‫بسم هللا الرحمن الرحيم‬

‫‪Group 4‬‬
‫‪Supervisor: Dr Alla‬‬
‫تريعة البجا‬
 Introduction
The village of Trait Albeja is located in the localities of Jabal
Awlia, Khartoum State, Sudan, where it is approximately 32
kilometers away from the capital.
The last statistics done concluded that the village homes 4500
people.
It consists of four neighbourhood blocks, the density of the
population in the first and fourth while the second and third
distribute service centers and facilities.
• An Estimated 70% of the population are self-employed and
span the course of various professional occupations such as
blacksmith, agriculture, fishing etc, the remaining 30% are
teachers and physicians.
• People in need in the area are down to 300 families.
• There are 7 mosques in the area & 2 public elementary school,
2 public high schools/secondary schools, 3 private elementary
schools, 2 private high schools.
• 1 craftsmen institute & 1 public university
 Boundaries
• From the eastern side the village is surrounded by factories &
Alloata, on the western side runs the White Nile river
• On the northern side, lies the area of Teyba Alhasanat, finally
the southern side is the area of Alassal.
 Culprits
1. Environmental Problems: Waste, as many residents of the
village complained, is one of the greatest challenges for the
people of Trait Albeja, where proper waste disposal is not
accessible.The youth of the area arrange campaigns every now
and then to collect and burn garbage, but to no avail.
2. Educational Problems: The feebleness of the budget and the
size of the population has had an impact on providing a proper
educational environment for the children of the village
• One school in the village in particular consists of 8 classes,
each class an estimated 180 students.
3. Health Problems: Lack of medical personnel, as there is no
service at the health center in the evening period.
Insufficient medicine to cover the whole span of the village.
 Departments of the Health Centre
Medical officer

Health Insurance (Shawamikh)

ECG & Ultrasound

Lab & Pharmacy

X-Ray

Family Physician

Dental Clinic

Accounting

Major, Minor Surgery & Asthma Room

 Pharmacy
• The availability of medicines for chronic diseases is 75% for
people with health insurance including malaria therapy
• Due to the high cost of medicine in the health centre pharmacy,
people are self-treating with home remedies
 Nutrition Department
The services provided by the department are
1. Meals for the malnourished
2. Nutritional education
This is done for children from 6 months to 59 months of age +
pregnant and lactating women
Malnutrition is classified into
3. Moderate
4. Severe
 Moderate Malnutrition
• Is more prevalent than severe malnutrition
• Assessed by the zero score, where -2 is deemed moderately
malnourished
• Mid upper arm circumference (MUAC): 11.5 - <12.5
• If a child's zero score is more than -2, they are deemed healthy
 Severe Malnutrition
• Zero score is -3, Follow up is performed weekly
• Severe malnutrition can transform to moderate malnutrition if
MUAC increases to 11.5 - < 12.5
• Meals for severe malnutrition is severed once per day and
consists of peanuts and carbohydrates (500 calories) and follow
up is done after 15 days from the first appointment, the child
should gain 1/2 a kilo in 15 days to be pronounced healthy
 Complications of Malnutrition
• Convulsions
• Loss of appetite
• Drowsiness
• Loss of consciousness
• Hypoglycemia
• Severe dehydration
• Severe anemia
• Lower respiratory tract infections
• Fever
• Bitot's spots (Sign of vitamin A deficiency)
• Severe diarrhea
• Skin ulceration
• Bi-lateral pitting edema of the legs
 Treatment for complications
• Vitamin A
• Folic acid
• Amoxicillin
• Metronidazole
 Malnutrition in pregnancy & lactation
• Moderate malnutrition is MUAC < 21 in pregnancy and the
assessment is only performed in the 2nd trimester

• According to lactating mothers: the assessment is performed

only when the newborn is 6 months old, the mother is
pronounced malnourished if the MUAC is < 21
 Health Visitor
• The duties of the health visitor is to educate women on:
1. Antenatal & postnatal care
2. Family planning & contraindications of contraceptive pills
(diabetes, hypertension, migraine, thyroid disease)
3. Awareness about female genital mutilation (midwives can be
subjected to penalty)
4. Referral to specialized centers in cases of twin birth,
eclampsia, severe anemia, lower limb edema, grand multipara,
primigravida & excessive vomiting
 Midwife
Training:
1. Basics of labour
2. Neonatal resuscitation
3. Prevention of bad practice
4. Female genital mutilation education
Referral:
Twin birth, Eclampsia, severe anemia, grand multipara,
primigravida, excessive vomiting
 Most prevalent problems
• Anemia, due to missed antenatal care vista, the midwife
administers folic acid at home & follows up with vital sign
assessment (eye pallor, mucus membrane pallor, palmer pallor)

• Increased home births leading to complications

• She recommends a labour room & an ambulance

(increased birth complications)
 Immunization
The Available Service;
1. Awareness ( posters – immunization cards –growth and
development booklets)
2. Messages ( natural lactation –personal hygiene –antenatal
care)
• All vaccination are available including vitamin A
• Case reporting system
• Frequency of immunization 50 children\day
• Vaccines preserved in the cold chain (pentavalent - rota virus-
opv)
• Medical officer Siddig Suliman (in 1995 the PHC centre used
to be a hospital then downgraded to a PHC Centre in 2021, in
2016 new buildings were added funded by Italian NGO’s
• Problems facing the Centre:
• Power cuts
• Unavailability of services
• Low finance
• Absence of labor room and ambulance
 Lab
• An estimated frequency of patients per day: 100 patients
• Most prevalent disease cases: Malaria, UTI, Giardia
• There are 2 lab techs working at the health centre
• Sterilization techniques used is the autoclave
 Lab Tests
Available Not Available
Urine General CBC

Blood Film for Malaria Widal

Urea Creatinine

Uric Acid LFT, RFT

HCG HBA1C

H. Pylori TFT

Viral Screening

ESR

CRP
 Asthma Room
• Frequency of patients per day: 25 Patients
• Available equipment: Nebulizer machine, an empty oxygen
cylinder and one salbutamol inhaler
 Community Feedback
• Treatment for children under 5 years old is free
• Most medicine is not available including antibiotics
• Work hours are very limited
 Statistics
• 70% of the occupant of the village have health insurance whilst
the other 30% don't.
• The health centre provides daily, monthly and infectious
records (malaria, dysentery, hepatitis) + referral cards for
nearby hospitals/ health centers
• Frequent cases admitted: Burns at home
 Solutions Proposed
1. Provision of trucks for the proper disposal and transport of
waste,
2. Employing new medical personnel to provide health services
in the evening period.
3. Review and supply of essential medicine
4. Trying to provide more space for building classrooms for
schools
DATA ANALYSIS
 Age group

18 - 25 15%
25 - 40 20%
40 - 60 40%
More than 60 25%
Gender
 
Male 17%
Female 83%
Occupation
 
Public sector 17%
Private sector 8%
Agriculture 1%
Trader 50%
Student 10%
Unemployed 14%
Education level
 
Ilitercy %28
Khalwha 25%
Basic % 30
Secondary %11
University 5%
Postgraduate 1%
 Health services of the centre
60%

50%
50%

40%

30%
30%

20%
20%

10%

0%
avialable Not avialabe didn’t answer
 Visits to the health centre
45%

40%
40%

35%

30%
30%

25%

20%
20%

15%

10%
10%

5%

0%
One time two time many time No
 Treatment preference
45%

40%
40%

35%

30%
30%

25%
25%

20%
20%

15%

10%

5%
5%

0%
home center hopsital shiakh not recived
 Midwife
60%

50%
50%

40%
40%

30%

20%

10%
10%

0%
avaliable not avaliable don’t know
 Chronic Diseases in the Family
60%
55%

50%

40%
40%

30%

20%

10%
5%

0%
No yes don’t know
 Blood Pressure Health Education
80%

70%
70%

60%

50%

40%

30%
30%

20%

10%

0%
Yes No
 Diarrhea & Diabetes Health Education
90%
80%
80%

70%
65%

60%

50%

40%
35%

30%
20%
20%

10%

0%
diabetes diarrhea

Yes No
 Blood Pressure
80%

70%
70%

60%

50%

40%

30%

20%
20%

10%
10%

0%
Male female don’t have
 Diabetes
60%

53%

50%

40%

30%
30%

20%
17%

10%

0%
Male female don’t have
 Diabetes & Blood Pressure
diabetes blood pressure

60%

50%
50%

40%
40%

30%
30%
25%
20%
20%
15% 15%

10%
5%

0%
18 - 25 25 - 40 40 - 60 more than 60
 Income
50%
45%
45%
40% 41%
40% 39%

35%

30%

25%
20%
20%
15%
15%

10%

5%

0%
10000 10000 - 20000 more than 20000

diabetes blood pressure

 COVID-9
25

21
20
20

15
15

10 10
10 9 9

5
5

2
1
0 0
0
Ilitercy Khalwha basic secondary university postgraduate

reviced Vaccine Not reveiced

 Diarrhea
45

40
40

35

30
30

25

20
20

15

10
10

0
Venitalator pit improved latrine traditional latrine Don't hav Syphone
 Malaria & Bed Net Use
90%
85%
83%
80%

70%

60%

50%

40%

30%

20% 17%

10% 7% 8%

0%
0%
Yes No didn’t answered

family member caused by Malaria use bed net

 Blood Pressure
80%

70%
70%

60%

50%

40%

30%

20%

10%
10% 7% 8%
2% 3%
0%
0%
worker in public sector worker in private farmer trader student not work don’t have
sector
 Diabetes
35%
32%
30%
30%

25%

20%

15%
15%

10%
8%

5% 4%

1%
0%
0%
worker in public sector worker in private farmer trader student not work don’t have
sector
 Health Services
60%

50%
50%

40%

30%
30%

20%
15%

10%
5%

0%
satisfaction accepted not satisfaction A/N

service in center
 COVID-19 Vaccine
60%
55%

50%

40%
40%

30%

20%

10%
5%

0%
vaccinated Non vaccinated didn’t answer
 Reasons why they didn't receive covid-19
vaccine
45%
42%
40%

35%

30%

25%
21%
20%
20%

15%

10%
10% 9%

5%

0%
not avialabe unprotected center far friad didn’t answer
 Have Children
60%

55%

50%

40% 38%

30%

20%

10%
7%

0%
Yes No didn’t answre
 Children with pneumonia
80%

70%
70%

60%

50%

40%

30%

20%
20%

10%
10%

0%
Yes No didn’t
 Children with diarrhea
90%

80%
80%

70%

60%

50%

40%

30%

20%
15%

10%
5%

0%
Yes No didn’t
 Child Immunization
60%

50%

40%

30%

20%

10%

0%
Vaccined non vaccined didn’t answer
 Findings
• The study showed different aspects of illiteracy other than
khalwa, elementary school university graduates
• The number of females is higher than males
• The majority of the population works in public sectors with low
income
• Most of the occupants of the village have traditional latrines
• Absence of maternal and child health
• Lack of education about chronic diseases is a common problem
 Recommendations
• Most curriculum of school contain materials and activities of personal
hygiene
• Must strengthen health education of population and promote health
activities in the area .
• There must be collaborations between health sector and families .
• Encourage family members to exercise health activities in their home
• There must be inspection from health authority about clean and
appearance of area.
• There must be follow up from mothers and fathers for their children
before and after got their vaccination and surround environment.
 The Chosen Problem
• We, group four, have chosen diarrheal diseases as our main
problem to tackle mainly due to it's high prevalence.
• In some parts of the world diarrhea is a life threatening
condition due to dehydration & electrolyte loss
 Intervention
• Hygiene (personal, environmental & community)
• People must know what diarrhea is (how many times per day,
signs and symptoms)
• Awareness about dehydration
• Oral re-hydration therapy preperation (ORS)
• Lectures, Posters, Videos & leaflets
• Education about food preperation, storage, boiling of water
• Distance between kitchen & bathroom
• Water source
• Health education for mothers & children
 Water
• All children, women & men in the community should use safe
water sources for drinking & food preparation.
• There should be no risk of contamination of water sources from
nearby latrines, waste water drainage, cattle or agriculture
chemicals
• Water should be transported in a covered container
 Food Handling
• Hands should be washed with soap or ash before food is
prepared or eaten. Vegetables & fruits should be washed with
safe water & food should be properly covered.
• Utensils used for food preparation & cooking should be washed
with safe water.
 Signs & symptoms of diarrhea
1. Frequent watery stools
2. Abdominal cramps
3. Fever
4. Bleeding
5. Lightheartedness/dizziness from dehydration
 What is dehydration?
• Dehydration is when your body loses more fluid & electrolytes
than you take in. If not treated it can get worse & lead to
serious problems.
• Symptoms of dehydration in adults:
1. Feeling thirsty
2. Dark coloured urine
3. Feeling dizzy & lightheaded
4. Dry lips, mouth and eyes
5. Urinating less than 4 times a day
 Preparation of ORS
• Give the child a drink made with 6 level teaspoons of sugar and
1/2 level teaspoon of salt dissolved in 1 liter of clean water.