HARAR HEALTH SCIENCE COLLEGE

COMMUNITYY BASED TRAINING PROGRAM (CBTP)

ASSESSMENT OF COMMUNITY HEALTH RELATED PROBLEM AND ENVIRONMENTAL

CONDITION IN GELMESHERA KEBELE, SOFI WOREDA, HARAR REGION, EASTERN
ETHIOPIA, 2025.

MARCH , 2025
HARAR, EASTERN ETHIOPIA
 Group Members

Medical Laboratory Comprehensive Nurse Pediatrics

Presentation outlines
 Introduction
 Statement of the problem
 Justification of the study
 Conceptual framework (if any)
 Objectives
 Study Area and Period; Study designs
 Population
 Eligibility Criteria
 Sample Size Determination
 Sampling Technique and Procedure
 Study Variables
 Data Collection Procedure and Data Quality Control
 Data Processing and Analysis
 Ethical Considerations
 Operational Definitions and Definition of Terms (if any)
 Introduction

 Community based education is an educational philosophy that is aimed at developing future professional
with problem identification and solving skills and positive attitude to solve the society.
 The CBE program was first adopted and implemented in Ethiopia by Jimma University as part of health
science education.
 (CBTP) is a strategy which is done for four weeks, and it is accomplished through consecutive procedures
like numbering, data collection, community diagnosis, planning, implementing and evaluation of health-
related issues (1).
Introduction

 The aim of CBTP is defining and understanding the

demographic, socioeconomic, political and environmental
aspects of society which are the main determinant of the
community health status
 Harar Health Science College adopted the program in 2007
E.C for the first time the education was extended to train
health personnel who will be responsible to the health need
of the society and the program was initiated in health
science fields.
 Statement of the problem

o In 2016, 91% of the global population did not breathe clean air.

o More than 50% of urban populations exposed to outdoor air pollution

levels at least 2.5 times above WHO safety standards.
o Over 3 billion people still use polluting stoves and fuels.

o Household air pollution caused an estimated 3.8 million deaths from

non-communicable diseases (NCDs) and respiratory infections in 2016.
o In 2016, an estimated 1 million people died from HIV-related illnesses,
including 120,000 children under 15.
Statement of the problem

o An estimated 870,000 deaths globally in 2016 due to unsafe drinking water,

sanitation, and hygiene.

o 2.6 billion people lack access to improved sanitation facilities.

o In 2015, approximately 303,000 women died from pregnancy and childbirth-

related complications.

o Over 40% of pregnant women globally did not receive early antenatal care in 2013.
o By the end of 2016, PCV had reached 42% coverage in 135 countries.
 . Significance of Study

 This study is targeted to identify community health and health related problems
in Sofi woreda(around back side of SOS children village).

 It gives a broad understanding about socio demography, environmental

sanitation, maternal and child health problems.

 It also crucial to create awareness in the community so that they can develop
problem solving capacity and develop healthy behavior that promotes health
 objectives
 General Objective
 To assess Community Health-Related Problems and Environmental Conditions

o Location: Gelmeshira Kebele (Back Side of SOS Children Village), Sofi Woreda, Harar
Region, Eastern Ethiopia, 2025.
 Specific Objectives

 To Identify the latrine conditions within the community.

 To Assess the kitchen conditions of households.

 To Identify the dry waste disposal mechanisms used by the community.

 To Assess antenatal care (ANC) follow-up among pregnant women

Cont.………..

 To Identify the methods of family planning utilized among

women of reproductive age.
 To Assess the immunization status of infants.

 To Differentiate breastfeeding conditions among children.

 To Assess the HIV status within the community.

 To Evaluate general drug utilization practices in the community

 Methodology

Study Areas
 The study will be carried out in the Sofi Woreda from march 4/7/2017.
Study Period
 The data will be collect in 5/7/2017 E.C
Study Design
 The type of design used is descriptive cross sectional survey.
Source Of Population
 All Households of Sofi woreda in Harar town.
Study Population
 All systematically selected households in Gelmashira kebele (around back
side of SOS children village).Sofi woreda, Harar town.
 ELIGIBILITY CRITERIA

Inclusion criteria

 All Selected households in Sofi woreda Gelmeshira Kebele (around Back Side of SOS Children Village)

Exclusion criteria

 Households with the resident of less than 6 months.

 Closed houses after two visit

 Sample size determination
Sample Size Determination


 Sample technique and Sampling procedures

 Our site was selected with the help of Harar health Science College, CBTP
coordinator office. To select the study subject Systematic random
sampling technique was used. Since the total number of households in Sofi
Woreda, Back to SOS school, is 980 HHs and Final sample size is 384.
K=N/n (sampling fraction)

K= 980/422

=2.3 ~ 2

 The first household was selected by using lottery method and third household selected
 Variables
Dependent variables:

 Environmental conditions (Housing condition like, latrine, kitchen, dray waste disposal mechanism, etc.)

 Maternal health condition (ANC, Abortion, Institutional delivery, family planning, etc.)

 Child health condition (immunization, Brest feeding, etc.)

 Family health condition

 Drug utilization

4.7.2. Independent variables

 Socio-demographic variables (Sex, Age, Educational status, Occupational status, Religion and Marital
status)
 Data Collection Procedure and Data Quality Control

 Structured Questionnaire

o Consisted of four parts, prepared in English.

 Data Collection Method:

o Utilized electronic devices with the Kobo Collect application.

o Participants included 3rd-year clinical nurse, 4th-year medical laboratory, and

4th year pediatric nurse students from Harar Health Science College.
Cont.……………
 Supervision and Training:

o Organized by a supervisor.

o One-day training provided on the instrument and participant engagement by

the CBTP coordinator and supervisor.

 Pre-Data Collection Preparation:

• Group discussions with assigned teachers to ensure common understanding of

questionnaires among group members.
• Collected data reviewed daily for completeness by group members
 Data Processing and Analysis

 Data Processing:

o Collected data checked for completeness, edited, and cleaned before

analysis.
 Data Analysis:

o Analyzed using Excel, focusing on identifying important variables.

 Presentation of Results:

o Results presented in various formats, including words, tables, and

graphs.
 Ethical Considerations

 Obtained from Harar Health Science College CBTP Coordinator office.

 A supportive letter acquired from Sofi Woreda Administration Office and provided to
Gelmeshira Kebele administrative office.

 Personal identifiers (e.g., names) were excluded from data collection formats to
maintain participant confidentiality.

 Information collected was used solely for survey purposes.

 Participants were informed of their right to refuse participation or withdraw from the
study at any time during data collection
 Operational Definitions and Definition of Terms (if any

 Kebele: The smallest administrative unit in Ethiopia, serving as a neighborhood

or community level for local governance and service delivery.

 Household: A group of individuals living together and sharing common

resources, typically including family members and sometimes non-family
members.

 Data Collection: The systematic gathering of information from participants using

structured questionnaires and electronic tools to inform research findings.
Cont.………..
 Ethical Clearance: Approval obtained from a relevant authority to
conduct research involving human subjects, ensuring adherence to
ethical standards.
 Confidentiality: The ethical principle of protecting participants'
personal information and ensuring that their identities remain private
throughout the research process.
 Systematic Sampling: A sampling technique where participants are
selected at regular intervals from a randomly ordered list of the
population
 Results
 Demographic Characteristics of Participants

A summary of the demographic information, including age, sex, educational status, and marital status.
Age Group Female Male Total Female (%) Male (%)

0–5 97 82 179 54.2% 45.8%

6–10 63 74 137 46.0% 54.0%

11–15 78 62 140 55.7% 44.3%

16–20 98 82 180 54.4% 45.6%

21–30 159 148 307 51.8% 48.2%

31–40 114 96 210 54.3% 45.7%

41–50 67 55 122 54.9% 45.1%

51–60 32 27 59 54.2% 45.8%

≥60 16 17 33 48.5% 51.5%

Total 724 703 1,427 50.7% 49.3%

 Summary of Demographic Information
Sex Distribution

Sex Frequency Percentage (%)

Male 703 49.3

Female 724 50.7

Total 1,427 100%

 Interpretation of Sex Distribution

 The sex distribution of the participants in this study provides valuable insights into the demographic
makeup of the sample.

1. Balanced Representation:

o The total number of participants is 1,427, with 703 males (49.3%) and 724 females
(50.7%). This indicates a nearly equal representation of both genders, which is crucial
for ensuring that the findings of the study are not biased towards one sex.

2. Slight Female Majority:

The data shows a slight majority of female participants, accounting for 50.7% of the total
sample. This could reflect various factors, such as the nature of the study
o the population being surveyed, or specific recruitment strategies that may have favored female
participants
3. Implications for Analysis:

o The balanced sex distribution allows for a more comprehensive analysis of the data, as it enables
researchers to explore potential differences in responses or behaviors between males and females. This
is particularly important in studies related to health, education, and social behaviors, where gender may
play a significant role.

4. Generalizability of Results:

o Having a diverse sample with respect to sex enhances the generalizability of the results. It suggests that
findings may be applicable to a broader population, making the conclusions drawn from the study more
robust and reliable.

5. Future Considerations:

o Future studies may want to explore the implications of this sex distribution on the outcomes measured.
For instance, understanding how gender dynamics influence the variables of interest could provide
deeper insights into the findings.
 Educational Status

Educational Status Frequency Percentage (%)

Underage 157 11.00%

KG 103 7.22%

Unable to read/write 95 6.66%

Formal education but able to read and write 59 4.13%

Primary 404 28.31%

Secondary 282 19.76%

College and above 327 22.92%

Total 1,427 100%

 Interpretation of Educational Status Distribution

The educational status of participants provides essential insights into the educational landscape of the
sample and its potential implications for the study's findings.

1. Diverse Educational Backgrounds:

o The total number of participants is 1,427, with a variety of educational statuses represented. This
diversity allows for a nuanced understanding of how education levels may influence the variables
being studied.

2. High Representation of Primary Education:

 The largest segment of participants falls within the Primary education category, comprising 404
individuals (28.31%). This indicates that a significant portion of the sample has attained basic
education, which may reflect the educational infrastructure in the population surveyed.
 Cont.………………
3.Secondary Education:

o The Secondary education category includes 282 participants (19.76%), suggesting

that a considerable number of individuals have progressed beyond primary education.
This level of education may correlate with increased awareness and participation in
the study's subject matter.

4.College and Above:

o Participants with College and above education total 327 (22.92%), indicating a
noteworthy segment of the population with higher education. This group may provide
valuable insights given their potentially different perspectives and experiences
compared to those with lower educational attainment.
 Cont.………………
5. Underage and Literacy Challenges:

o The Underage category includes 157 participants (11.00%), reflecting the inclusion of
younger individuals in the study. Additionally, 95 participants (6.66%) reported being
unable to read/write, highlighting a critical issue regarding literacy that may impact
engagement and understanding of the study's content.

6. Formal Education but Limited Literacy:

o The category labeled Formal education but able to read and write includes 59
participants (4.13%). This suggests that some individuals may have received formal
education yet still face challenges in literacy, which could affect their ability to engage
fully with the study's material.
 Cont.…………..
7. Overall Educational Landscape:
o The educational status distribution indicates a mix of educational attainment levels within the sample. This
variety enriches the study by allowing for comparisons across different educational backgrounds and their
potential influence on the outcomes.

8. Implications for Research:

o Understanding the educational status of participants is crucial for contextualizing the findings. Education can
significantly impact individuals' perspectives, behaviors, and access to resources, which may shape their
responses in the study.

9, Future Research Directions:

o Future studies could explore the relationship between educational status and the variables of interest,
examining how education influences attitudes, knowledge, and behaviors within the population.
 Marital Status

Marital Status Frequency Percentage (%)

Married 730 51.15%

Single 262 18.36%

Divorced 19 1.33%

Widowed 14 0.98%

Underage 402 28.18%

Total 1,427 100%

Interpretation of Marital Status Distribution

The marital status of participants provides important insights into the social dynamics and
demographic characteristics of the sample, which can significantly influence the study's findings.

1. Majority Married Population:

o A significant portion of the participants, 730 individuals (51.15%), are married. This indicates that more than half of
the sample is in a marital relationship, which may reflect societal norms and values regarding marriage within the
population studied.

2. Single Participants:
o The single category includes 262 participants (18.36%). This group represents a substantial segment of the
population and may offer unique perspectives compared to their married counterparts, particularly in relation to social
behaviors and attitudes.
3. Minority Divorced and Widowed:

o The divorced group comprises only 19 participants (1.33%), while the widowed
group has 14 individuals (0.98%). These figures suggest that divorce and
widowhood are relatively uncommon within this sample, which might reflect
cultural attitudes towards marriage and family stability.

4. Underage Participants:

o Notably, the underage category includes 402 participants (28.18%). This significant
number indicates that a substantial proportion of the sample consists of individuals
who are not yet of legal age to marry. This demographic may have different needs
and perspectives, particularly regarding education, health, and social services.
5. Overall Marital Landscape:

o The distribution of marital status highlights a diverse range of relationship statuses among
participants. The majority being married suggests a potentially stable family structure,
while the presence of single and underage individuals indicates varying life stages and
social dynamics.

6. Implications for Research:

Understanding marital status is crucial for interpreting the study's findings, as marital
relationships can influence individual behaviors, access to resources, and decision-making
processes. For example, married individuals may have different
health behaviors or economic considerations compared to singles or those who are underage.

7. Future Research Directions:

Future studies could explore the implications of marital status on the variables being studied,
such as health outcomes, educational attainment, and social support systems. Analyzing how
marital status interacts with other demographic factors could yield valuable insights
 Occupation

Occupation Frequency Percentage (%)

Merchant 177 12.40%

Housewife 132 9.25%

Student 436 30.55%

Daily labor 134 9.39%

Underage 237 16.61%

NGO 102 7.15%

Other 209 14.65%

Total 1,427 100%

 interpretations of Occupation Distribution
The occupational distribution of participants provides valuable insights into the economic engagement and
social roles within the sample, which can significantly influence the study's findings.

1. Diverse Occupational Backgrounds:

o The total number of participants is 1,427, with various occupations represented. This diversity allows for a
broader understanding of how different occupations may impact perspectives and behaviors related to the
study's subject.

2. Predominance of Students:

o The largest segment of participants consists of students, totaling 436 individuals (30.55%). This high
representation indicates a significant focus on the younger population, likely reflecting the educational context
of the study. The insights gathered from this group may provide critical information about educational needs
and challenges.
3. Merchants and Daily Labor:

o Merchants account for 177 participants (12.40%), while daily laborers comprise 134
individuals (9.39%). These groups represent the working population engaged in trade and
manual labor, highlighting the economic activities prevalent in the community. Their
perspectives may shed light on economic stability and employment challenges faced by
individuals in these roles.

4. Housewives and NGO Workers:

o The housewife category includes 132 participants (9.25%), reflecting traditional family
roles. Additionally, 102 participants (7.15%) work in NGOs, indicating a segment of the
population engaged in social services and community development. This involvement may
suggest a commitment to social issues and community welfare.
6. Underage Participants:
o The underage category includes 237 individuals (16.61%). This significant number suggests that many
participants are not yet engaged in formal employment, which could influence their perspectives on education,
career aspirations, and social responsibilities.

7. Other Occupations:
o The other category consists of 209 participants (14.65%), indicating a variety of occupations not specifically
categorized. This diversity may include informal work or unique roles within the community, enriching the
overall occupational landscape.
 Religion Distribution

Religion Frequency Percentage (%)

Muslim 1085 76.03%

Catholic 5 0.35%

Orthodox 283 19.83%

Protestant 54 3.78%

Others 0 0%

Total 1,427 100%

 Interpretation of Religion Distribution

The religious distribution of participants provides insights into the cultural and spiritual context of
the sample, which can impact social behaviors and attitudes.

1. Predominance of Islam:

o The majority of participants identify as Muslim, totaling 1,085 individuals (76.03%). This
significant representation suggests that Islamic cultural values and practices may play a
crucial role in shaping the community's social dynamics and behaviors.

2. Orthodox and Protestant Minorities:

o The Orthodox category includes 283 participants (19.83%), indicating a notable presence of
Orthodox Christians within the sample. Meanwhile, Protestants account for 54 individuals
(3.78%). These groups may contribute diverse perspectives and cultural practices, enriching
the overall religious landscape.
3. Minimal Representation of Other Religions:

o There are only 5 participants (0.35%) identifying as Catholic, and no individuals reported
belonging to other religions. This limited diversity in religious affiliation may reflect the
demographic makeup of the community and could influence the social and cultural norms
prevalent in the study.

4. Implications for Research:

o Understanding the religious affiliations of participants is essential for interpreting the study's
findings, as religion can significantly influence individual behaviors, values, and community
engagement. For example, religious beliefs may affect health practices, educational priorities,
and social interactions.

5. Future Research Directions:

o Future studies could explore the implications of religious affiliation on the variables being
studied, examining how different belief systems influence attitudes, behaviors, and access to
resources within the community.
 .
 Interpretation of Maternal and Child Health Conditions

Maternal Health Insights

1. Reproductive Age Group:

o Among the 431 women of reproductive age, only 27 women (6.4%) are currently pregnant.
This low percentage may suggest a variety of factors influencing pregnancy rates, including
family planning practices, access to reproductive health services, or cultural considerations.

2. Antenatal Care (ANC) Visits:

o Of the pregnant women, 25 mothers (89%) have visited clinics for ANC, indicating a strong
engagement with healthcare services during pregnancy. Notably, 50% of these mothers
attended three or more ANC visits, which is essential for monitoring maternal and fetal
health.
3. Births Within the Last 12 Months:

o 63 women (15.0%) reported giving birth in the family within the past year, with all
deliveries occurring in health institutions and attended by healthcare professionals. This
reflects a positive trend towards institutional deliveries, which are associated with better
maternal and neonatal outcomes.

4. Abortions:

There were 25 abortions (6.0%) reported in the last 12 months in the study area.
Understanding the reasons behind these abortions could provide insights into reproductive
health challenges faced by women in the community
 Child Health Insights

1. Immunization Status:

o Among children born in the past 12 months, 319 children (76.1%) received the BCG
vaccine with a visible scar, indicating successful vaccination. Additionally, immunization
rates for polio (0-3), PCV (1-3), Rota (1-2), and measles are also high at 76.1%,
demonstrating good coverage for essential vaccines.

2. Childbirth Outcomes:

In terms of childbirth outcomes, there were 62 live births (38.71% female and 61.29% male) and 48
stillbirths (70.83% female and 29.17% male) reported. The higher percentage of stillbirths
among females may warrant further investigation into potential underlying causes
 Family Health Conditions

1. Health Issues Within the Family:

o Out of 419 households, 390 reported no sick individuals within the last 14 days, suggesting
a relatively healthy population. However, 29 households did report sickness, indicating a
need for ongoing health monitoring and support.

2. Preferred Healthcare Access:

o When family members fall ill, 97.9% of participants indicated they first seek care at a health
facility, which reflects a strong reliance on formal healthcare services. Only a small
percentage (1.9%) turn to traditional healers, showing a preference for modern medicine.

3. Disability in Family Members:

o Only 10 individuals (2.4%) reported having a disabled family member, which may reflect
the prevalence of disability in the community or effective health interventions.
4. Medication Practices:

o A significant majority, 384 individuals (91.6%), take medications by physician’s

order, demonstrating adherence to medical advice. Furthermore, 94.3% reported
taking the full dose of medications, which is critical for effective treatment outcomes.

5. Medication Storage Practices:

268 participants (64.0%) store medications out of children's reach, highlighting awareness
of safety practices. However, 20.8% keep medications in non-hot/dry areas, and 12.9%
store them in sunlight, indicating areas for improvement in medication storage practices
 Conclusion
The maternal and child health conditions, along with family health insights, suggest a
community that is largely engaged with healthcare services, particularly for maternal
health and immunization of children. However, there are areas for improvement,
particularly in understanding the factors leading to abortions and stillbirths, as well as
enhancing medication storage practices. Continued efforts to promote antenatal care,
institutional deliveries, and vaccination coverage will be essential for improving
overall health outcomes in the community.
 Conclusion and Recommendation

Conclusion:

 The demographic analysis of the community reveals significant insights into the population’s
structure:

o Gender Distribution: The sample is nearly balanced, with 49.3% males and 50.7%
females, indicating a gender-equitable representation.

o Educational Status: A substantial portion of individuals (28.31%) has attained primary

education, while 11% are underage and 6.66% are unable to read or write. This highlights
the need for improved literacy and educational opportunities.
 Cont.…………………
o Marital Status: The majority of participants are married (51.15%), with a notable percentage of underage
individuals (28.18%), suggesting a focus on family structures and youth engagement.

o Occupational Landscape: A significant portion of the population is comprised of students (30.55%), reflecting the
community's youthfulness, while 12.40% are merchants, indicating economic activity.

o Religious Affiliation: The community is predominantly Muslim (76.03%), which may influence cultural practices
and health-seeking behaviors.
 Recommendations:
1. Enhance Educational Programs:

o Develop community-based educational initiatives to improve literacy rates, especially targeting underage individuals and those
unable to read or write.

2. Promote Gender Equity:

o Foster programs that empower both males and females, ensuring equal access to education, healthcare, and employment
opportunities.

3. Support for Young Families:

o Implement support systems for young and married individuals, focusing on family planning, health education, and economic
opportunities.

4. Economic Development Initiatives:

o Encourage entrepreneurship and vocational training to enhance the employability of students and individuals in the community,
particularly in sectors like trade and services.

5. Cultural Sensitivity in Health Programs:

o Design health interventions that are culturally sensitive and align with the predominant religious values of the community,
 Acknowledgements

 We would like to acknowledge Harar Health Science College for providing us the opportunity
to conduct and present this community-based training program (CBTP) successfully.

 We extend our heartfelt gratitude to the Harar Town, Sofi Woreda Gelmeshira Kebele
community and the administration office for their invaluable support, interest, and permission to
conduct the CBTP within the community.

 Furthermore, we would like to express our sincere appreciation to our instructors, Amanuel F.
(MH in Nutrition), who tirelessly provided us with valuable guidance and constructive
feedback, contributing significantly to the successful completion of CBTP.

 Finally, we wish to convey our deep gratitude to all Gelmeshira Kebele health extension workers
for their exceptional cooperation and support throughout our activities, which played a crucial
role in our success.
 REFERENCE
1. WHO: Environmental sanitation and hygiene development [Internet].

2. Jimma university health science research March (2012).

3. Public health and environment [online database]. Global Health Observatory (GHO) data. Geneva: World
Health Organization (http://www.who.int/gho/phe/en/).

4. UNICEF/WHO database 2018).

5. Global Health Estimates: Deaths by cause, age, sex, by country and by region, 2000–2016. Geneva: World
Health Organization; 2018).

WHO/UNICEF Joint Monitoring Programmed for Water Supply and Sanitation. Progress on Sanitation and
Drinking Water: 2010 Update; WHO Press, Geneva, 2010
End of CBTP Proposal Defense
Presentation
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