JIMMA UNIVERSITY

Institute Of Health

Faculty Of Health Science

School Of Pharmacy
CBTP phase IV evaluation report

By: year 4 pharmacy students,

Place: Buyo Kechema Kebele, jimma zone

1
 Outline
 Introduction
 Background of the study area
 Significance of the study
 Objective
 Method and material use
 Result and discussion
 Problem encountered during the data collection
 Conclusion and recommendation
 Acknowledgement
 Reference
2
List of Abbreviations
CBE: Community Based Education
CBTP: Community Based Training Program
DTTP: Developmental Team Training Program
FIG: Figure
HI: Health Institution
JU: Jimma University
SRP: Student Research Program
OTC: Over The Counter
POM: Prescription Only Medication

3
Key Terms
 Modern medicine: Also known as Allopathic or western medicine, modern
medicine is the most advanced, scientifically based, and statistically
approved therapeutic system and diagnostic methodology.
 Complementary medicine :is a term used to describe types of treatments
you may receive along with traditional Western medicine. 
 Rational drug use (RDU): is the process of appropriate prescribing,
dispensing, and patient use of drugs for diagnosis, prevention, and
treatment of diseases.
 Self Medication: The act or process of medicating oneself especially
without the advice of a physician

4
Cont..
 Social drug: kchat, tobacco, alcohol, Coffee, tea
 Chewing kchat: more than 15 days per month
 Kitchen room: putting medication around the place where they Cooke, bake.
 Visiting health institution: visit less than 1 yrs ago
 woina Dega :a climate with average temperature is 22 °C, the annual rainfall
is between 800 and 1200 mm, and the average elevation ranges between
1500 to 2500 m

5
 Introduction
 CBE is a means of achieving educational relevance to community needs.
 It consists of learning activities that uses the community extensively as a
learning environment.
 The learning takes place within the community rather than in class room
setup.
 Phase IV CBTP is the last phase of CBTP which all the phases are discussed
together and changes secondary to students involvement in the community are
measured.
 It is an evaluation phase.
 

6
 Strategies Of CBE
In order to realize the philosophy, the college uses the following
strategies:
 Based Training Program (CBTP)
 Team Training Program (TTP) or (Developmental Team Training
Program DTTP)
 Student Research Program (SRP)

7
 Significance of the study

 It provides us some skill and experience on how to solve various problems of

the community.
 Led us to understand how a certain intervention can bring a difference in the
community.
 This Phase broaden our understanding of our community and encourage us to
engage in the events that can create awareness about rational drug use as well
as social drug use.

8
The Background of study

 Buyo kechema is one of the kebele found in ,Seka Chekorsa Woreda,

Jimma zone, Oromia region, south-west Ethiopia, located about 15km away
from main campus of Jimma University in North West .
 Have a total population of 8321 (Male 4189 Female 4132) and Households
are 1045.Climatic condition is Woina-dega.
 It is bounded by four kebele It has the boundaries East: kusaroo, qofe, West:
G/Boosee, south: D/Gibee, north: Allagaa, yabbu woreda

9
 Objective
General objective
 To measure the quantitative effect of changes due to intervention made on use
of social drugs, self-medication, drug sharing, stocking of drugs, taking more
doses, and drug storage.
Specific objective
 To measure the quantitative changes due to intervention made on social drug
use and self medication.
 To observe the quantitative changes due to intervention made on sharing of
drugs and stocking of drug.
 To measure the quantitative changes due to intervention made on drug storage
and taking more dose.

10
 Study Method and Design
 Study area – Buyo Kechema Kebele, Seka Chekorsa Woreda,
Jimma Zone, Oromia Region, South West Ethiopia
 Study period _August 24-26, 2022 GC
 Study design _cross-sectional study
 Target population_ all residents of Buyo Kechema(8321)
 Study population_ house hold in Buyo kechema kebele(1045)
 Sample size_281 households (Buyo kechema Kebele)
 Frame of reference_4
 Sampling technique_ systematic random sampling

11
 Sample size determination

n=
Correction formula
nf =n/1+n/N since our total population is less than 10,000
K =N/nf
Where N, total house hold (1045)
n, sample size(384)
nf, final sample size(281)
P, proportion rare and q, is 1-p, (p= 0.5)
d, Margin of error(5%)
z, Critical value of the normal distribution at the required confidence level,(1.96)
12
Materials used

 Questionnaire

 Computer
 Chalk
 Pen
 Calculator
 Mobile phone
Data collection and analysis

Data collection technique And tools

 Data was collected using standardized questionnaires applying face to face
interview.
Data analysis
 Data processing tally sheet was used.
 collected values were presented using tables, graphs, and pie charts.

14
 Quality assurance

◉ All questionnaires we used for data collection was

checked with respect to their number and content
before we start the activity and also like wise it
was checked back its completeness after we
finished our data collections.

15
Ethical Consideration

 Permission letter was sent from Jimma University to the Buyo Kechema
kebele administration and approved by the head.
 The students surveyed throughout the kebele in a polite manner respecting
the culture, custom and belief of the society

16
Summary of previous phases of CBTP( I, II, III)
 CBTP phase I
The general objective of phase-1 CBTP was:

 To assess the socio-demographic characteristics, vital statics, and means

of communication and income in Buyo kechema Kebele.

The specific objectives were:-

 To determine the socio-demographic characteristics
 To determine the vital statics of the community
 To know the average annual income of the community
 To collect, analyze and interpret health and health related data.

18
 Major findings of phase I
The major findings were;
 majority of the study community were Oromo ethnic group.
 majority of the study community were illiterate.
 majority of the study community were married.
 There means of communication were radio.
 Problems like fever, safe water supply, and diarrhea was identified and
prioritized based on the severity, feasibility government concern and
magnitude and community concerns.

19
The problems identified and prioritized from phase I

I. Home delivery
II. TTBA
III. Febrile illness
IV. Lack of access to postal and Telephone service
V. Poor hygiene

20
 CBTP phase II
The general objective of this phase was: -
 To assess type, availability and distribution of health facilities, social drug,
rational drug use as well as complementary medicine practice in Buyo
Kechema kebele.
The specific objectives were:-
 To collect on the type, availability and distribution of health facility in the
study community.
 To identify the common complementary medicine practice and the community
attitude towards them.
 To know the understanding of community on some local drugs (alcohol, khat,
tobacco….)
21
 Cont.…
 To identify some common problems in setting the drugs community.
 To identify and prioritize some of the common problem related drugs.
 To use appropriate technique to asses drug using status of the
community
 To organize, analyze, interprets and draw interference on the drug
information, self-medication, rational drug use, complementary
medicine and some social drugs using pattern.
 To draw an action plan for some of the drug related problems they
identified in the community.

22
Major findings of phase II
The major findings were;
 There is one health center in buyo kechema kebele
 The study concluded that most of the study community who visited the health center
were unsatisfied because of not respected by health workers.
 Majority of the community use modern medicine for their day to day illness.
 Most frequently used social drug were kchat and coffee especially by young age
male and middle age female.
 Most of the community prefer health center pharmacy as a source of medicine
because it is nearer.
 The community also use complementary medicine practice like that of bone sitting,
herbs religious and quaternization. They choose this kind of practice because of
effective and accessibility.

23
Identified and prioritized in phase II

Based on the severity, feasibility, government concern, magnitude and

community concern, the following problem were identified and proritized.
 Social drug use
 Sharing of drugs
 Stocking of drugs
 Dissatisfaction of healthcare service
 Self medication and non adherence

24
 CBTP phase III
In this phase students are supposed to make interventions based on the already
developed action plans in the previous CBTP phases (phase one and two).
General objective

 To perform an intervention on problems that are identified from phase II in

collaboration with the community members and governmental institution.
Specific objective
The students here are expected to :–
 Reconsider the previously identified and prioritized problems for possible
changes.
25
 Cont.…
 Refine the action plans developed to make adjustments and corrections where
needed.
 Make interventions in the collaboration with the community members
governmental and non-governmental health institutions etc…..
 To educate the community about the rational drug use
 To aware the community on the dangers of self medication and non
adherence.
 To create awareness in the community about effects of sharing drug.
 To aware the community on the ways of transmission and prevention of Covid-
19

26
 Problem intervened
Problems reprioritized after merging the problems in the two phases where :

 Social drug
 Sharing drug
 Self medication
 Drug storage
 Covid-19
 Inappropriate drug use i.e unable to take medication
accordingly, taking more dose of medication than
recommended.

27
Result And Discussion Of CBTP Phase IV

28
A, Availability, Type and Distribution of Health Facilities

In Buyo kechema kebele there is only one health center available and
there are no hospital and health post in this kebele.
This health center located around kebele bureau and Buyo kechema primary
school on the side of main road of Jimma to seka chekorsa.

29
 Table 1. The distance of households in terms of minutes from health
institution in Buyo kechema Aug 24-26 2022 G.C.

Distance <15 15-30 31-45 46-1hr Min. Max. Range Mean Std.Dev
in minute aition

Frequenc 74(26.3) 117(41.6 66(23.4) 24(8.5) 3 45 42 24.95 13..96

y (%) )
 CBTP PHASE II CBTP PHASE IV CBTP PHASE II CBTP PHASE IV

Have F % F % Do you F % F %
you satisfied
ever with the
visited service
HI

YES 279 99.3 96 YES 111 39.5 259 92.2

NO 2 0.7 4 NO 170 60.5 21 7.8

TOTAL 281 100 281 100 TOTAL 281 100 281 100
31
Table 3. Reason for un-satisfaction by health service in Buyo Kechema Kebele,
jimma zone Aug 24-26 2022 G.C.

Reason for CBTP PHASE II CBTP PHASE IV

dissatisfaction
Insufficient service 54 54.5

Not respected by health 28.4 22.7

workers
Unavailability of 14.4 13.6
pharmaceuticals
Other * 3.7 9

* Poor hygiene, lack of quick and integrated work

Medicine preference for curative purpose in Buyo Kechema Kebele,
Jimma zone Aug 24-26 2022 GC

 In CBTP II 62.6% of the community preferred Modern medicine for curative

person over complimentary medicine.
 In CBTP IV this has been increased to 95%.

The reasons for increased preference for modern medicine,

 Health insurance program that has been started with in recent months.
 Increasing awareness about modern drug after the intervention.
 Increasing the trust of modern medicine than complimentary

33
The source and preference of modern drugs in Buyo Kechema
Kebele, Jimma zone Aug 24-26 2022 G.C
 Most of the community in Buyo Kechema prefer The health center
pharmacy both on CBTP phase II (90%) and IV (98%)than the Hospital and
Red cross pharmacy.
 The reason they reported for choosing health center pharmacy is that
because it’s nearer and cost effective.
 Some of them (5.4%) in CBTP phase II and (0.7%) on CBTP phase IV
chooses the hospital pharmacy because it have high quality drugs.

34
 COMPLIMENTARY MEDCINE IN BUYO KECHEMA KEBELE, JIMMA ZONE

60
52.5
50 %
39.5
40 %
30

20

10 5.1% 3%
0
Bone setting Herb Religious Quaternazation

Fig. 1 The most common complimentary medicine practice in Buyo Kechema

Kebele, Jimma zone Aug 24-26 ,2022G.C
Cont.…

 Most common complimentary practices are herbs and bone

setting
 They use complementary medicine because they believe it’s
effective.

36
The perception of community towards complementary medicine practice
in Buyo Kechema kebele, Jimma zone August 24-26 2022 G.C.

 The community members perception about the complimentary

practice is that 206 of them said it’s effective and cheap.
 146 said it’s easily accessible and also affordable.

37
 Table 4. Showing some of the plants used for the treatment of different diseases
in Buyo Kechema kebele, jimma zone in Aug 24-26 2022GC.
no. Traditional Name Scientific name Used plant part Medicinal Use
1 Damakese Ocimum spp leaf Common cold and anti-
inflammatory
2 Togo leaf Eye inflammation
3 Tenadam Ruta graveolense Leaf Headache, evil eye and
abdominal pain

4 Qoricha Adi Steam Evil eye

5 Aramiro leaf abdominal pain

6 White eucalyptus Allium sativum Leaf Common cold

7 Grawa Veronia amygdalina Leaf Abdominal pain

8 Moringa Moringa Oleifera leaf For all disease

 Disease cured only by complimentary medicine
70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Buda(Evil eye) Mitch(sun stroke) Cold Hepatitis Almaz Balechra Bone setting

Disease cured only by complimentary medicine

Fig 2. Diseases cured only by complementary medicine in Buyo kechema kebele,

Jimma zone, Oromia region, South west Ethiopia, Aug 24-26 2022 GC.
39
 B. Social Drugs

60 Social drug use

50
40
30
20
10
0
Alcohol Khat Tobacco Coffee Tea
Before intervention After intervention

Fig 3 .The most commonly used Social drugs in Buyo Kechema Kebele, jimma
zone before and after the intervention, Aug 24-26 2022 G.C.
40
 elder female Most frequent community that uses social Drug

middle age female

young age female

elder male

middle age male

young age male

0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00% 45.00%

After intervention before intervention

Fig 4.The most frequent groups of community which use social drugs before and
after the intervention in Buyo Kechema Kebele, jimma zone Aug 24-26 2022G.C.
41
 Cont.…
 The most commonly used social drug in Buyo Kechema Kebele is Khat
(52.6%) followed by Coffee, Tobacco ,Tea and Alcohol both before and
after intervention.
 Before the intervention the most frequent community that use social drugs
were young age male(36.6%) and middle age male(21.3%)
 Despite the intervention it has increased however by 2.1 and 1.2%.
 The reason for this might be the political situation of the country (schools
were closed most of the time) and because of the COVID 19 lockdown
(since there is nothing they can do)

42
 Chewing khat status

32.4%

67.6%

YES NO

Fig 4. number of people chewing khat in Buyo kechema kebele, Jimma zone
August24-26 2022GC
Study conducted in Buyo Kechema 2021 before intervention shows 40% of
respondent are khat chewing and 7% alcohol consumption.
Despite The intervention the khat chewing has increased by 27.6%
43
C. Rational drug use

Status of the community for taking drugs according

to the Informati on given by health worker.

90.60%
83.30%

16.70%

9.40%
YE S NO
Before intervention After intervention

Fig 5. Status of the community for taking drugs according to the information given by the
health workers before and after the intervention Buyo Kechema Kebele , Jimma zone
Aug 24-26 2022GC.
44
 Table 5. Reasons for not taking the drugs according to the information given
by health workers in Buyo Kechema Kebele, Aug 24-26 ,2022 G.C
Probable reasons for not taking drugs according to info given Frequency %

The information is not clear 12 75

The information is given verbally, hence forgettable 4 25

Total 16 100

45
 Do you take more doses during medicati on?

92%

92%
8%
8%

YE S NO
BEFORE INTERVENTION AFTER INTERVENTION

Fig 6 . The percentage of community taking more doses before and after the
intervention in Buyo Kechema kebele, Jimma zone Aug 24-26,2022 G.C
As we can see from this figure most of the community don’t take more drugs
before and also after the intervention.
46
 Reasons for taking more doses during medication

For fear of relapse of Disease

To get immediate relief

To shorten the duration of the medication

0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00% 45.00% 50.00%

Series3 After intervention Before Intervention

Fig 7. The probable reason for taking more dose by the community of Buyo
Kechema Kebele, Jimma zone in Aug 24-26,2022 G.C
47
 Drug sharing status
90.00% 81.90%
80.00% 76.80%
70.00%
60.00%
50.00%
40.00%
30.00% 23.20%
20.00% 18.10%

10.00%
0.00%
YES NO

Before Intervention after intervention

Fig 8 .The percentage of the community sharing drugs before and after the
intervention in Buyo Kechema Kebele, Jimma zone Aug 24-26 2022 G.C

48
Cont..
The above figure shows some of the places where the community stores drugs.
 Locked cabinet are the place where most of the community uses to store
drugs followed by bed room ,open area and Kitchen.
 After the intervention, there was some change that the community tried to
store their drug in locked cabinet and there were an increment which is
around 25.9%.

49
Table 7. showing most commonly stocked drugs in the household medicine
cabinet in Buyo Kechema Kebele, Jimma zone August 24-26 2022 G.C

Most commonly Before intervention After intervention

stocked drugs

% %

NSAIDS 58.8 51.2

Antibiotics 31.6 39.5

Anti-helminthics 9.6 9.3

Total 100 100

50
 Probable reason for stocking of drug in the community

for emergency case

for treatment relapse case

Lack of Knowledge about drug disposal

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

Series3 After intervention before intervention

Fig 10. Reasons for stocking Drugs in Buyo Kechema Kebele, Jimma zone Aug
24-26 2022 G.C
51
 Having Drug information
23.80%
No
24.20%

76.20%
Yes
75.80%

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00%

After intervention
Before intervention
Fig 11. The amount of community having information about drugs before and
After Intervention in Buyo Kechema Kebele, Jimma zone Aug 24-26 2022G.C.
52
 Table 8: the information that the community have about drugs in Buyo Kechema,
Jimma zone before and after intervention.
The information they Before intervention After intervention
have % %

About drug storage 63.8 66.4

About drug toxicity 18.3 11.2

About (drug-drug, drug- 8.45 1.8

food) interaction
About drug expiry date 9.38 20.6

Total 100 100

53
 Before intervention After intervention

31.60%
35.30
64.70 %
% 69.40%

YES NO YES NO
Fig 12. Practice of self-medication in Buyo kechema kebele, Jimma zone
Before and after intervention Aug 24-26 2022 G.C
54
Cont..
 From the above pie chart we conclude that before our intervention majority
of the community (64.7% ) were not practice self- medication.
 Fortunately after we intervened we slightly increased the number of the
community that don’t practice self medication around by 4.9%.

55
 Kind of illness for which the community uses self Med-
ication
120.00%

100.00%

80.00%

60.00%

40.00%

20.00%

0.00%
minor pain cough wound Helmentiasis

Before intervention After intervention

Fig 13. Kinds of illnesses for which the community use self-medication before
and after intervention in Buyo Kechema kebele, Jimma zone August 24-26
2022 G.C
56
 Cont..

 From the data above, minor pain are the most self-medicated
followed by cough, wounds, helimentisis, malaria.
 Compared to data before intervention there is slight decline in self
medication practice.

57
Table 9. shows the most commonly used drugs for self-medication in the community
Before and After intervention Buyo Kechema Kebele, Jimma zone August 24-26
2022 G.C.
Most common drugs used Before intervention After intervention
for self-medication % %

NSAIDS 70.8 60.6

Antibiotics 16.8 35.4

Anti- helmentics 12.4 2

total 100 100

58
Problem and limitation encountered
Problem we encountered
 Unwillingness of the respondents to tell about their income.
 Some of the residents house were closed for 1st day
 Language barrier
 Most of the respondents lacked interest due to repetitive interview carried
out by different department of Jimma University.
 Most of the Community have little knowledge of the types of medication.
Limitation
 We faced a problem of getting all needed information from the kebele.
 Scattered house in the community.

59
 Solutions

 Students were grouped according to language proficiency.

 We ask their daily expenditure and converting into annual income.
 We returned back on the second day.
 we told them about the importance of the research and they were willing to
cooperate with us.
 We try to list and describe the type of medications when we collect data

60
Table 10.Problem prioritization based on criteria in Buyo Kechema, Jimma Zone
August 24-26,2022G.C

No Identified Magnitude Severity feasibility Community Government

problems Concern concern

1 Drug overdose 4 3 4 4 3

2 Sharing of drug 4 4 4 4 2

3 Chewing chat 3 5 4 2 4

4 Self-medication 5 3 2 1 4

5 Inappropriate 3 3 3 3 3
storage of drug
61
Table 11. action plan on identified problem in Buyo kechema,Jimma Zone August 24-
26,2022G.C
  Identified Objectives Target Strategies Activities Resource Responsibility
No problem
1
Drug To minimize usage of Buyo kechema Increasing the Teaching the impact Knowledge Next pharmacy
overdose overdose 90% kebele community awareness of taking of drug overdose of team student of CBTP
appropriate dose through drama and member member and CBE
using poster office
2
Sharing of To minimize drug sharing Buyo kechema Creating awareness Teaching the impact Knowledge Next pharmacy
drug habits in the community kebele community on the impact of of drug sharing of team student of CBTP
by 80% sharing drug through drama ,and members member and CBE
using poster office
3
Chewing To reduce the number of Buyo kechema Creating awareness Teaching the impact Knowledge Next pharmacy
chat chat chewer kebele community on the impact of of chewing chat by of team student of CBTP
chewing chat different technique members member and CBE
office
 
 
Practice of To minimize usage the Buyo kechema Educate the Teaching the impact Knowledge Next pharmacy
4 self- level of self-medication kebele community community about of self-medication of team student of CBTP
medication by 50% self-medication by using posters, and members member and CBE
public talk office
5
Inappropri To minimize usage the Buyo kechema Educate the Teaching the Knowledge Next pharmacy
ate storage level of inappropriate kebele community inappropriate inappropriate storage of team student of CBTP
of drug storage of drugs storage of drug of drug by members member and CBE
office
62
 Conclusion

 When compared with phase II results some good results were obtained on
intervened problems.
 Most of community members are satisfied by the service given in health
institution.
 kchat is the most commonly used social drug followed by Coffee and Tobacco
and some of the community chew Khat and their number is Increased after the
intervention by more than a quarter.
 Cont.…

 Most of the community takes drug according to the information given by the
health worker both before and after the intervention.
 NSAIDS are the most frequently stocked drugs followed by Antibiotics for
the treatment of emergency cases and for relapse cases.
 Most of the community don’t take more drugs before and also after the
intervention.
 It has been seen slight increment in the number of the community that don’t
practice self medication.

64
Recommendation

1. The Buyo Kechema Kebele Health Institution & the Kebele Administrators
Should work on creation of awareness about impact of social drugs, sharing of
drugs & provision of information related to stocking of drugs as well clearly
identify reasons for community un-satisfaction helps to solve problems easily.

2. The literate individual of the kebele such as health center workers, as well
as other people those know about the effect of chewing khat on social,
economy & health of the community should inform the community.

65
Conti…
3. Health extension workers should warn Buyo kechema kebele community on
drawbacks of sharing drugs so as to avoid possible accidents.

4. School of Pharmacy has to involve in studying medicinal plants that are found
in the community.

5. CBE office and Buyo kechema health institution workers should work in
cooperation with the kebele administrators on educating the community about
impact and benefit of complementary medicine together with modern medicine

66
 Reference
1. CBTP phase1, 2 and 3 documents
2. Asefa M., Community-based education: Concept and practice Ethiop. J. Health
Dev.2000; 14: 227-237.
3. Central Statistical Agency [Ethiopia] and ORC Macro. 2001. Ethiopia Demographic
and Health Survey 2000. Addis Ababa, Ethiopia, and Calverton, Maryland, USA: Central
Statistical Agency and ORC Macro.
4. Kandari et al. Springer Plus 2014,3:579(http://www.springerplus.com/content/3/1/579)
5. HEALTH SERVICES UTILIZATION AND ASSOCIATED FACTORS IN JIMMA

67
 Acknowledgement
We would like to express our huge gratitude of thanks to;
 our study community
 Kebele Administrative
 CBE coordinative office
 Our supervisors
 Finally we would like to appreciate the unity and active participation of
our group members in intervening the problems of society.

68
 Thank you
we are in the community

69