of differentiation skills ability of group members.
 Fair task distribution with in member’s subgroups
 Active role of community to the questionnaire
 Completion of most of the tasks within given time
Weakness
 Since this is our first experience, we lack compressive understanding regarding community based
education.
 Being untimely during meeting held between the group members.
 Due to the area are so far from gazer town and having difficult road, our group members
experience feeling of tardiness.
Opportunity
 Getting of the orientation before starting the program
 Willingness and passion of community members for the questionnaire
 Being able to get the information we need from the Keble
Threat
 Shortage of technology and network in some village
 In some homes, the dogs frightened us.
 Financial problem also was limiting us from some tasks

LIMITATIONS
 Dispersed housing condition cost long travel on foot and its relief make it challenging to reach
house hold.
 We are strange for the environment and we lack experience
 Language barriers while data collection.
 its rainy climate conditions also hindered us to some extent
 Absence of previous documents
 It's too rural and we face difficulty by absence of place to buy food(cafe, hotel)
 some of its village are located far away from the gazer town

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 Reference
 https://ju.edu.et/cbe/community-based-training-program-cbtp/
 https://www.scribd.com/document/545163383/JIMMA-University-CBTP-PHASE-2
 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10201159/
 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10201159/
 http://www.solidstatetechnology.us/index.php/JSST/article/view/8187
 https://peerta.acf.hhs.gov/upitoolkit/content/community-based-training
 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693018/
 https://www.exemplars.health/topics/under-five-mortality/ethiopia
 https://www.paho.org/en/immunization/immunization-data-and-statistics

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