WALLAGA UNIVERSITY

INSTITUTE OF HEALTH SCIENCES

TTP PROPOSAL OF BURKA JATO SUB-CITY, NEKEMTE TOWN,
WESTERN ETHIOPIA, COMMUNITY BASED CROSS-SECTIONAL
STUDY FROM OCTOBER 10--NOVEMBER 8, 2016 E.C.
ADVISORS:

Mr. Mr.Dagim Samuel

Mr.Hunduma Dina

Mr.Worku Fikadu

Mr.Jibril Dori

OCTOBER,2016 E.C.

NEKEMETE, ETHIOPIA
 WALLAGA UNIVERSITY

INSTITUTE OF HEALTH SCIENCES

ASSESSMENT OF COMMUNITY HEALTH AND HEALTH RELATED

PROBLEMS IN NEKEMETE TOWN BURKA JATO SUB CITY, EAST
WOLLEGA ZONE, ETHIOPIA OCTOBER, 2016 E.C

OCTOBER 2016 E.C

NEKEMETE, ETHIOPIA
Pricimpal investigators

S.no Student Name Group number

1 Asana Abera
2 Biniyam Zakariyas
3 Chala Dasalegn
4 Chuol Chot
5 Ebise Mamo
6 Gatwech Dech Pharmacy
7 Hirut Efrem
8 Kanani Fayissa
9 LetaAdugna
10 Martha Balachew
11 Moa Bekele
12 Paulos Emiru
13 Sara Iseta
14 Tsion wondwossen
15 Zamzame Abdulkadir
16 Abdusamd Abdulfeta Midwifery
17 Gadise Cherinet
18 Lalise Fikadu
1 Minase Deressa
9
2 Sinshaw mekuriya
0
2 Yomiyu Dasalegn
1
2 Eliyas Babu Nursing
2
2 Galata Mulgeta
4
2 Lelise Tamasgen
5
26 Nagale Feyo
27 Sifan Tinshu
28 Yohanis Tariku
29 Mizbah Ali
30 Ayifokiru Gizachew
31 Dr Yirgalem Diriba
32 Dr Tokkumma Kalacha
33 Dr Milki Bayisa Medicine
34 Dr Niftalem Teshome
ACKNOWLEDGEMENT
First and fore most we want to thank Almighty GOD for everything. Next, our heartfelt thanks
go to Institute of health science for their constructive comments, sharing of ideas and
suggestion throughout proposal development beginning from designing and preparing the
questionnaires up to their assistance in covering cost of other expenditures. Our deep
appreciation also goes to our advisors Mr.Dagim Samuel, Mr.Hunduma Dina, Mr.Worku
Fikadu, Mr.Jibril Dori for their assistance, constructive comments and suggestion for our
proposal development. We would like to thank Cheleleki health centre professionals, Burka
Jato kebele leaders and community for their cooperation for the success of this Team training
program proposal.
 SUMMARY
Background: Community health problems are major issues of the world which contribute too
much for the high burden of mortality and morbidity and economic crisis across nations. Despite
technological advancement in disease detection and treatment, both Communicable and non-
communicable diseases are still major health problems in developing countries including
Ethiopia.

Objective: The aim of this study is to assess health and health related problem of the Nekemte
Town Burka Jato sub city resident from october 10 –24, 2016 E.C.

Method: A systematic random sampling methods will be conducted from october 10 –24, 2016 E.C.
We will use 5096 households as a sampling frame and a calculaed sample size is 379. But the real sample
size determined by institute of health science is 384. The first house hold will be selected by random
lottery method of the kebele and then survey will take place every 13 th(5096/384) house interval. the
data will be collected by using a face to face interview using structured questionnaire.The data will be
checked for completeness, accuracy, clarity, and consistency by advisors and Orientation will be given to
data collectors before the actual data collection. The data will be analyzed by SPSS Version 20.

Budget breakdown: the total budget required to conduct this study will be 14136.00. Ethiopian
birr.
 TABLE CONTENTS
Contents Page
ACKNOWLEDGEMENT...........................................................................................................................4
SUMMARY................................................................................................................................................5
TABLE CONTENTS..................................................................................................................................6
ACRONYMS AND ABBREVIATION......................................................................................................8
1. INTRODUCTION.................................................................................................................................10
1.1. Background...................................................................................................................................10
1.2. Statement of the Problem................................................................................................................12
1.3. Significance of the Study................................................................................................................13
2. LITERATURE REVIEW......................................................................................................................14
3. OBJECTIVES.......................................................................................................................................19
3.1 General Objectives..........................................................................................................................19
3.2 Specific Objectives..........................................................................................................................19
4. METHOD AND MATERIALS.............................................................................................................20
4.1 Study Area and Study Period...........................................................................................................20
4.2 Study Design and period..................................................................................................................21
4.3 Populations......................................................................................................................................21
4.3.1. Source population....................................................................................................................21
4.3.2. Study population......................................................................................................................21
4.3.3. Study unit.................................................................................................................................21
4.3.4. Sampling unit...........................................................................................................................21
4.4 Inclusion and Exclusion criteria.......................................................................................................21
4.4.1. Inclusion criteria......................................................................................................................21
4.4.2 Exclusion criteria......................................................................................................................21
4.5 Sample Size Determination.............................................................................................................21
4.6 Sampling Technique........................................................................................................................22
4.7 Variables of the Study.....................................................................................................................22
4.7.1 Dependent Variable..................................................................................................................22
 4.7.2 Independent Variables..............................................................................................................22
4.8 Operational Definition.....................................................................................................................23
4.9 Data collection tool and Procedure..................................................................................................23
4.10 Data Quality Control......................................................................................................................24
4.11 Data Analysis.................................................................................................................................24
4.12 Ethical Consideration.....................................................................................................................24
4.13. Dissemination of result..........................................................................................................24
5. WORK PLAN AND BUDGET.............................................................................................................25
6. REFERENCES......................................................................................................................................27
ACRONYMS AND ABBREVIATION
ANC Antenatal Care

ART Anti Retro-Viral Treatment

CBE Community Based Education

CDR Crude Death Rate

EDHS Ethiopian Demographic Health Survey

EPHI Ethiopian Public Health Institute

HMIS Health Information System

MCH Maternal and Child Health

MHM Menstrual Hygiene Management

NCD Non Communicable Disease

NGO Non-Governmental Organization

PHEM Public Health Emergency Management

SDG Sustainable Development Goal

SNNP Southern Nations, Nationalities and People’s Region

SSA Sub-Saharan Africa

TB Tuberculosis

TTP Team Training Program

UNCEF United Nation Children Fund

Table 1.......................................................................................................................................................26
Table 2.......................................................................................................................................................27
List of figure…………………………………………………………………………………………………………………
 1. INTRODUCTION
1.1. Background
Team training program is important community based learning activity that follows a problem
solving approach. It provides practical and significant development in field of health professional
training. In this program students from different health disciplines are posted at training health
centers as a team in during their graduation year. In this program it is believed that students work
as a member of a team in addressing community problems by applying and integrating their
theoretical knowledge and skill with that of the other members of the team. It also helps students
to familiarize themselves to the primary health care units. In addition to this, it gives them a
chance to learn through the process of work in a natural setting. The main objective of TTP is to
make the student able to work as members of the health team in addressing community health
challenges by applying the knowledge and skills of one’s profession and integrating these
with the knowledge and skill of other members of the team (1).

Health according to the World Health Organization is “a state of complete physical, mental and
social well-being and not merely the absence of disease and infirmity. “Health related problems
are those problems that can be caused by a person’s genetic makeup, lifestyle behaviors (e.g.,
smoking), and exposure to toxic substances (e.g., asbestos) or other reasons. Neglected
populations living under poverty throughout the developing world are often heavily burdened by
communicable and non-communicable diseases, and are highly marginalized by the health sector
due to their limited access to health and social support services (2).

Health related problems still remain one of the main causes of mortality and morbidity
worldwide as well as in sub-Saharan Africa. Among the growing concerns the top 10 health
related problems (2017-2021) are HIV/AIDS, Malaria, Tuberculosis, Road Traffic Accident,
Stroke and Ischemic Heart Diseases, Lower Respiratory Tract Infections, Malnutrition, Diarrheal
Diseases, Neonatal Conditions and Congenital Anomalies and Diabetes (3).

In sub-Saharan Africa, communicable diseases such as Malaria, Tuberculosis and HIV have long
been among the most prominent contributors to disease burden. Non-communicable Diseases
(NCDs).Although the burden of disease in Sub-Saharan Africa continues to be dominated by
infectious diseases, countries in this region are undergoing a demographic transition leading to
increasing prevalence of non-communicable diseases (NCDs) (4).

Community health problems are major issues of the world which contribute too much for the
high burden of mortality and morbidity and economic crisis across nations. Health care systems
especially in most developing countries provide inadequate coverage and do not efficiently assist
the public to produce its own health. The problem is more noticeable in developing countries due
to prevailing poor socioeconomic, health care delivery services, and environmental health status.
Poor environmental sanitation, personal and food hygiene, low coverage of maternal and child
health care services, and high morbidity and mortality related to communicable disease are the
main health problems of Ethiopia (5).

Different factors like lack of professional commitment, population awareness about the problems
of waste disposal, adequate and necessary medical equipment, in accessible health facility and
low health seek behavior leads to the community to have low health status. Communicable
diseases, nutritional problems, maternal and child health problems are the major challenging
health care related problems in Ethiopia. Ethiopia experiences a heavy burden of disease with a
growing prevalence of communicable infections (6).
1.2. Statement of the Problem
Globally, an estimated 24% of the disease burden and an estimated 23% of all death was
attributable to environmental factor. Worldwide, in 2016, 1.9 million deaths and 123 million
disability-adjusted life-years (DALYs) could have been prevented with adequate water,
sanitation and hygiene. The water, sanitation and hygiene Attributable disease burden amounts to
4.6% of global DALYs and 3.3% of global deaths (7). Ethiopian households use improved toilet
facilities (16% in urban areas and 4% in rural areas). More than half (56%) of rural households
use unimproved toilet facilities. More than one-third (35%) of toilet facilities are shared in urban
households, whereas only 2% of rural households share their toilet facilities with other
households. One in three households in Ethiopia has no toilet facility (39%in rural areas and 7%
in urban areas (8).According to cross sectional study conducted in Mettu town, south eastern,
Ethiopia the prevalence of health and health related problem was 66.23% (9).

In Ethiopia Different factors like lack of professional commitment, population awareness about
the problems of waste disposal, adequate and necessary medical equipment, in accessible health
facility and low health seek behavior leads to the community to have low health status Rapid
Population Growth followed by unmeet basic need is the basic factor that significantly causes the
problem. (6). Even though the sanitary coverage of this zonal town was relatively higher, there is
still lack of proper utilization of latrine. The town municipality has attempted to manage the solid
and liquid waste by converting in to compost for agricultural activities. Although the above
measure has been taken, there is a problem in collection, transportation and disposal of wastes on
time as a result this the community is exposed to different communicable disease (8).

Health related problems are the most serious and affecting many Sub-saharan African countries
including our country Ethiopia(10).Improper disposal of solid and liquid waste create breeding
places for insects such as flies, mosquitoes etc.; provide food and harborages for rats. These
insects and rats are health risk to human being. The growth of Municipal Solid Waste has
outpaced the growth of the population due to increasing urbanization, industrialization resulting
in change in lifestyles, food habits & living standards. The increase in non-degradable waste is
alarming. The production and consumption of non-degradable material in day to day life have
increased many folds, and finds a way out in Dumpsite which is challenging the stakeholders on
solid waste management system. Similarly, indiscriminate disposal of liquid waste from
individual houses, institutions and working places pollute water sources and land, posing serious
health problems, nuisance in a community (11,).

The government of Ethiopia refreshed its commitment to end FGM/C and child marriage by
2025 at the London Global Girls’ Summit held in July 2014. The commitment, which employs
an integrated and comprehensive strategy, puts girls at the center and targets girls themselves,
families and communities, service providers, and policy makers. As part of the commitment, the
following key areas have been identified: improving availability of data; strengthening
coordination; putting in place accountability to enhance enforcement of the existing law; and
increasing the budget for the effort to end the practice altogether or decrease it by 10% (12).

Many studies has been conducted on health and health related problem across the country.
however there is no sufficient studies in western Ethiopia specifically in Nekemte town. So our
study aimed at identifying and address health and health related problem in this town.
 1.3. Significance of the Study
The main goal of this study is to have full understanding of major health and health related
problems of Burka jato sub city. This study will help develop knowledge and skills; share
experiences among integrated disciplines of the team and teach community as a whole. The study
will help for planning and implementing of appropriate intervention at study area. This study was
used to identify the community’s health and health related problems and intervene on prioritized
problems through team work by sharing skill, knowledge and experiences. It is designed to
familiarize students with the community. In this program students are expected to go into the
community, to identity health problems with the available resource. It familiarizes graduating
health professional students with responsibility to manage health services. It also enables the
student to exercise team training practice in leading the health team in a real work situation at the
health center. The finding and recommendations from this survey will also be helpful for: local
health planners, for other students, NGOs and other stake holders to consider during their
planning provide baseline information and directions for further research activities in the area.
The information from the study will help to identify gaps in the provision of health and health
related problems.
2. LITERATURE REVIEW
2.1 Housing Condition
Healthy housing is shelter that supports a state of complete physical, mental and social well-
being. It provides a feeling of home, including a sense of belonging, security and privacy.
Housing also contributes to the burden of disease through exposing people to dangerous
substances or hazards, or to infectious diseases. For example, almost 110 000 people die every
year in Europe as a result of injuries at home or during leisure activities, and a further 32 million
require hospital admission because of such injuries (13). In Europe, it has been estimated that
7500 deaths and 200 000 DALYs are attributable to lack of window guards and smoke detectors
(14).

Approximately 10% of hospital admissions per year in New Zealand are attributable to
household crowding (12). In 2012, India recorded over 2600 deaths and 850 of various injuries
resulting from the collapse of over 2700 buildings (13). In Kyrgyzstan, household crowding
causes of deaths per 100 000 from tuberculosis (TB) per year (18). Exposure to lead is estimated
to have caused 853 000 deaths in 2013 (14).

While everyone can be exposed to the risks associated with unhealthy housing, people with low
incomes and vulnerable groups are more likely to live in unsuitable or insecure housing, or to be
denied housing altogether (15).

2.2 Condition of water Supply

Water supply should be safe, adequate and accessible to all. Safe water supply means the supply
of water is free from any form of disease-causing agents. Water supply should be free from
diseases-causing microbes, parasites, dissolved chemicals at the level that would damage health,
and any naturally occurring radioactive substances (16).

Ethiopia is naturally endowed with abundant water resources that help to fulfill domestic
requirements, irrigation and hydropower. It’s current per capital fresh water resources estimated
at 1,924 m3 year and the ground water potential of the country is estimated to be 2.8 BM3. Even
if the country is endowed with abundant water sources, the problem of getting adequate and
reliable water supply still is the most challenging issue of the country. The problems are
exacerbated by high population growth and mushrooming Towns in Ethiopia. For instance, in
1984 there were 629 locations classified as Towns and by 2000 the number had increased to 925,
all in need of water supply and sanitation services (17)

2.3 Latrine facility

Latrine utilization is defined as the use of the latrine by all the family members in the
households. Approximately, 1.1 billion people did not use any facility at all and practiced open-
defecation. Globally, about 2.3 billion people who still have no basic sanitation service either
practice open defecation (892 million). Moreover, billions of people have continued their life
without the basic sanitation services in the world (18).

In Sub-Saharan Africa (SAA) like Ethiopia, 76% of the rural population did not use a better-
quality hygiene facility, and people were exposed for diarrheal diseases in high burden especially
under five children. The majority of households, 91% rural and 54% urban, use non improved
latrine facilities (19).

The recent data Mini EDHS indicates that, in Ethiopia, more than half 55% of households
(56.7% in rural and 4.4% in urban areas) access to unimproved sanitation. The government of
Ethiopia had set to achieve a national target of 100 percent sanitation coverage in both rural and
urban areas and made different effort to achieve it by 2015. As 2011 EDHS finding, the coverage
latrine utilization in SNNP, Amhara, Tigray, and Oromia was 56%, 46%, 41%, and 40%,
respectively. Similarly, in the study done in Aneded district, the level of latrine utilization was
63% (20).

2.4 Waste disposal systems

According to community based cross sectional study conducted in bahirdar showed that Sixty-
four percent of the respondents among 270 households discharge their waste water in to the
streets and open fields. The inadequacy of sanitation services resulted in defecating in open
fields and discharging of raw waste water into inappropriate places and these, in turn, have
created serious environmental problems (21).

Ethiopia is one of the low income countries facing the consequence of improper solid waste
management. It was reported that about 20 to 30% of the waste generated in Addis Ababa, the
capital city, remains uncollected. Proper solid waste management requires the commitment of the
town municipality and the active involvement of the community members. There are many
initiatives taking place in Ethiopia to improve the environmental health especially in the capital
city. In Addis Ababa the awareness of the community members about solid waste management is
enhanced and more than 70% of the Community in habitant was willing to pay for door to door
solid waste collection service which is one of the initiatives introduced by the government (22).

2.5 Maternal and child health

According to Mini EDHS showed that the 5-year period preceding the survey, the infant
mortality rate was 47 deaths per 1,000 live births and the under-5 mortality rate was 59 deaths
per 1,000 live births. This means that 1 in 17 children in Ethiopia die before reaching age 5.
There has been a slight increase in neonatal mortality since 2016, from 29 to 33 deaths per 1,000
live births. Seventy-three percent of currently married women are in a high-risk birth category.
In the 5 years preceding the survey, 60% of infants were at elevated odds of dying from
avoidable risks; 39% fell into a single high-risk category, and 21% fell into a multiple high-risk
category. Only 23% of births were not in any high-risk category (23).

Regarding Vaccinations 44% of children age 12-23 months have received all basic vaccinations
at some time, and 40% received these vaccinations by the appropriate age. The percentage of
children who received all basic vaccinations has increased by 5 percentage points since 2016
(from 39% to 44%). A vaccination card, booklet, or other home-based record was seen for
41%of children age 12-23 months and 26% of children age 24-35 months. : 62% of children age
0-35 months did not have a vaccination card seen during the home visit. Vaccination history was
sought at a health facility for 33% of children and obtained for 29% of children (23).

Nutritional status of children: 37% of children under age 5 are stunted (short for their age), 7%
are wasted (thin for their height), 21% are underweight (thin for their age), and 2% are
overweight (heavy for their height). (23)

Breastfeeding: Almost all children (96%) born in the 2 years preceding the survey were breastfed
at some point. However, only 59% of infants under age 6 months are exclusively breastfed.
Minimum acceptable diet: Only 11% of children age 6-23 months was fed a minimum acceptable
diet in the 24 hours before the survey. Fourteen percent of children have an adequately diverse
diet (23).

The 2019 EMDHS results show that 74% of women who had a live birth in the 5 years before
the survey received ANC from a skilled provider for their last birth. The proportion of women
age 15-49 who received ANC from a skilled provider has increased over time, from 28% in 2005
and 34% in 2011 to 62% in 2016 and 74% in 2019. Institutional deliveries increased from 5% in
2005 to 26% in 2016 and 48% in 2019. During the same period, there was a sharp decline in
home deliveries (94% in 2005, 73% in 2016, and 51% in 2019) (23).

Women who delivered in a health facility were 20 times more likely to have a postnatal health
check within 2 days of delivery than those who delivered elsewhere (60% versus 3%)
Knowledge of family planning is nearly universal in Ethiopia, with 96% of currently married
women having heard of at least one modern method. Modern contraceptive use among currently
married women has increased steadily since 2005, from 14% to 41%. Injectable are the most
commonly used method among currently married women (27%), followed by implants (9%).
The most common source of modern contraception is the public sector (87%); only 12% of
women obtain their method from private sector sources (23).

2.7 Breastfeeding and Complementary Feeding

Percent distribution of youngest children under two years living with the mother by
breastfeeding status and the percentage of children under two years using a bottle with a nipple,
according to age in months. Currently, mothers exclusively breastfeed approximately half of
children under six months (52 percent). Among sub-groups the percentage of young children
who are exclusively breastfed decreases sharply from 70 percent of infants age 0-1 month to 55
percent of those age 2-3 months and, further, to 32 percent among infants 4-5 months. The
HSDP IV targets an increase in the proportion of exclusively breastfed infants under age 6
months to 70 percent by 2015. (29).
Breastfeeding can prevent a million of child hood deaths and increasing optimal breast feeding
practice could save an estimated 1.5 million infants life annually. One cross sectional community
based study on knowledge attitude and practice of breast feeding in Haromayya town showed
that 80.55% knew the exact duration of exclusive breast feeding 75.7% of mothers started
complimentary feeding at 6 months of child age and only 2.2%of mothers grew their children
without breast feeding or bottle feeding.(30).

2.8 Age at First Marriage

In the percentage of women and men who have married by specific exact ages, according to
current age. For women, marriage takes place relatively early in Ethiopia. Among Marriage and
Sexual Activity women age 25-49, 63 percent married by age 18, and 77 percent married by age
20. The median age at first marriage among women age 25-49 is 16.5 years, a slight increase
from the 16.1 years reported in the 2005 EDHS. The proportion of women married by age 15 has
declined over time, from 39 percent among women currently age 45-49 to 8 percent among
women currently age 15-19. Men tend to marry at much older ages than women. Among men
age 25-59, only 13 percent (29).

2.9 Knowledge of Contraceptive Methods

The overall knowledge of contraceptive methods among currently married women has increased
from 86 percent in 2000 to its current level, a 13 percent increase over the last fifteen years.
Knowledge has remained steady at 97 percent in the last three years. However, knowledge about
IUD and implants has increased by 41 percent and 8 percent, respectively, while knowledge
about male condoms decreased by 10 percent, over the same period (31).
 3. OBJECTIVES
3.1 General Objectives
 To assess community health and health related problems in Burka Jato Sub-city, Nekemte
Town, East wollega Zone, Western Ethiopia, from October 10-24 2016 E.C.

3.2 Specific Objectives

 To describe the Socio-demographic characteristics in Burka Jato Sub-city, Nekemte
Town, East wollega Zone, Western Ethiopia, 2016 E.C.
 To Identify Housing Condition in Burka Jato Sub-city, Nekemte Town, East wollega
Zone, Western Ethiopia, 2016 E.C.
 To identify water related problems in Burka Jato Sub-city, Nekemte Town, East wollega
Zone, Western Ethiopia, 2016 E.C.
 To describe Latrine facility utilization in Burka Jato Sub-city, Nekemte Town, East
wollega Zone, Western Ethiopia, 2016 E.C.
 To determine Waste disposal systems in Burka Jato Sub-city, Nekemte Town, East
wollega Zone, Western Ethiopia, 2016 E.C.
 To identify Maternal and child health related problem in Burka Jato Sub-city, Nekemte
Town, East wollega Zone, Western Ethiopia, 2016 E.C.

.
 4. METHOD AND MATERIALS
4.1 Study Area and Study Period
The study will be conducted in Burka Jato Sub City Nekemte town. The town is located 331
kilometers away from Addis Ababa. The location of this town on the map is 9-degree 04’North
latitude and 36-degree, 30’ Northwest latitude. Its altitude ranges from 1960-2170 above sea
level and the total surface area of the town is 32 square kilometers. The climatic condition of the
town is “Woinadega” with annual environmental temperature range of 14-26 degree Celsius. The
rain fall covers about seven months of the year (from April to the beginning of December) (36).

The total population of the town as 2021 is around 96,555 from which 49,273 (51.031%) are
males and 47,282 (48.97%) are females. There are 15312 household is live in 03 kebele. Under
<1 years 3,061(3.17%) and under <5 years 15,835 (16.4%), pregnant women 3,572 (3.7%), non-
pregnant women 17,766 (18.4%).

Different ethnic group like Oromo, Gurage, Amhara, Tigre are living in the town. Among which Oromo is
the dominant ethnic group. Afan Oromo is the official and common language of communication in the
area. Different religion followers like protestant, Orthodox and Muslims are found in the town. Among
which protestant followers are the highest in number (36).
The town is divided into seven sub cities such as: 01, 02, 03, 04, 05, 06 and 07 kebeles. From this kebeles
,07. Burka Jato subcity has 24547 population with 5096 house holds and there are 11 villages. In village 1
(685 house holds),village 2 (613 house holds ),village 3(366 house holds),village 4(365 house
holds),village 5(340 house holds),village 6(340 house holds),village 7(722 house holds),village 8(509
house holds),village 9(509 house holds),village 10(323 house holds) village 11(324) village .In this kebele
there are 11 different level of Non-governmental and Private clinics, 12 pharmacies, 46 hotels, grocery
and restaurants, one Orthodox , 10 Protestant churches, 4 governmental schools and 4 private schools.
4.2 Study Design and period
A community based descriptive cross sectional survey will be conducted from October 10 24,
2016 E.C.

4.3 Populations
4.3.1. Source population

All households in Burka Jato sub- city, Nekemte town.

4.3.2. Study population

The study population will be all households selected by stratified sampling technique in Burka
Jato sub- city, Nekemte town
4.3.3. Study unit

The study unit will be representative of household in Burka Jato sub city, Nekemte town.
4.3.4. Sampling unit

The sampling unit will be house hold in Burka Jato sub city, Nekemte town.

4.4 Inclusion and Exclusion criteria

4.4.1. Inclusion criteria
Household family’s representative/heads who are greater than or equal to 18 years of age and
those who live in the Burka Jato sub city for six or more months before the community survey
begin and have systematically selected to participate in the community diagnosis.

4.4.2 Exclusion criteria

Household members who came for vacation, a household member who lived less than 6 months
in the town and an individuals who are seriously ill.

4.5 Sample Size Determination

The sample size will be calculated using a single proportion formula with the following
assumptions. According to study conducted in Mettu town in 2021,the prevalence of health and
health related problem was 66.23%. Confidence interval of 95%, margin of error 5%, α = 0.05.

n = (Zα/2)2P (1-P)

d2

n = (1.96)2x 0.6623 X 0.3377 = 344

(0.05)2

Where,

 Z α/2 is standard score value for 95 % confidence level,

 P is proportion of success in a sample and
 d is margin of error (5%) and P is 66.23%.
 so, we have 10% nonresponse rate to get required sample size

10*344/100
34.4~35

344+35=379

So, the final sample size was 379

4.6 Sampling Technique

Systematic random sampling technique was used to select the sample. We will beprepared
sampling frame based on the list of available households in Burka Jato sub city. The lists will be
obtained from the Burka Jato kebele office.

To calculate K-value

K=N/n

K=5096/384

K=13.27

K=13

4.7 Variables of the Study

4.7.1 Dependent Variable
Health and health related problems

4.7.2 Independent Variables

 Socio-demographic factors like age, sex,
 Housing condition and environmental health survey
 Condition of water supply
 Availability Latrine facility
 Waste disposal systems
 Maternal and child health

4.8 Operational Definition

Community diagnosis: is identification and quantification of health problems in a community
as a whole In terms of mortality and morbidity rates and ratios, and identification of their
correlates for the purpose of defining those at risk or those needs of health care (32).
 Health & health related problems:- Includes MCH (ANC, Abortion ,TT immunization status
of women 15-49 years old, family planning ,breast feeding, immunization status of under 5
children) ,HTP, Housing , common cause of morbidity and mortality, larine, water supply (33).

Poor environmental sanitation: the all uncontrolled factors in man’s physical environmental
which exercise or may exercise a deleterious effect on his physical, mental or social wellbeing
(34).

Water supply: is the provision of water by public utilities, commercial organization, community
endeavors or by individuals, usually vie a system of pumps and pipes (35).

Inadequate water supply; Lack of safe water for use (36).

Skilled birth attendant: Birth attendants who attend birth in or out of health institution with
scientific skill and knowledge (37).

Home delivery: when a mother gave birth at her home or others home (neighbor, relatives, or
family) or when a birth takes place outside of health institution (38).

 Ventilation:
 Good – A house which has one or more widows for a room which are functional

 Fair – A house which has one window but function partially

 Bad: No windows or closed all the time/non functional

 Illumination
 Good:- A house in which lead/pencil written material can be read by natural light

 Fair: A house in which ink written material can be read by natural light

 Bad: ink written material is illegible

4.9 Data collection tool and Procedure

The quantitative data will be collected by all group members using structured questionnaire face
to face interview and checklist.. The questionare will be prepared by wallaga university institute
of health science. Then we will discuss on thoroughly about the questionare in order to get
common understanding before data collection. The questioner will be prepared in English and
data collectors translated it in Afan oromo during data collection. Then fill it by English on
prepared questionnaire. The questioner consists of socio demographic characteristics, housing
condition, water supply, waste disposal system latrine facility and mother and child health. The
data will be collected by systematic random sampling technique.

4.10 Data Quality Control

Data will be collected by group members after having common understanding on the
questionnaire then the Collected data will be checked for completeness and consistency on daily
basis by group members and Visited houses will be marked to avoid re-enter by other data
collectors and there will be deep supervision by the supervisor.

4.11 Data Analysis

The data will be analyzed by using SPSS software; descriptive statistics will be done for most
variables in the study using statistical measurement frequency, percentage, means, and Standard
deviation in the form of table and graphs.

4.12 Ethical Consideration

Before actual data collection Formal letter was written from Wallaga University similarly the
permission is needed from Burka Jato sub city then Full consent of a respondent will be asked
during data collection, the aim of the study will be explained before asking questions, Data will
be kept confidential, Culture, Norm & life style of the society will be respected.

4.13. Dissemination of result

The findings will be presented to the Wallaga University community service office and
department of public health, Burka Jato Sub-city administration and it will also be communicated
with local health and development planners in the area.

5. WORK PLAN
6.1. Table 1: work plan

No Activities December
 Responsible
body

2nd Wk

3rd Wk
1st Wk
1 Receiving orientation on X Sup+
CBTP Students

2 Formation of CBTP group X WU

3 Naming of the team leader X Students
and reporter
4 Knowing the supervisors of X Students
group 4
5 Site selection and X WU
assignment for CBTP
6 Collecting letter from X Students
department.
7 Communicating with head X Students
of Cheleleki HC & Burka-
jato sub-city head.
8 Identifying the study X Students
community, collecting
baseline/background
information and data.
9 Develop proposal and X Students
investigation tools
10 Gather data for problem X Students
identification
11 Process and analyses of X X Students
data
12 Problem identification and X Students
priority setting
13 Submitting the community X Students
diagnosis for supervisors
14 Develop intervention X Students
action plan
15 Presentation of community X Students
Diagnosis

6. BUDGET PROPOSAL
Table 2: Budget break down
6.2.1. Personnel and transportation expenses
S. Title No. of person Day Allowance Total
No (duration) /day E.B
1 Data collector 34 3 100 5100.00
2 Advisor fee - - -
Total 34 3 100 5100.00
6.
7. 5.2.2. Materials and equipment expenses
8.
S. No Budget category Unit Quantity Unit price Total prices
1 Duplicating paper Dosta 4 650.00 2600.00
2 Pen Each 34 20.00 680.00
3 Pencil Each 34 10 340.00
5 CD each 2 60 120.00
6 Stapler Each 1 150 150.00
7 Staples Pack 3 10 30.00
8 Sharpener Each 17 20 340.00
9 Marker pack 12 50 600.00
10 Binding Each 17 80 1360.00
11 Note book Each 34 50 1700.00
12 Printing Page 420 3 1260.00
12 Flip chart Pad 2 150 300.00
13 Plaster Roll 2 150 300.00
Total 9780.00

5.3. Budget Summary

S. No Budget category Total price
A Personal 5100.00
B Materials cost 9780.00
C Sub - total (A+B) 14880.00
D Contingency (5% sub total 744.00
E Grand total (C+D) 14136.00

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