ARSI UNIVERSITY

COLLEGE OF MEDICINE AND

HEALTH SCIENCES
DEPARTMENT OF PUBLIC HEALTH
IDENTIFYING, PRIORITIZING & DRAWING AN ACTION PLAN FOR
HEALTH AND HEALTH RELATED PROBLEMS IN ASELLA TOWN

C-II STUDENTS

Asella, Arsi, Oromia, Ethiopia

August, 2023
FIRST FORTNIGHT
REPORT
Outline
• Background
• Objective of the research
• Methodology
• Results with conclusions
• Identified problems & Prioritized problems
• Challenges & Attempted solutions
• References
 Background
• Asella is a town,Located in the Arsi Zone of Oromia Region 126 km
south from Addis Ababa
• has a latitude and longitude of 7°57′N 39°7′E with an elevation of 2,430
meters
• The estimate of population for mid 2022 produced a total of 139,537
inhabitants, of whom 69,459 were male and 70,078 were female.
• Total number of Kebeles -
• Total number of health center -
Asella District Map
Objectives
• General Objectives

• Identifying, prioritizing and drawing an action plan for health and health
related problems in Asella town.
Objectives
• Specific Objectives

 Identification of community problems

 Give an intervention
Introduction
Community Diagnosis
- Refers to the identification and quantification of health problems in a community
as a whole in terms of morbidity and mortality rates and ratios, and identification
of their correlates for the purpose of defining those in need of health care.
Methodology
• Study Period: august 6 – august 20, 2023 .
• Study Area: Asella Town, Kebele 10(dinsho area)
• Study Design: Community based descriptive cross-sectional study design
• Source Population: All households in Asella town
• Study Population: All households in Kebele 10, asella town(dinsho area)
Methodology
• Sampling Unit: Household
• Sample Size: 495
• Sampling Interval (k): 5
• Sampling Technique: Simple and Systematic Random Sampling
• Sampling Frame: Asella Town Kebele 10(dinsho area) office registry
 Exclusion & Inclusion Criteria
Inclusion criteria: all individuals in the selected household living in the
house at the time of data collection.

Exclusion criteria: all individuals in the selected household not living in

the house at the time of data collection.

10/01/2023 12
Data Collection Process
The data collection tool was structured in an open & closed ended
questions in English version questionnaires which was used to collect
the required information, and data was collected by 33 members of C-
2 medical students of ARU, COHS. The duration of data collection was
from august 6 – august 8, 2023.

Data Entry and Analysis

• Data was entered with epidata and analyzed employing SPSS version
25.

10/01/2023 13
Operational definitions
Household - officially registered family living in the study area and
includes persons currently living in the specific house.

Family income- total annual income changed to money, divided to 12,

it including all assets.

10/01/2023 14
Data Quality management
To control the quality of the study፡

• orientation of the respondents.

• Revision of the data before analysis were done.

10/01/2023 15
Ethical consideration
• Supportive letter was taken from kebele administration.

• Autonomy-approval was obtained from Asella Health office, respondents & other
stakeholders.

• The objective of the study and the procedure was explained to the study
participants that no harm would happen on them regarding the study conducted.

• Moreover, the issues of confidentiality was explained.

10/01/2023 16
Dissemination of result

• Based on the findings, after conclusion and recommendation was

made, one copy of the research paper will be submitted to ARU-
COHS, Department of public health & other stakeholders in need.

• If possible, to be published in journal's.

10/01/2023 17
Limitation of the study
• Sampling error
• Responder bias –respondents answer what they know rather than
what they practice.
• Questionnaire not comprehensive and targeted regarding the
organization and listing of options and problems.

10/01/2023 18
 WORK PLAN
- Work plan for community diagnosis in Asella town, Kebele 10 Arsi zone,
Oromia, Ethiopia august 6-august 20,2022.

10/01/2023 19
Day 1
• All students gathered and selected working areas then we draft a
roadmap on what we should do next .

• After sorting out our working area we try to visit the area .
Day 2
• Introduced with the local health centre and municipal office.
• Letters were given to each office.
• Kebele 10 was picked .
• Introduced with Kebele 10 and collected necessary data from there to
determine our sample size.
Sample Size Determination
•
Non-response Rate
• 5% (15) non-response rate was added on determined sample size.

Final Sample Size = 495

Day 3-5
• Visited and observed dinsho area.
• We assembled into 5 groups to cover the 5 zones for data collection.
• Tried to understand the basis of the questionnaire and discussed on
how to proceed with the data collection.
• Raised questions to our supervisor and it was clarified.
Day 6 – 8
• Data collection was started early morning at 03:00 LT – 10:00 LT.
• Our main point of reference was the municipality.
• Data collection took 3 days.
Day 9-11
• Data entry on epidata was well elaborated by our supervisor.
• Template preparation was done.
• Each student filled their own respective data on epidata.
• Data clearing was done.
• Difficulties were discussed with supervisors.
Day 12 - 17
• Data analysis was completed.
• Preparation on fortnight report.

• Grouped into two groups of 16 and 17: Static and Outreach.

Work plan
S.N august 2023 4 5 8-9 10-13 14-20 21

1. Area selection

2. Letter from kebele administration to

stakeholders.
3. Data collection.

4. Data entry and cleaning

5. Data analysis and write up

6. Fortnight reporting
Sociodemographic Data

Variables Frequency Percent (%)

Sex Male 141 29.5
Female 354 71.5
Total 495 100
Age 20-29 31 6.2
30-39 91 18.3
40-49 133 26.8
50-59 130 26.2
60-69 81 16.3
70-79 20 4
80-90 9 1.8
Total 495 100
Con’t

Variables Frequency Percent(%)

Ethnicity Oromo 334 67.5
Amhara 110 22.2
Tigre 15 3.0
Others 22 4..4
Total 481 100
Marital Status Single 27 5.5
Married 390 78.8
Divorced 22 4.4
Separated 48 9.7
Widowed 8 1.6
Total 495 100
Con,t
Variables Frequency Percent(%)
Educational Primary school 74 14.9
Status Secondary school 111 22.4
Diploma level 67 13.5
College level 51 10.3
university 59 11.9
Degree and Above 87 17.6
missing 46 9.3
Total 495 100
Religion Orthodox 268 54.1
Protestant 68 15.8
Catholic 3 0.6
Muslim 144 29.1
waqefetta 1 0.2
Others 1 0.2
Total 495 100
Con,t

Variables Frequency Percent(%)

Occupation student 8 1.6
housewife 62 12.5
merchant 104 21.0
Civil servant 144 29.1
Private employee 98 19.8
Farmer 25 5.1
Daily laborer 23 4.6
Other 31 6.3
Total 495 100
Family Members Male 495 495
Female 1040 52.6
Total 1,978 100
Con’t
Income

3%2%
0% 1000-5000
6%
21% 5000-10000
11000-15,000
16,000-20000
18% 21,000-30000
above 30000
missing

49%
Enviromental health and personal hygiene

Variable Frequency Percent(%)

Number of rooms
1 21 4.1
2 82 16.6
3 151 30.5
4 127 25.7
5 77 15.6
6 23 4.6
7 11 2.2
8 3 0.6
Total 495 100
Cont

• Windows are available in 97.4% of houses and 95.4% of those houses have good
ventilation.

• On 96.2% of households there is kitchen where 26.3% of the kitchen is attached

to the main house while 69.9% is separate from the main house.

• 22.0% keeps food on open environment ,18.8% uses shelf and 58.2% uses
refrigrator
Water Supply
• For 488(98.6%) households source of drinking water is
pipe/tap water
• Only 1(0.2%) and 6(8.4%) use well and chemically treated
water, respectively.
120
source of water supply
100

80

60

40

20

0
pipe well other

Series 1
Con,t
• 43.2% of the households say the frequency of amount of water used is sufficient
while 56.8% of the say it is not suffiecnent

• 15.2% of them say this water supply is adequate through out the year and 84.8
says it is not adequate.

• 85.5% says there is no cause of pollution of water supply, 12.9% says it is

contaminated by soil.
Waste disposal and sanitation
do you have latrine
4

96

yes no
• For those who have latrines 67.1 % of them has pit latrine, 10.3% have ventilated
improved pit latrine,18,3% have water flushed latrine.

• 74.3% of them has 1 toilet, 21% have 2 and 0.6% of them has 3 toilets.

• 67.5% of the households say the toilet have enough water supply, while 21.7% says
otherwise
Solid Waste Disposal

Variables Frequency Percent(%)

Put it in the sack 195 39.4%
Dispose in the open whole 25 5.1%
prepared
Burning 47 9.5%
Collected by municipality 187 37.8%
Dispose on the open field 25 5.1%
Other 16 3.2%
Total 495 100
Waste Disposal
• Out of 495 households 475 (96.0%) have their own latrine.
 332 (67.1%) is pit latrine
 51 (10.3%) is ventilated improved pit
 89 (18.0%) is water flushed

• Out of 495 households 20 (4.0%) have no independent latrine.

 8 (1.6%) share with neighbors
 10 (2.0%) use common latrine
 2 (0.4%) use open field
Solid Waste Disposal

Variables Frequency Percent(%)

Put it in the sack 195 39.4
Dispose in open holes prepared 25 5.1
for this purpose
Burning 47 9.5
Collected by municipality 187 37.8
Dispose on the open field 25 5.1
others 16 3.2
Total 495 100
Personal Hygiene

Handwashing Time
Variables Frequency Percent(%)
Always before meal 478 96.5
Always after meal 473 95.5
Always after toilet 437 88.2
Always when touching dirty things 368 74.3

During food preparation 411 83

Handwashing Material

Variables Frequency Percent

Water Only 56 11.3
Other 6 1.2
Water and Soap 433 87.5
Total 495 100.0
Tooth Brushing
Frequency Percent(%)
Brushing teeth No 87 17.6
Yes 408 82.4

Total 495 100.0

Maternal & Child Health
• 64 (13.7%) were 18 or below and 402 (86.3%) were above 18 years of
age at marriage.

• 35 (7.5%) were 18 or below and 428 (92.5%) were above 18 years of

age during their first birth.
• 198 (40%) of the 383 have been vaccinated twice or less while the
rest have been vaccinated 3 times or more.
Place of Delivery
• 415 (83.8%) delivered in health institutions and all deliveries were
attended by skilled personnel.

• 47 (9.5%) delivered at home.

• There is no maternal death registered in any household associated

with delivery.
Variable Frequency Percent
Postnatal follow up Yes 129 26.1
No 335 67.7
Total 464 93.7
Initial Breastfeeding After Birth
Variables Frequency Percent(%)
Within 1 hour after birth 398 80.4
After 1 hour of birth 66 13.3

Exclusive Breastfeeding Duration

Variables Frequency Percent (%)
For less than 6 months 78 15.7
For first 6 months 408 82.4
Fore more than 6 months 9 1.81
Is your last child immunized
Variable Frequency Percent
child immunization Yes 453 91.5
No 11 2.2
Frequent Child Diseases
• 74 (14.9%) – child sickness in the past 2 weeks

Variables Frequency Percent

Common Cold 51 10.3
Thyphoid 9 1.8
Tuberculosis 5 1.0
Pneumonia 5 1.0
Others 4 0.8
Total 74 14.9
Environmental pollution
source of noise polllution source of air pollution
yes
11.1 1%

88.9 no
99%

yes no
yes no
Vector
vector
15.20%

37.40%

23.20%

3.40%
6.30% 14.50%

common housefly cockroach fleas ticks mosquitos other

9.1% use bed net to control vectors,28.9% just clean house and environments.33.7%
uses nothing and 28.3% uses roach killer.
 Infectious and Non-infectious
Disease
Types of Illness
Sick family member in the past 2 weeks
Frequency Percent (%)
Frequency Percent (%) common cold 51 10.3

No 421 85.1 Pneumonia 5 1

Tuberculosis 5 1
Yes 74 14.9
Typhoid 9 1.8
Total 495 100
Other 4 0.8
Family Member with Chronic Diseases
Variables Frequency Percent
None 384 77.6
Hypertension 74 14.9
Diabetes Mellitus 23 4.6
Cardiac Diseases 7 1.4
Renal Diseases 4 0.8
mental illness 3 0.6
total 495 100

Family Member Chronic Disease Follow-up

Variables Frequency Percent (%)

Yes 110 22.2

No 1 0.2
Total 111 22.4
 Awareness on cause and prevention
of chronic diseases
• Cause
– 101 (20.4%) – Family History
– 58 (11.7%) – Stress
- 81(16.4%) – Obesity
- 100(20.2)-aging
-49(9.9)-excessive salt
– 106 (21.4%) – No awareness of cause

• Prevention
– 217(43.8%) – has awareness of prevention
– 278 (56.2%) – No awareness of prevention
 Frequency of death in the last 12 months

Frequency Percent

No 450 90.9

Yes Male 32 6.5

Female 13 2.6

Total 495 100

The reason for death is Old age 10(47.6%), Cardiac related 5(23.8%), unknown reason 2(9.5%), RTA 2(9.5%), Military service 2(9.5%)
VECTORS
which vector are common
40

35

30

25
Percent

20

15

10

0
common house fly cockroach fleas tick mosquitos other

which vector are common

Vector Control Mechanism
• 167 (33.7%) use no control mechanism.
• 143 (28.9%) use cleaning home and environmental hygiene as control
mechanism.
• 140 (28.3%) use insecticide spray androach killer as control
mechanisms.
presence of harmful traditional
practice
frequency percent

yes 43 8.7

no 452 91.3
kind of traditional practice
q1903 what kind
50

45

40

35

30
Percent

25

20

15

10

0
early marriage abduction female circumscision cutting uvula tattoo others

q1903 what kind