WACHEMO UNIVERSITY

COLLEGE OF MEDICINE AND HEALTH SCIENCES

DEPARTMENT OF SURGICAL NURSING

ASSESSMENT AND INTERVENTION OF HEALTH AND

HEALTH RELATED PROBLEMS IN KALISHA KEBELE,
LEMO WOREDA, HADIYA ZONE, SNNPR, ETHIOPIA, 2023

ADVISORS: Mr. Tilahun Beyene (BSc, MPH)

Mr. Jabir Abdella (BSc, MSc)

By: 4th Year Surgical Nursing Department Students

Community Based Training Program Report To Be Submitted To Wachemo

University, College Of Medicine And Health Sciences , School Of Nursing,
Department Of Surgical Nursing

APRIL, 2023
HOSSANA, ETHIOPIA
WACHEMO UNIVERSITY

COLLEGE OF MEDICINE AND HEALTH SCIENCE

ASSESSMENT AND INTERVENTION OF HEALTH AND

HEALTH RELATED PROBLEMS IN KALISHA KEBELE,
LEMO WOREDA, HADIYA ZONE, SNNPR, ETHIOPIA, 2023
ADVISORS: Mr. Tilahun Beyene (BSc, MPH)

Mr. Jabir Abdella (BSc, MSc)

Group Members
STUDENT NAME ID NUMBER
AMANUEL TADDESE 130303
ASMAMAW DAGNAW 1201623
BETHEL KALEB 1201563
BETELHEM BELAY 1200787
BETELHEM NIGUS 1201368
BETELHEM TEKA 1201108
BETIGIST ASMAMAW 1200468
CHALTU AMAN 1200727
DAWIT ABIYE 1201373
DERARA TAYE 1200346
FEVEN MELLO 1201576
FIROMSA MOSISA 1201382
GUTEMA MERGA 1200806
HAYAT ADEM 1201260
HABTAMU TEKA 1201128
MASAME PETROS 130251
MULKEN ESUBALEW 1201406
MELKAM GETACHEW 1200884
SAMUEL ASFAW 12D0443
SOLOMON DESALEW 005626
SUFIYAN FEYISO 12D0565
TSEGAYE BIRU 12D0724
TSIGEREDA GUTA 12D0735
ZE-ELIAS ABEBAW 12D0912
ACKNOWLEDGMENT
Firstly, we want to thank the Almighty God for giving us the strength in all the ways we went
through in developing this report next, we would like to express our deepest appreciation to
Wachemo University, College of Medicine and Health Sciences, Department of Surgical Nursing
for supporting us to develop this report to community based training program. And we wish to
express our deepest gratitude to our advisors Mr.Tilahun Beyene (BSc, MPH) and Mr.Jabir
Abdella (BSc, MSc) for their guidance and constructive comment during the development of this
report. Also, we would like to thank the kebele administration, health extension workers of
Kalisha Kebele, and our respondents and all stake holders for providing us with the needed
information and data.
TABLE OF CONTENTS
Contents pages
ACKNOWLEDGMENT..................................................................................................................i
LIST OF TABLES...........................................................................................................................v
LIST OF FIGURES........................................................................................................................vi
ACRONYMS AND ABBREVIATIONS......................................................................................vii
ABSTRACT....................................................................................................................................x
CHAPTER ONE..............................................................................................................................1
INTRODUCTION...........................................................................................................................1
1.1 Background............................................................................................................................1
1.2 Statement of Problem.............................................................................................................1
1.3 Significance of the Study.......................................................................................................3
CHAPTER TWO.............................................................................................................................4
LITERATURE REVIEW................................................................................................................4
2.1 Drinking Water and Sanitation Facility.................................................................................4
2.2 Family Planning.....................................................................................................................4
2.3 Child Health and Nutrition.....................................................................................................5
2.4 Vaccination............................................................................................................................5
2.5 Communicable and Non-Communicable...............................................................................5
2.6 Solid Waste Management......................................................................................................6
CHAPTER THREE.........................................................................................................................7
OBJECTIVES..................................................................................................................................7
3.1 General Objective..................................................................................................................7
3.2 Specific Objective..................................................................................................................7
CHAPTER FOUR...........................................................................................................................8
METHODOLOGY AND MATERIALS.........................................................................................8
4.1 STUDY AREA AND PERIOD.............................................................................................8
4.1.1 STUDY AREA................................................................................................................8
4.1.2 Study Period....................................................................................................................9
4.2 Study Design..........................................................................................................................9
4.3 Population..............................................................................................................................9

ii
4.3.1 Source Population............................................................................................................9
4.3.2 Study Population.............................................................................................................9
4.3.3 Study Unit........................................................................................................................9
4.3.4 Eligibility Criteria............................................................................................................9
4.4 Sample Size Determination and Sampling Technique...........................................................9
4.4.1 Sample Size Determination.............................................................................................9
4.4.2 Sampling Technique......................................................................................................10
4.5 Data Collection Tool and Techniques..................................................................................11
4.6. Data Quality Assurance......................................................................................................11
4.7 Data Processing, Analysis and Presentation........................................................................11
4.8 Variables of the Study..........................................................................................................12
4.8.1 Dependent Variable.......................................................................................................12
4.8.2 Independent Variable....................................................................................................12
4.9 Operational Definition.........................................................................................................12
4.10 Ethical Consideration.........................................................................................................13
4.11 Dissemination of Results...................................................................................................13
CHAPTER FIVE...........................................................................................................................14
RESULT........................................................................................................................................14
5.1 SOCIO DEMOGRAPHIC CHARACTERISTIC................................................................14
5.2 Vital statics...........................................................................................................................16
5.2.1 Birth...............................................................................................................................16
5.2.2 Morbidity and Mortality................................................................................................17
5.3 Environmental condition......................................................................................................18
5.4 Water supply........................................................................................................................20
5.5 Environmental Survey..........................................................................................................23
5.6 Family planning...................................................................................................................24
5.7 Child Nutrition.....................................................................................................................26
5.8 Child Vaccination................................................................................................................28
5.9 Maternal health....................................................................................................................29
5.9.1 Antenatal care................................................................................................................29
5.10 Morbidity...........................................................................................................................30

iii
5.11 Mental Illness.....................................................................................................................32
5.12 Eye disease.........................................................................................................................33
5.13 Nutrition status of women and children.............................................................................34
CHAPTER SIX..............................................................................................................................36
Discussion......................................................................................................................................36
Conclusion.....................................................................................................................................36
Recommendation.......................................................................................................................37
For The Community...................................................................................................................37
For Health Worker.....................................................................................................................37
For Governmental & Non-Governmental Organizations...........................................................37
Identified Problems........................................................................................................................38
Action plan.................................................................................................................................41
Team Intervention......................................................................................................................44
SWOT Analysis.........................................................................................................................45
References......................................................................................................................................46
Annex: questionnaire.....................................................................................................................46

iv
LIST OF TABLES
FIGURE 4.1:SCHEMATIC REPRESENTATION OF KALISHA KEBELE, LEMO WOREDA, HADIYA
ZONE, SNNPR, ETHIOPIA,2023 8
FIGURE 4.2:SCHEMATIC REPRESENTATION OF KALISHA KEBELE, LEMO WOREDA, HADIYA ZONE,
SNNPR, ETHIOPIA,2023. 9
FIGURE 6.1 SURGICAL NURSING TEAM INTERVENTION ON HAND WASHING IN KALISHA
KEBELE,LEMO WOREDA,HADIYA ZONE,SNNPR,ETHIOPIA 2023 47 VII
TABLE 5.1: SOCIO-DEMOGRAPHIC CHARACTERISTICS OF 206 HOUSEHOLDS IN KALISHA
KEBELELE, HADIYA ZONE, SNNPR,ETHIOPIA,APRIL,2023 14
TABLE 5.2: BIRTH STATUS WITH IN LAST 12 MONTH OF 206 HOUSEHOLDS IN KALISHA
KEBELE ,LEMO WOREDA,HADIYA ZONE,SNNPR,ETHIOPIA,APRIL 2023. 16
TABLE 5.2:CHILD BIRTH STATUS AMONG 206 HOUSEHOLDS IN KALISHA KEBELELE, HADIYA
ZONE, SNNPR,ETHIOPIA,APRIL,2023 17
TABLE 5.3:HOUSING CONDITION OF 206 HOUSE HOLDS IN KALISHA KEBELELE, HADIYA ZONE,
SNNPR,ETHIOPIA,APRIL,2023 18
TABLE 5.4: SOURCE OF WATER SUPPLY OF 206 HOUSEHOLDS IN KALISHA KEBELELE, HADIYA
ZONE, SNNPR,ETHIOPIA,APRIL,2023 20
TABLE 5.5: WASTE DISPOSAL CHARACTERISTICS OF 206 HOUSEHOLDS IN KALISHA KEBELELE,
HADIYA ZONE, SNNPR,ETHIOPIA,APRIL,2023 24
TABLE 5.6:FAMILY PLANNING UTILIZATION OF 206 HOUSEHOLDS IN KALISHA KEBELELE,
HADIYA ZONE, SNNPR,ETHIOPIA,APRIL,2023 25
TABLE 5.7:CHILD NUTRITION UNDER TWO AGES OF 206 HOUSEHOLDS IN KALISHA KEBELELE,
HADIYA ZONE, SNNPR,ETHIOPIA,APRIL,2023. 27
TABLE 5.8:CHILD AND MATERNAL OF 206 HOUSEHOLDS IN KALISHA KEBELELE, HADIYA ZONE,
SNNPR,ETHIOPIA,APRIL,2023 28
TABLE 5.9: ANTENATAL CARE COVERAGE OF 206 HOUSEHOLDS IN KALISHA KEBELELE,
HADIYA ZONE, SNNPR,ETHIOPIA,APRIL,2023 29
TABLE 5.10: MORBIDITY STATUS IN THE LAST 2 WEEKS(INCLUDING UNDER FIVE CHILDREN) OF
206 HOUSEHOLDS IN KALISHA KEBELELE, HADIYA ZONE, SNNPR,ETHIOPIA,APRIL,2023 30
TABLE 5.11:MENTAL ILLNESS OF 206 HOUSEHOLDS IN KALISHA KEBELELE, HADIYA ZONE,
SNNPR,ETHIOPIA,APRIL,2023 32
TABLE 5.12:ABOUT EYE DISEASE OF 206 HOUSEHOLDS IN KALISHA KEBELELE, HADIYA ZONE,
SNNPR,ETHIOPIA,APRIL,2023 33
TABLE 5.13:NUTRITIONAL ASSESSMENT ON MOTHERS AND CHILDREN OF 206 HOUSEHOLDS IN
KALISHA KEBELELE, HADIYA ZONE, SNNPR,ETHIOPIA,APRIL,2023 34
TABLE 6.1: SHOWING THE PRIORITIZED PROBLEM OF KALISHA KEBELE IN APR 2023 40
TABLE 6.2: ACTION PLAN FOR PRIORITIZED PROBLEMS IN KALISHA KEBELE IN APRIL,2023 41

v
LIST OF FIGURES
FIGURE 4.2:SCHEMATIC REPRESENTATION OF KALISHA KEBELE, LEMO WOREDA, HADIYA ZONE,
SNNPR, ETHIOPIA,2023..........................................................................................................8
FIGURE 6.1 SURGICAL NURSING TEAM INTERVENTION ON HAND WASHING IN KALISHA
KEBELE,LEMO WOREDA,HADIYA ZONE,SNNPR,ETHIOPIA 2023............................................44

vi
ACRONYMS AND ABBREVIATIONS
ANC Antenatal Care
BCG Baccilus Calmatte –Guerin vaccine
CBE Community Based Education
CBTP Community Based Training Program
CDI Community Direct Intervention

CSA Central statistical Agency

DALY Disability Adjusted Life year
DTP Diphtheria Tetanus pertussis
EDHS Ethiopian Demographic Health Survey
EPI Expanded Program of Immunization
FP Family Planning
HEW Health Extension Workers
HEP Health extension program
HH Households
HIV/AIDS Human immune deficiency virus/Acquired immune deficiency
syndrome
ICF International Classification of function
IUD Intrauterine device
Km Kilometer
MOH Minister of health
PCV Pneumococcal conjugate vaccine
PHC Primary health care
PNC Post-natal care
SNNPR Southern Nation Nationality and Peoples Region
SRP Student research program
TB Tuberculosis
TT Tetanus Toxoid
TTP Team training program
TV Television
UNICEF United Nation international children emergency fund
WCU Wachemo University

vii
WHO World Health Organization

viii
ix
ABSTRACT
Background: According to WHO, health is “a state of complete physical, mental, economical,
spiritual and social well-being and not merely the absence of disease or infirmity”. Health is not
just a key to measure the quality of life but also a must for one’s existence. CBTP is one of the
means of teaching and learning which permits different classes of students of the health
profession to study together. It helps the students to understand the real community life and
needs practice how to identify the real community problems, and help the community to solve
those problems. There are different problems that affect health of the community. Among
environmental health characteristics; maternal and child health characteristics; morbidity and
mortality rate are the most common problems. Even though the sanitary coverage is relatively
good, there is still lack of proper utilization of latrine
Objective: To assess health and health related problems of the community and to provide
possible interventions in Kalisha Kebele, Lemo Woreda, Hadiya Zone, SNNPR, Ethiopia, 2023.
Methodology: Community based cross sectional study was conducted. By using structured
questionnaire data were collected from 206 households. The study was conducted in kalisha
kebele of lemo woreda and the collecting data was, processed and analyzed by using manual
method using calculator and tallying. The analyzed data was displayed by the appropriate tables,
percentage.
Result: This study was collected from 206 HHs and all were responded the questionnaire.
Among our respondents majority 737(73%) of them were Protestants and Out of 206 HHs,
206(100%) pipe water. Among 206 households who live in in Kalisha Kebele 206(100%) have
latrine. From the total of 206 HHs, 37(18.1%) HHs maternal had anemia symptoms. From 206
households, the woman that knows about the family planning method was 179(87%).
Discussion: From 206 households of all had latrine which is higher compared to EDHS 2016
(56%) due to active community participation and HEWs in the kebele. Around 32% of
reproductive age group women uses family planning currently which is lower compared to the
EDHS, 2016 (35%) due to lack of awareness and not wants to used.
Conclusion: As it is semi urban kebele, agriculture is a major income source and means of
livelihood in Kalisha. Most of the household 59.2% from the sampled households use sanitary
field waste disposal.

x
.

xi
CHAPTER ONE
INTRODUCTION
1.1 Background
Health, according to the WHO is “a state of complete physical, mental, economical, spiritual and
social well-being and not merely the absence of disease or infirmity”. (1)
CBE is a means of achieving educational relevance to community needs. In order to realize the
educational philosophy of CBE, three strategies have been developed. These are: CBTP, TTP
and SRP. (2)
Health and health related issues are the major concerns of the world. Even though it is still
worsening in most developing countries, many developed countries succeeded in infectious
disease control. In Africa, we are still unable to decrease the prevalence of communicable
diseases like TB, HIV, Malaria, Amebiasis, and water and food borne diseases which are related
to lack of environmental and personal hygiene in the community. The government of Ethiopia is
giving special emphasis to the health of its citizens since recent years and the allocation of the
budgeting system has been increasing. Most of the country’s higher education centers are now
working to improve the health status of the community by producing health professionals who
can identify and treat health-related problems. (3)
The Health extension program serves as the primary vehicle for the prevention, health
promotion, behavioral change, communication, and basic curative care. (4)
1.2 Statement of Problem
Health and health related problems are the major problems in the world even though the
problems are easily preventable. Our country Ethiopia is relatively more affected than developed
countries due to various factors which include: Environmental health factors; maternal health
factors; child health factors; morbidity & mortality associated factors . (3)
The community is suffering from the problems resulted from the environmental health conditions
such as improper latrine utilization, improper hand hygiene, inadequate access to water and
improper waste disposal system. The health status indicators of the population of Ethiopia are
among bad compared to the world. There are different problems that affect health of the
community. Among environmental health characteristics; maternal and child health
characteristics; morbidity and mortality rate are the most common problems. (3)

1
Majority of the population do not have access to sanitary facility and safe and adequate water
supply according to the 2020 estimates three of ten globally lack a facility with water and soap
available to wash their hand at home. In 2019 7 percent sub Saharan Africa had no hand hygiene
service at all. (6)
Soap and water, the essential hand washing agents, were observed in 28% of urban households
and 7% of rural households. Water, soap, and other cleaning agents were absent in 43% of urban
households and 68% of rural households. The availability of soap and water varies across
regions, from a low of 5% in Amhara to a high of 39% in Addis Ababa. Soap and water
availability increases with increasing wealth. Households in the highest wealth quintile are
almost 9 times as likely to have soap and water as those in the lowest wealth quintile (26%
versus 3%). the simple act of cleaning hand can saves lives and reduce illness by helping prevent
the spread of infectious disease. The disease can be caused by pathogens (germ) transmitted
through the air or viral surface, hand play significant role in spreading disease. It is estimated
that half a million people die each year from diarrhea or acute respiratory infection that could
have been prevented with good hand hygiene .As well as preventing multitude of disease hand
hygiene can help avoid significant financial costs resulting from sickness and death. (5)
Diarrhea is major communicable disease caused by in proper hand sanitation. In kalisha kebele
diarrhea affects 50% of children under 5 years. In addition to communicable disease in Kalisha
nutritional problems, maternal and child health problems are the major challenging health care
related problems.
Health indicators maternal, infant and under 5 mortality which can be minimized by utilization
of health service, like family planning, ANC, Delivery, PNC, TT vaccination, nutrition and
immunization, are significantly high in Ethiopia. Regarding the maternal and child health aspect
high fertility is usually associated with high maternal, infant and child mortality rate. In
developing countries women continue to give excess birth because of lack access to
contraceptive and awareness. In Ethiopia, the levels of maternal and infant mortality and
morbidity are among the highest in the world. [5]

2
1.3 Significance of the Study
For the community this study were provide relevant information on health and health related
problems in Kalisha kebele and serve as an input to prioritize, plan and properly execute
appropriate, feasible, timely and cost effective public health interventions and evaluation of the
continuity of the intervention. As most of the health related problems in Ethiopia are preventable
and minimized by good health services management and strong political commitment as well as
community participation, community health assessment is an important tool to identify health
status, health related problems, and factors that could affect the society’s health.
For Governments And NGO’s The result of this survey will be used by governmental and non-
governmental institutions to solve the community health related problems.it provides the
platform for concerned bodies to intervene, create awareness and mobilize the community for
maximum and sustainable results. The study will also serve as a baseline to perform further study
on the subject by an individual, governmental and non-governmental organization in the future.
For Students CBTP help the students to gain practical knowledge other than the academic one. it
also help students to address Health and health related problems of the community, to address the
existing gaps by identifying and assessing health and health related problem. It was used as a pre
foundation to see the community in actual place, to practice the habit of teamwork, to know how
to collect raw data and to process or analyze it.

3
CHAPTER TWO
LITERATURE REVIEW
2.1 Drinking Water and Sanitation Facility
According to 2016 EDHS Nearly two-thirds (65%) of households have access to an improved
source of drinking water. Almost all households in urban areas have access to an improved
source of drinking water, compared to 57% of rural households only 6% of households in
Ethiopia use improved sanitation. Urban households are more likely than rural households to use
improved sanitation (16% versus 4%). Ninety-four percent of households use unimproved
sanitation. (3)Half of households in urban areas (50 percent) use an unimproved toilet facility,
compared with more than 9 in 10(94percent) of households in rural areas. (6)
2.2 Family Planning
More than one-third (36%) of married women age 15-49 use any method of family planning—
35% use a modern method and 1% use a traditional method. Injectables are the most popular
modern method (23%), followed by implants (8%), IUD (2%), and the pill. Among sexually
active, unmarried women age 15- 49, 55% use a modern method of family planning and 3% use
a traditional method. The most popular methods among sexually active, unmarried women are
injectables (35%) and implant (11%). Modern method use ranges from a low of 1% in Somali to
a high of 50% in Addis Ababa. (3)

The use of any method of family planning by married women has increased more than fourfold
from 8% in 2000 to 36% in 2016. Similarly, modern method use has increased fivefold from 6%
to 35% during the same time period. (3)

The 2016 EDHS results show that 62 percent of women who gave birth in the five years
preceding the survey received antenatal care from a skilled provider at least once for their last
birth. Three in 10 women (32 percent) had four or more ANC visits for their most recent live
birth. Urban women were more likely than rural women to have received ANC from a skilled
provider (90 percent and 58 percent, respectively) and to have had four or more ANC visits (63
percent and 27 percent, respectively). (5)

4
2.3 Child Health and Nutrition
In Ethiopia, 58 percent of infants lower than 6 months are exclusively breastfed. Contrary to
recommendation by WHO those children under age 6 months should be exclusively breastfed, 17
percent of infants 0-5 months consume plain water, 5 percent, each, consume no milk liquids or
other milk, and 11 percent consume complementary foods in addition to breast milk. Five
percent of infants under age 6 months are not breastfed at all. (5)
The study conducted show that 38% of children under five are considered short for their age or
stunted, and 18% are severely stunted in Ethiopia. Stunting ranges from a high of 46% in the
Amhara region to low of 15% in Addis Ababa. Overall, 10 of children in Ethiopia are wasted and
3% are severely wasted. Regional variation exists with Somali and Afar having the highest
percentages of children who are wasted, 23% and 18% respectively. (3)
2.4 Vaccination
Globally, 116.5 million children’s received DTP3 in 2010 compared with 24.4 million in 1980.
In 2016, DTP3 coverage ranged from 74% in the WHO Africa region to 97% in the western
pacific region. (3)

Nearly 4 in 10 children age 12-23 months have received all eight basic vaccinations—one dose
each of BCG and measles and three doses each of DPT-Hep B-Hib and polio vaccine. (3)
Urban children are more likely to have received all eight basic vaccinations than rural children
(65% vs. 35%). Basic vaccination coverage is lowest in Affar (15%) and highest in Addis Ababa
(89%). (3)
2.5 Communicable and Non-Communicable
Communicable diseases are a leading cause of morbidity and mortality around world. According
to WHO, infectious and parasitic diseases cause every year around 10.9 million deaths and result
in a loss of an estimated 350 million DALYs. Of these about 56% deaths are caused by
HIV/AIDS, TB and Malaria. (7)
Communicable and non-communicable diseases are common in Ethiopia. According to
UNICEF’s study developing countries commonly early up to 1000 hook worm and round worm
at a timeline gram of feces can contain, 10,000 viruses, 10,000,000 parasitic cyst and 100
parasitic eggs and some non-communicable diseases. The fact in Ethiopia indicates that about
80% of diseases are related to poor sanitation and unsafe water supply. Diarrhea and parasitic

5
infections are the leading among the top ten diseases causing high mortality and morbidity
especially in less than five years. (7)
2.6 Solid Waste Management
The scope of solid waste management encompasses planning management systems, waste
generation processes and organizations, procedures and facilities for waste handling. Developing
strategies comprise specific objectives and measures in these areas. They need to consider the
specific interests, roles and responsibilities and numerous factors including households;
community based organizations and other service users, local and national government
authorities and non – governmental organizations. As a result, effective solid waste management
depends upon an appropriate distribution of responsibilities between national, provincial and
local governments. The rapid rate of uncontrolled and unplanned urbanization and high rate of
population growth in the developing nations and Africa brought environmental degradation.
Indeed, one of the most pressing concerns of urbanization in the cities and towns of developing
world especially in 25 Africa has been the problem of solid, liquid and toxic waste management.
(3)

6
CHAPTER THREE
OBJECTIVES
3.1 General Objective
To assess health and health related problems of the community and apply possible
interventions in kalisha Kebele, Lemo Woreda, Hadiya Zone, SNNP, Ethiopia, 2023
3.2 Specific Objective
 To assess food hygiene
 To assess nutritional status
 To identify problem of water supply and coverage
 To assess family planning practice
 To determine the EPI coverage in under two years old children
 To assess insect control
 To assess rodent control

7
CHAPTER FOUR
METHODOLOGY AND MATERIALS
4.1 STUDY AREA AND PERIOD
4.1.1 STUDY AREA
Study was conducted in kalisha kebele of lemo woreda, which is nearby of hosanna town, capital
of Hadiya zone, south nation nationalities and peoples region(SNNPR)
Kalisha is found in southern Ethiopia; Located in Hadiya Zone of the Southern Nations
Nationalities, and Peoples Region about 227 kilometers south of Addis Ababa and 3.4 kms from
Wachemo University.
Kalisha is bounded by: Kidigsa in the North, Ambicho Gode In The West, Hosanna Naramo In
The East And Chemo Hossana In The South.

FIGURE 4.2:Schematic representation of kalisha kebele, Lemo woreda, Hadiya zone, SNNPR,
Ethiopia,2023.

8
It has 1 primary school, one health post, one Green area, one mosque, two churches and one
kebele administration. The total population of this kebele is 1805 in which 910 were females and
895 of males among the total population and there is 368 total household. Infants less than 1 year
age are 57; children under 3 year age are 148 children under 5 year age are 277. The climatic
condition is Woyenadega. The economy is mainly based on agriculture and well known for its
wheat production. 63% of populations are Protestant, 17% orthodox, 10% Muslim. The major
language is hadiyissa. The community is known by their cultural foods like kocho. (From
Kalisha Kebele Administration)
4.1.2 Study Period
The study was conducted from March 24 to March 29 /2023
4.2 Study Design
A community based cross sectional study was conducted
4.3 Population
4.3.1 Source Population
All households that found in Kalisha Kebele
4.3.2 Study Population
Selected households of Kalisha kebele community
4.3.3 Study Unit
Individual household
4.3.4 Eligibility Criteria
4.3.4.1 Inclusion Criteria
 Households who live in the kebele for more than or equal to 6 months.
 A Person whose Age greater than eighteen years old (18)
4.3.4.2 Exclusion Criteria’s
 Forlorn house
 Households who refuse to participate
4.4 Sample Size Determination and Sampling Technique
4.4.1 Sample Size Determination
The sample size was determined by using a formula for estimating a single population proportion
assuming confidence level of 95%, 5% marginal error with proportion of 41.5% (proportion of

9
determinants of family planning use among married women in kalisha) (8) and 10% allowance
for non-respondent rate.
n = [Zα/2]2 p (1-p)/d2) considering the following assumptions:
Where,
P = 41.5%
d = marginal error of 5%=0.05.
Z = confidence interval of 95% and Zα/2 is the value of the standard normal distribution
corresponding to a significance level of alpha (α) 0.05, which is 1.96.
n = the required sample size when the target population less than 10,000.
n=Z2p(1-p)/d2
= (1.96)20.415(0.585) =373
(0.05)2 =373
Since the target household is 1805 we need to calculate correction factor formula, as follows
n=no /¿
Where: n = minimum required sample size
no = minimum sample
N = Total household=368
n= 373 = 187
1 + 373
368
Consider as 10% is non-respondent rate (19), so our final sample size is ~206.
nf =206
4.4.2 Sampling Technique
The sampling procedure was performed by using systematic random sampling method. The First
household was selected randomly by lottery method by using health post as bench mark.
The systematic random sampling technique was used to select sample size of 206 from the total
HHs of 368, using health post as bench mark, we selected the first house by lottery methods and
then by using sampling fraction we selected the rest of houses every two house until our sample
size was filled to be 206.
That is sampling fraction (K) =N/nf, 368/206= 2

10
4.5 Data Collection Tool and Techniques
The tools which were used to collect the data include; structured Questionnaires for interview,
direct observation and using secondary data. The questionnaires contains socio-demographic
characteristics (age, sex, educational level, ethnicity, religion, income, and occupation), mortality
and morbidity factors, nutrition related factors, maternal and child related factors health service
related factors and environment related factors (housing conditions, water supply, sanitation and
hygiene related factor).
The questionnaires were originally prepared in Amharic version. This original version was used
for collecting the data, but in the time of writing result questionnaires are translates to English.
In households where there are married couples, the husband or wife will be considered as
respondent.
In other circumstance when there were no married couples, the head of the house hold was
considered as respondent to questionnaires. In condition where the appropriate respondent may
not be available in the house during initial visit one more revisit was conducted to contact the
appropriate person and the data were collected by students.
4.6. Data Quality Assurance
In order to keep the quality of data, every questionnaire was discussed and checked by the team
members. Every items of the Selection of households during sampling was kept random. Data
collection supervision by assigned supervisors were undertaken in order to solve any problem
that may arise during data collection. After all the data was checked for completeness and
inconsistence, and we rechecked it again before the data was analyzed.
4.7 Data Processing, Analysis and Presentation
The completed questionnaires were checked for completeness and consistency. Data cleaning
was performed to check for accuracy, and consistencies starting from the day of data collection.
The data was analyzed manually by using scientific calculator and tallying. The result was
summarized by using figures and tables. The highest problem will be identified by ranking the
higher percentage as due consideration and considering descriptive statistics.

11
4.8 Variables of the Study
4.8.1 Dependent Variable
Heath and health related problem (housing condition, environmental sanitation, knowledge
about sanitation).
4.8.2 Independent Variable
 Age
 Sex
 Religion
 Marital status
 Occupational status
 Educational status
4.9 Operational Definition
 Rodents: small animal they either live in house or outside house. Include rat and mice.
 Insect: small fly living thing they are either vector or transmit disease from one to another
 Inappropriate latrine usage: not used latrine properly, excretes outside holes, excrete
around the environment.
 In proper waste disposal system: the household with no dumping site or do not collect and
burn the solid waste but rather dump at open field.
 Ventilation
 Good – A house which has two or more windows for each room which are
functional.
 Fair - A house which has one window but functions partially.
 Bad – No windows or windows closed all the time or non-functional.
 Daily water consumption
 Inadequate - <50L/households/day
 Adequate - ≥50L/households/day
1. Distance from home to water source
1. Near - <30 minutes
2. Far -≥30 minutes(EDHS,2016)
Good environmental sanitation- house and compound free from animal dung, plastic, waste
Poor environmental sanitation- a house and /or a compound with animal dungs, plastics, waste

12
Poor latrine construction - a latrine w/C have no shelter, floor, and door.
Poor latrine utilization -a latrine with no hand-washing material after toilet use and without
target use of the hole.
Illumination
 Good illumination = presence of window every room and enables to read 12 letter
sentence at center of room.
 Medium illumination= light enters to room either by window or other opening but not
disseminate in equal.
Household: The peoples in a family that are living together in one house.
Head of household: The person who is leading the household.
4.10 Ethical Consideration
The study was conducted after obtaining formal letter from CBE office. Permission was obtained
from administrative officials of the study area. Verbal consents were also obtained from the
respondents after explanation of the purpose of the study. Data is kept to be
confidential .Culture; norms and life style of the society were respected throughout our study
process.
4.11 Dissemination of Results
This CBTP work will be presented to;-
 Wachemo University, School of Nursing, Department of Surgical Nursing

13
CHAPTER FIVE
RESULT
5.1 SOCIO DEMOGRAPHIC CHARACTERISTIC
This study was collected from 206 HHs and all were responded the questionnaire. There were
1010 people in our sample households, from the sample households (501) 49.6% were males and
509(50.4%) are females. Among our respondents majority 737(73%) of them were Protestants.
Majority of people 340(34%) are students Among 340, 321 (32%) were Primary while 46 (5%)
are children’s who are under 7 year and attend kindergarten school. The remaining are discussed
in the below table.
TABLE 5.1: SOCIO-DEMOGRAPHIC CHARACTERISTICS OF 206 HOUSEHOLDS IN KALISHA
KEBELELE, HADIYA ZONE, SNNPR,ETHIOPIA,APRIL,2023

Variables Categories Frequency Percent%

Relationship to the Father 190 18.8
household Mother 198 19.6
Children 560 55.4
Grand child 22 2.2
Grand parent 17 1.7
Other relatives 23 2.3
Total 1010 100
Sex Male 501 49.6
Female 509 50.4
Total 1010 100%
Age 0-5year 134 13.3
6-14year 201 19.9
15-24year 169 16.7
25-49year 253 25.04
50-64year 178 17.6
>65year 75 7.4
Total 1010 100

14
Religion Protestant 737 73
Orthodox 172 17
Muslim 101 10
Catholic - -
Other - -
Total 1010 100
Marital status Married 219 21.6
Single 357 35.3
Divorced 2 0.2
Separated 30 3
Widowed 9 0.9
Under 18 not eligible to 393 39
married
Total 1010 100
Education status Unable to read and write 172 17

Can read and write 276 27

Primary 321 32

Secondary 65 6

Above 12 92 9

Under 7yr 38 4
A, not attended
kindergarten
46 5
B.attend kindergarten
Total 1010 100
Farmer 163 16

15
Occupational status Government employed 146 14.5

Merchant 42 4

House wife 121 12

Under 18 who are not 106 10.5

eligible for work
Under 18 and who works 60 6

Student 340 34

Other 32 3
Total 1010 100

5.2 Vital statics

5.2.1 Birth
There were 32 (15.5%) birth in Kalisha kebele in last 12 months of which 20 (63%) were
females and 12 (37%) were male almost all of them were born in health facilities by
professionals and 32(100%) were alive and none (0%) of them were still birth. The following
table shows about birth in last 12 months of Kalisha kebele. The remaining are discussed in the
below table.
TABLE 5.2: BIRTH STATUS WITH IN LAST 12 MONTH OF 206 HOUSEHOLDS IN KALISHA
KEBELE ,LEMO WOREDA,HADIYA ZONE,SNNPR,ETHIOPIA,APRIL 2023.
Variable Categories Frequency Percentage
Birth in the last 12 month Yes 32 15.5
No 174 84.5
Total 206 100
Sex of new born Male 12 37
Female 20 63
Total 32 100
Status of birth- Live birth 32 100
Still birth - -

16
Total 32 100

5.2.2 Morbidity and Mortality

Out of 1010 house hold populations, 32(2.89 %) births within the past 12 months and 15(1.48%)
is found death from last 12 months and majority of death is taken an age above 46(44.44%). The
remaining are discussed in the below table.
TABLE 5.2:CHILD BIRTH STATUS AMONG 206 HOUSEHOLDS IN KALISHA KEBELELE, HADIYA
ZONE, SNNPR,ETHIOPIA,APRIL,2023

Variables Categories Frequency percent%

Birth last 12 month M 12 41.5
F 20 58.5
Total 32 100
Children who are <5 M 58 43
year in HH F 76 57
Total 134 100
Death last 12month M 9 61.11
F 6 38.89
Total 15 100
Age of death <18yrs 2 16.62
18-35yrs 1 11.11
36-45yrs 4 27.83
>46yrs 8 44.44
Total 15 100
Cause of death Sickness 7 47
Accident 3 20
Age 5 33
Total 15 100

17
5.3 Environmental condition
Among 206 households 5 (2%) had one rooms, 51(25%) had two rooms and 150(73%) had three
and greater than three rooms. From the sampled households 159 (77%) sufficient and 47(23%)
medium illumination. The households who have kitchen are 196(95%). Among this kitchens
80(39%)have smoke exhale. From 206 households in Kalisha kebele 90(44%) are using wood
and 10(5%) are using electric. Among 206 households who live in in Kalisha Kebele 206(100%)
have latrine. From 206 households who live in Kalisha Kebele 78(59.2%) dispose waste in
private hole outside the compound while 122(40.8%) are dispose waste in the field. Among 206
household who live in Kalisha Kebele, 206(100%) house hold uses tap water. Water
consumption of 39(18.9%) the households were <40 liter per day. Among 206 households
125(61%) have domestic animal, from these 111(89%) households have separated households
for animal. Among 206 household of Kalisha Kebele have 159(77%) rodents and 206(100%)
insects.
TABLE 5.3:HOUSING CONDITION OF 206 HOUSE HOLDS IN KALISHA KEBELELE, HADIYA ZONE,
SNNPR,ETHIOPIA,APRIL,2023

Variables Categories Frequency percent%

Design of house Attached to fence or neighbor 122 59.2
house
Some distance from fence or 84 40.8
neighbor house
Total 206 100
No of rooms 1 5 2
2 51 25
>=3 150 73
Total 206 100
Ventilation Good 165 80
Fair 29 14
Bad 12 6
Total 206 100
Illumination Sufficient 159 77
Medium 47 23

18
Poor - -
Total 206 100
Cleanness Good 139 67.5
Fair 67 32.5
Bad - -
Total 206 100
Small insects and Rat Yes 159 77
rodent in the house No 47 23
Yes Mosquito 6 2.9

Cockroach 45 21.8

Lea 10 4.9

House fly 145 70.4

No - - -
Total 206 100
Presence of Yes 125 61
livestock around the No 81 39
house Total 206 100
Have separate Yes 111 89
living for live stock No 14 11
Total 125 100

Source of fuel for Fire wood and muck 60 29

cooking Fire wood 90 44
Electricity and fire wood 46 22
Electricity 10 5
Total 206 100
Is there separated Yes 196 95
kitchen No 8 5
Total 206 100

19
Did the kitchen has Yes 80 39
opening No 126 61
Total 206 100
If you use electric Yes 53 95
did the cable intact No 3 5
or open inside the
Total 56 100
wall
Is there any things Yes - -
that makes fire in the No 206 100
kitchen
Total 206 100

5.4 Water supply

Out of 206 HHs, 206(100%) of them uses tap water,206(100%) pipe water.201(97.6%) store in
jar and uses pouring method,5(2.1%) in barrel whereas 5(100%) are uses separated equipment to
jogging from what they stored in. From total of 206 HHs 39(18.9%) consumed less than 40 liter
per day.135 (65.5%) HHs is got a journey that takes 11-20 minutes to provide the water from the
source. The remaining are discussed in the below table.
TABLE 5.4: SOURCE OF WATER SUPPLY OF 206 HOUSEHOLDS IN KALISHA KEBELELE, HADIYA
ZONE, SNNPR,ETHIOPIA,APRIL,2023

Variables Categories Frequency percent%

Source of water supply Tap - -
Stream - -
Tap and - -
steam

Pipe 206 100

Total 206 100
If you get the water from Boiling - -

20
the river what did you do Exposed to - -
before using it for drinking sun
Chlorine - -

None - -

Where did you put a water Jar 201 97.6

that you used for drinking Pitcher - -

Barrel 5 2.4

Other - -
Total 206 100
How did you pour By pouring 201 97.6
By jogging 5 2.4
Total 206 100
Did you pour through a Yes 5 100
separated equipment No - -
Total 5 100
Daily water consumption <40lt 39 18.9
per litter per HHs 40-80lt 145 70.4
>80lt 22 10.7
Total 206 100
how long it takes round <10 min 53 2.89
11-20min 135 65.5

>20 min 18 8.8

Total 206 100
By what you wash food Only water 43 20.9
equipment Soap and 163 79.1
water
Total 206 100
Is there separated place for Yes 4 1.9

21
cooked and row food No 202 98.1
Total 206 100
How did you dry up the Drying with 98 47.6
cleaning equipment towel
By help of 108 52.4
air
Total 206 100
Where did you put dry tool On floor 26 12.6

On shelf 4 1.9

On modern 176 85.5

kitchen shelf
Total 206 100
Did you eat remaining Yes 110 53.4
food again No 96 46.6
Total 206 100
Did you heat well while Yes 110 100
you use the remaining food No - -
Total 110 100
Did you cook while you’re Yes - -
sick(diarrhea ,cough ,woun No 206 100
d) Total 206 100
Did you cover your hair Yes 153 74.3
and take off jewelry while
No 53 25.7
you cook
Total 206 100
Did you touch Yes 15 7.3
face ,eye ,ear while you’re
No 191 92.7
cooking
Total 206 100
When did you wash your before 206 100

22
hand preparing
meal
after using 206 100
toilet
after 54 26.2
washing
children
after 41 19.9
touching birr
&other
things
after 32 15.5
touching
nose, face,
ear

By using what did you water &soap 85 41.3

wash your hand only water 121 58.7
Does not - -
wash hand
Total 206 100

5.5 Environmental Survey

Out of 206 HHs latrine coverage kalisha kebele, 206(100%) had latrine facility for family. Out of
total households 198(96%) used pit latrine type. From selected study community 81(39.3%) used
latrine properly. Around 200(97%) households latrine less than 20m, 6(3%) HHs latrine >20m,
and 15(5.47%) HHs, far away from their houses. Around 112(54.4%) households latrine were
not clean and 94(45.6%) households latrine were cleaned and used in good condition. Out of 206
households 122(59.2%) were disposed the waste in open field. The remaining are discussed in
the below table.

23
TABLE 5.5: WASTE DISPOSAL CHARACTERISTICS OF 206 HOUSEHOLDS IN KALISHA KEBELELE,
HADIYA ZONE, SNNPR,ETHIOPIA,APRIL,2023
Variables Categories Frequency percent %
Presence of latrine Yes 206 100
No - -
Total 206 100
Do you use latrine properly Yes 81 39.3
No 125 60.7
Total 206 100
Type of latrine Pit latrine 198 96
VIP 8 4
Flush - -
Total 206 100
Distance of latrine from the house <20m 200 97
>20m 6 3
Total 206 206
Is latrine clean Yes 94 45.6
No 112 54.4
Total 206 206
Where did you dispose dry west Field 122 59.2
Private hole 78 37.9
Common disposal 6 2.9
area
Total 206 100

5.6 Family planning

From 206 households, the women that knows about the family planning method were 179(87%)
and the remaining women does not know about family planning method 27(13%). 57(32%)
women currently using contraceptive and 122(68%) women do not using contraceptive currently.

24
The main reason for not using contraceptive is personal choice for not using 59(48). The
remaining are discussed in the below table.
TABLE 5.6:FAMILY PLANNING UTILIZATION OF 206 HOUSEHOLDS IN KALISHA KEBELELE,
HADIYA ZONE, SNNPR,ETHIOPIA,APRIL,2023

25
Variable Categories Frequency Percent%
Knowing about family Yes 179 87
planning method No 27 13

Total 206 100

Do you want additional Yes(now) 54 26.6
child

Yes but after 2yr 26 12.6

No 125 60.8
Total 206 100
Knowing type of Pills 36 20
family planning Condom 21 12
method Inject able 82 46
Implant 36 20
IUCD 4 2
Surgical - -
Total 179 100
Have you ever used Yes 95 53
family planning
84 47
No
Total 179 100
Women using currently Yes 57 32
contraceptive No 122 68
Total 179 100
Family planning Depo 27 48
method they are Pills(COC) 18 32
currently using Implanon 11 20
IUCD - -
Condom - -
Surgical - -
Total 57 100
Reason for not using No want 59 48
Health problem 16 13
No accessible -26 -
Cost - -
Religion 34 28
5.7 Child Nutrition
Among the total under 2 years childrens,44(81.3%)were started breast feeding with in 1hr;
34(63.79%) of the children under 2 years were started complementary food after 6 month and
10(22%) children feeding breast more than four times per day.

TABLE 5.7:CHILD NUTRITION UNDER TWO AGES OF 206 HOUSEHOLDS IN KALISHA KEBELELE,
HADIYA ZONE, SNNPR,ETHIOPIA,APRIL,2023.
Percentage
Variables Categories Frequency
(%)
Yes 54 26
Is there less than 2 years
No 152 74
old child
Total 206 100
Yes 44 81.3
Breast feed the child
No 10 18.7
during first one hour
Total 54 100
Yes 45 83
Currently breast feed No 9 17
Total 54 100
<6 month 20 36.21
Receive complementary
>=6 month 34 63.79
food
Total 54 100
Fluid 25 46
Semi fluid 18 33
Combination of food
Same family 11 21
Total 54 100
Frequency of child Once - -
feeding Twice 5 11
3x 7 16
4x 10 22
>=5x 23 51

27
Total 45 100

5.8 Child Vaccination

From total households those who had under 1yr old children, 28(87.5%) children had vaccinated
and 25(89.3%) had vaccination card. Out of vaccinated children 17 of them got vaccine against
polio virus and 15 children completed all dose whereas 9 were against measles virus. The
remaining are discussed in the below table.
TABLE 5.8:CHILD AND MATERNAL OF 206 HOUSEHOLDS IN KALISHA KEBELELE, HADIYA ZONE,
SNNPR,ETHIOPIA,APRIL,2023

Variables Categories Result %

No of children 28 87.5
<1yr had
vaccinated
Among those who 25 89.3
have vaccine card
Had vaccine card BCG 25 89.3
represents POLIO P1 17 68
vaccinated in P2 17 68
P3 15 60
PENTAVALE P1 17 68
NT P2 17 68

P3 15 60

ROTA R2 17 68

R3 15 60

PCV P1 17 68

28
P2 17 68

P3 15 60

MEASLES 9 36
No of women from Yes 135 63
15-49 age had No 78 37
tetanus vaccine Total 213 100
How many time 1 26 19
did they get 2 45 34.4
vaccinated 3 19 14.3
4 32 23.8
5 13 9.5
Total 135 100
Among pregnant Yes 23 88
women vaccinated
tetanus vaccine No 3 12
Total 26 100
From Their uvula removed 46 34
total Their roof (gig) removed 15 11
house Their eye brows cut down 38 28
hold Female mutilation -
under 5 No 36 27
children Total 134 100
5.9 Maternal health
5.9.1 Antenatal care
Among the study households 206 there were 213 women in age group 15-49 among these 26 are
pregnant women in the residence of kalisha kebele and there were about 41.4% of antenatal care
coverage and high prevalence of TT vaccine among those pregnant women. The remaining are
discussed in the below table.

29
TABLE 5.9: ANTENATAL CARE COVERAGE OF 206 HOUSEHOLDS IN KALISHA KEBELELE,
HADIYA ZONE, SNNPR,ETHIOPIA,APRIL,2023
Variables Categories Frequency Percentage (%)
Yes 26 13
It there pregnant mother? No 180 88
Total 206 100
1st - -
2nd 15 58
Term of pregnancy
3rd 11 42
Total 26 100
Yes 21 81
No 5 19
Antenatal care visit
Total
26 100

Yes 23 88
Did she receive TT
No 3 12
vaccine?
Total 26 100
TT1 7 30
TT2 6 26
How many times receive TT3 5 19
TT vaccine? TT4 4 15
TT5 2 8
Total 23 100

5.10 Morbidity
Among 1010 total population studied in 206 HHs, there was morbidity in 24(11.7%) HHs
population in the last two weeks; among those 8(33.3%) and 16(66.7%) were male and female
respectively. According to the study age group who faced morbidity with age group of 21-60 are
6(25%). From those majority of morbid individuals who are susceptible to diarrhea diseases was
scored 10(41.7%) and from 206 total HHs 195(95%) were seek help from health institution. The
remaining are discussed in the below table.

30
TABLE 5.10: MORBIDITY STATUS IN THE LAST 2 WEEKS(INCLUDING UNDER FIVE CHILDREN) OF
206 HOUSEHOLDS IN KALISHA KEBELELE, HADIYA ZONE, SNNPR,ETHIOPIA,APRIL,2023
Variables Categories Frequency Percent %
Morbidity Yes 24 5
Within 2 week No 986 95
Total 1010 100
Sex of sick M 8 33.3
F 16 66.7

Age 0-4 years 8 33.5

5-20years 7 29
21-40 4 16.7
41-60 2 8.3
>60 3 12.5
Total 24 100
What was the disease? Typhus/typhoid 4 16.7
Cough 6 25
Diarrhea 10 41.7
Other 4 16.7
Total 24 100
Physically Ye Eye 1 0.3
disabled person in s Brain 5 0.5
HHs No 981 99.2
Total 1010 100
Seek help where? HI 195 95
Traditional 2 1
Religious 9 4

Magicians - -
Total 206 100
From where you got Pharmacy 196 95
Traditional drug 6 3

31
drug when you feel ill store
Shop - -
Other 4 2
Total
What will happen if Don’t recover 181 87.6
you not take it properly Drug resistance 10 5
Relapse 9 4.47
Total

5.11 Mental Illness

Out of 206 HHs 186 (90.3%) had heard about mental illness, 20(9.7%) has no idea about the
cause of mental illness. 1(1%) HHs had mental illness in their family. 112(72.7%) were seek
help from religious places while 41(26.6%) from health institution. The remaining are discussed
in the below table.
TABLE 5.11:MENTAL ILLNESS OF 206 HOUSEHOLDS IN KALISHA KEBELELE, HADIYA ZONE,
SNNPR,ETHIOPIA,APRIL,2023

Variables Categories Frequency percent%

have you heard about Yes 186 90.3
mental illness No 20 9.7
Total
Do you know cause Yes 42 22.6
of mental illness No 144 77.4
Total
Do you believe Yes 7 16.7
mental illness is No 35 83.3
communicable Total
disease
Is there anyone who Yes 1 1
have got mental No 205 99
illness in your family Total

32
Do you believe Yes 154 82.8
mental illness seek No 32 17.2
help Total
Where you take HI 147 95.5
when someone Traditional treatment 41 26.6
affected by mental Magician - -
illness Religious institution 112 72.7
Other - -
Is there anyone yes 23 11.2
who addicted in Chat 15 65.2
your family(chat, Alcohol 5 21.7
alcohol, smoke, Smoke 3 13
cannabis) Cannabis - -
NO 183 88.8
Total
Do you believe this Yes 143 76.9
addicted brought in No 43 23.1
mental illness Total

5.12 Eye disease

Out of 206 HHs 151(73.3%) had knew about trachoma whereas 55(26.7%) had not knew about
trachoma disease. The remaining are discussed in the below table.
TABLE 5.12:ABOUT EYE DISEASE OF 206 HOUSEHOLDS IN KALISHA KEBELELE, HADIYA ZONE,
SNNPR,ETHIOPIA,APRIL,2023

Variable Categories Frequency Percent%

Do you know about Yes 151 73.3
trachoma No 55 26.7
Total
If you say yes, do you Env’t unhygienic 132 87.4
know about method of Personal unhygienic 143 94.7

33
transmission Contact with other 23 15.2
Through fly 149 98.7
Other - -
Do you believe Yes 139 92.1
trachoma is preventable No 9 6

Don’t know 3 1.9

Total
Way of preventable if Env’t hygiene 128 92.1
you said yes HI 138 99.3
Traditional drug - -

Self-limit 13 9.4
Is there anyone who Yes 14 6.8
affected trachoma in
your family No 192 93.2
Total

5.13 Nutrition status of women and children

From the total of 206 HHs, 37(18.1%) HHs maternal had anemia symptoms. Out of 206 HHs,
53(66%) women did not get iron supplement. The remaining are discussed in the below table.
TABLE 5.13:NUTRITIONAL ASSESSMENT ON MOTHERS AND CHILDREN OF 206 HOUSEHOLDS IN
KALISHA KEBELELE, HADIYA ZONE, SNNPR,ETHIOPIA,APRIL,2023

Nutritional Categories Frequency %

Assessment
Have you feel Vision blurred 4 2
symptom of anemia Ear blare 5 2.6
Dizziness 15 7.3
Weakness 11 5.2
Tachycardia 2 1

34
No 169 81.8
Total 206 100
Have they sign of Eye paleness 3 1.5
anemia Palm paleness 2 1
No finding 201 97.5
Total 206 100
Do you get iron Yes 27 34
supplement during No 53 66
pregnancy Total 80 100
For how long 3 month 12 44.5
2 month 9 33.3
1 month 6 22.2
Total
Daily number of meal Once - -
during pregnancy Twice 15 19
Three times 53 66
More than three times 12 15
Total 80 100
Daily number of meal Once - -
during breast feeding Twice - -
Three times 16 30
More than three times 38 70
Total 54 100
Is there any food you Yes 32 59
don’t eat during
No 22 41
pregnancy
Total 54 100
Is there any food you Yes 9 16.98
don’t eat during beast
No 44 83.02
feeding
Total

35
Have a problem to Yes 6 2.9
see bright light No 200 97.1
Total 206 100

36
CHAPTER SIX
Discussion
This community based cross-Sectional study tried to assess health and health related problem in
kalisha kebele, Lemo woreda, Haddiya zone, SNNPR. From 206 households of all had latrine
which is higher compared to EDHS 2016 (56%) due to active community participation and
HEWs in the kebele. Around 32% of reproductive age group women uses family planning
currently which is lower compared to the EDHS, 2016 (35%) due to lack of awareness and not
wants to used. 81% of pregnant women use at least one ANC visit which is higher than that of
EDHS, 2016 (62%) because of good awareness and participation and communication between
kalisha kebele women’s and HEWs. 34% of women took iron supplement during pregnancy,
which is greatly differ from 17% of EDHS report 2016 ; this may be due to access of women’s 1-
5 health army and working in collaboration with HEWs. All of respondents used improved water
(tap) for drinking whereas according to EDHS, 2016 (57%), these could be due to high access for
pure water supply in the kebele. Vaccination card are critical tools in insuring that children
receive all recommended vaccinations according to schedule. The 2016 EDHS found that 77.4%
of vaccinated children were reported to have a vaccination card; in our study 89.3% of
vaccinated children have vaccination card that is confirmed.
Nearly all households had good habit of washing and covering water containers, 71.9 percent has
no washing materials near the latrine; this poor rate was estimated due to poor access to clean
water supply and lack of knowledge
Majority of households 122 (59.2%) dispose waste in sanitary land field and about 78(37.9) used
private hole. From total respondents majority of them know about mental illness 90.3% and
trachoma (73.3%).

Conclusion
As it is semi urban kebele agriculture is major income source and means of livelihood in Kalisha.
Regarding to housing condition ventilation seems like good in the community 80% of
households were well ventilated in Kalisha. Most of the household 59.2% from the sampled
households use sanitary field waste disposal. Most of the HHs has lack good hand washing habit.
Majority of house hold use only water to hand wash about 58.7% and about 41.7% use water and
soap for hand wash In Kalisha kebele. Almost all latrines about (96%) was pit type which found

37
0-20 meters to house in most households. Most of the households 77% faced rodent infestation.
Majority of households 70% faced house fly infestation. This study found that 87.5% of eligible
children were immunized, and all most all are ownership of vaccination card 89.3%of them have
card that is confirmed.

Recommendation

 The various health problems prevailing in Kalisha kebele are discussed in the discussion
part of this study. Since the health problems generally need effective intervention from
governmental or non-governmental organization as well as the community, association
of those organizations is needed.
For The Community

 The community should collaborate with the officials and community leaders to avoid
malpractices that affect environmental sanitation and personal hygiene of HHs.Also
they should strengthen their capacity in collaboration with HDA to sustain health
promoting activities, strengthen practice for what they get information.
For Health Worker

 They should create awareness to reproductive age women about the benefit of family
planning, ANC follow up, impacts of early initiation of complementary food and early
weaning, and collaborate with women.
 They should also educate the community about negative health impacts of improper
waste disposal.
 They need to plan and design mechanism in order to minimize and eradicate the
identified problem.
For Governmental & Non-Governmental Organizations

 The government and NGOs should focus on sustainable strategies, like training and
construction of model latrines and waste disposal systems, follow-up, supervision and
monitoring activities.

38
 Need to full fill health equipment for health center to intervene the identified problem
and also control the overall activities of health center and listen the feedback of the
community.
 The Kebele leaders should arrange cleaning campaign in collaboration with HEW by
using community mobilization
 The Kebele should arrange additional waste disposal system

Identified Problems
Improper usage and unclean latrine
Poor waste disposal practice
Low usage of soap for hand washing
Low utilization of family planning method
Lack of iron supplement among pregnant women
Prioritizing criteria
1. Magnitude
5= It covers very high percentage of the identified problems
4= It covers high percentage of the identified problems.
3= It covers medium percentage of the identified problem.
2= It covers low percentage identified problem.
1=It covers very low percentage of the identified problem.
2. Severity
5= Very high consequent suffering and disability from the identified problem
4= High consequent suffering and disability from the identified problem.
3. Moderate consequent suffering and disability from the identified problem.
2= Low consequent suffering and disability from the identified problem.
1= Very low consequent suffering and disability from the identified problem.
3. Feasibility
5= highly feasible considering available resource
4= more feasible considering available resource.
3= feasible considering available resource.
2=Less feasible considering available resource.

39
1= Not feasible considering available resource.
4. Community Concern
5= Very high in terms of political and social acceptability with consideration of equity from the
identified problem.
4= High in terms of political and social acceptability with consideration of equity from the
identified problem.
3= Moderate in terms of political and social acceptability with consideration of equity from the
identified problem.
2= Low in terms of political and social acceptability with consideration of equity from the
identified problem.
1= Very low in terms of political and social acceptability with consideration of equity from the
identified problem.
5. Government concern
5= Very high involvement of government is required.
4= High involvement of government is required
3= Moderate involvement of government is required.
2= Low involvement of government is required.
1= Very low involvement of government is required.

40
TABLE 6.1: SHOWING THE PRIORITIZED PROBLEM OF KALISHA KEBELE IN APR 2023
Score criteria Tot Ran
S. no Magnitude Severity Communit Feasibilit Governmen al k
Problem y concern y t concern
identified
1. High proportion 3 4 2 3 2 14 2
of improper
usage and
unclean latrine

2. High proportion 4 2 2 3 2 13 3
of poor waste
disposal
3. Low usage of 5 4 2 3 2 16 1
soap for hand
washing
4 Low utilization 1 2 3 1 2 9 4
of family
planning method

5. Lack of iron 2 3 2 2 2 11 3
supplement
among pregnant
women

Problem prioritization
1. Low usage of soap for hand washing
2. High proportion of improper usage and unclean latrine
3. High proportion of poor waste disposal

41
4. Lack of iron supplement among pregnant women
5. Low utilization of family planning method
Action plan
TABLE 6.2: ACTION PLAN FOR PRIORITIZED PROBLEMS IN KALISHA KEBELE IN APRIL,2023

Prioritized problem
1.Low usage of soap Base line data Non usage of soap is 58.1%
for hand washing Objective To increase awareness about Disease
transmitted through improper hand hygiene
from 41.9% to 52% within 3months
Strategy By working with community and group
members
Activities Open discussion with individual household on
usage of soap for hand hygiene
Indicators No of educated people about hand washing
Target population All residents of kalisha kebele
Resource All needed resource(soap and water)
Responsible body Households, group members and HEW.
2.Proportion of Base line data Improper usage and unclean latrine 54.4%
improper usage and Objective To maximize clean latrine from 45.6%to
unclean latrine 56.6%
Strategy By working with community and group
members.
Activities Open discussion with individual house hold
about usage of latrine
Indicators No of hand washing material attach to latrine
Target population All resident house hold of Kalisha kebele
Resource Human resource
Responsible body Households, group members and HEW
3.Poor waste disposal Base line data Poor waste disposal of 59.2%
Objective To increase utilization of private dump 37.9 to

42
48% within 1year.
Strategy By working with community and group
members
Activities Creating awareness to maximize private dump
usages.
Indicators No of prepared private dump for the kebele
Target population All resident house hold of North Kalisha
kebele
Resource Human resource
Responsible body Households, group members and HEW
4.Lack of iron Base line data Lack of iron supplement 66%
supplement among Objective To increase utilization of iron supplement
pregnant women from 34% to 45% within 1 year
Strategy Strong team spirit, Working with cooperation
with HEW, groups and to teach about use of
iron supplement
Activities Health education about importance of Iron
folate supplementation
Indicators No of women who get the services.
Target population All 15 to 49 pregnant women in kalisha kebele
Resource Teaching material like leaflet and manual
Responsible body Households, group members and HEW
5.Low utilization of Base line data Low utilization of family planning method
family planning 68%
method Objective To increase utilization of family planning
from 32% to 43% within 1 year
Strategy Working with HEWs, community and group
members.
Activities Creating awareness to minimize
misunderstanding and misconception on family

43
planning.
Indicators No of women who got the services.
No of women who seek the service after health
education
Target population All 15 to 49 age non pregnant women in
kalisha kebele
Resource Teaching material like leaflet and manual
Responsible body Households, group members and HEW

44
Team Intervention
Depending on our plan our team members were intervened by providing hand washing education
in 20 households and also provides mass education around were peoples are found by mass for 9
person.

Figure 6.1 Surgical nursing team intervention on hand washing in kalisha kebele,lemo
woreda,hadiya zone,SNNPR,Ethiopia 2023

45
SWOT Analysis
Strength Opportunity
Wise use of resources by group members. Willingness of kebele leaders to provide information
Active participation of group members. Willingness of respondents during data collection
Close supervision of our advisor and providing us the period
right comment at the right time Preparation of data collection tools by the university
Punctuality of group members Community smooth relationship
Coordination and collaboration of members
Ethics of members
Weakness Threats
Unable to find the actual map of Kalisha. Climate condition (rain)
shortage of time. Absence of Heath extensions workers in health post
Less access of information
Misconception of the community about the question
we asked

46
References
1. Constitution of the World Health Organization. Basic Documents. Switzerland,Geneva :
World Health Organization, October 2006.
2. Prof, . Dr.-Ing Esayas Alemayehu(PhD, P.E)Director,Community Based Education.
Jimma University Community Based Education. ju.edu.et. [Online] 2023.
3. ICF., Central Statistical Agency (CSA) [Ethiopia] and. Ethiopia Demographic and Health
Survey. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF : s.n., 2016.
4. FDRo, Ethiopia. Health Mo:Health Sector Development Programme IV. Addis
Abeba,Ethiopia : MoH, 2015.
5. Agency, Central Statical. Ethiopia Demographic and Health Survey 2016. Addis Abeba,
Ethiopia : s.n., 2016.
6. (UNICEF), 3. World Health Organization (WHO) and United Nations United Nations
International Children’s Emergency Fund. .Progress on Drinking Water and Sanitation. .
Geneva : WHO and UNICEF, 2014.
7. (WHO), World Health Organization. World Health Report . Geneva: : WHO, 2021.
8. Alemayehu Gonie, Alemayehu Wudneh,Dejene Nigatu,Zelalem Dendir. Determinants of
family planning use among married women in bale eco-region,Southeast Ethiopia:a community
based study. s.l. : BMC women's health, 2018.
9. organization, world health. GLOBAL HEALTH OBSERVATORY. who.int. [Online] 2023.

Annex: questionnaire
Informed consent
Dear respondent my name is -----------------------medical student from Wachemo University
college of medicine and health. Since this is a part of our academic requirement, we need to

47
conduct this study in health and health related problem in kalisha kebele. Your voluntary
contribution and accurate reply to these questions has a crucial value for the achievement of this
study. So you are kindly wanted to collaborate in responding the following questions. Your
confidentiality will be insured.
Do you agree A. Yes B. No
Questionnaires code ------------------
Part 1 Socio demographic status

House number ------

2) What is the family size?
3) Number of children
4) Age family members
5) Ethnicity
6) Religion
□Orthodox
□Islam
□Protestant
□Catholic
□Adventist
□Other
7) Educational status
□Illiterate
□Preschool
□primary School
□secondary School
□college/university
8) Marital status
□Married
□Single
□Divorced

48
□Widowed
9) Occupational status

□Government employee
□Trader
□Farmer
□Daily labor
□Student
□Other (specify) __________________

1) Approximate monthly income__________________

2) Accessibility to information

a. Radio set (yes, no)

b. TV set (yes, no)
c. Telephone in the house (yes, no)
d. Access to postal service (yes, no)
e. Access to newspaper (yes, no)
12-Any birth in the last 12 month in the family (yes, no)
13- If yes:

a) Status of the birth (live birth, still birth)

b) Sex of the newborn (male, female)
c) Place of delivery (house, health institution)
Attendant of delivery (TTBA, professional, untrained person)
14- Was there any death in the last 12 months (yes, no?)
15- If yes:

1. Sex (male, female)

2. Age at death (<1, 1-5, 5-18, >18)
3. Perceived cause of death (due to illness, accident, unknown)
16- Sick family members during the last two weeks (yes, no)
17-If yes:

49
a) Sex (male, female)
b) Age (<1, 1-5, 5-18, >18)
c) Ailments (fever, diarrhea, cough, others)
18- Days lost because of illness (<3 days, 3-7 days, >7 days)
19- Did the person seek any help? (Yes, no)
20- If yes, where? (Health institution, traditional healer, home level self-treatment, religious
treatment, others)
Part 2 Housing condition

1.1 Number of rooms?

No of rooms Ventilation(window) Adequate light Cleanness
1
2
3
Keys: 1, Good 2, Fair 3, Bad

1.1. Who is the owner of the house?

A: private B: rented C: other
1.3. What is the total area of the house in square meters?
1.4. What type of materials is the wall made out of?
A: Mud B: Stone C: Wood D: Cement E: Concrete f: other
1.5. Type of material used for constructing the roof
A: Iron sheet B: Thatched C: If other, specify
1.6. Constructing material for the floor?
A: wood B: concrete C: Soil D: If other, specify
1.6.1. Any crack visible in the floor?
A: yes B: No
1.7. Number of windows in the house?
1.8. How often do you clean the house?
1.9. Is there any domestic animal living in or around then house?
A: yes B: No
2.0. If yes, are they living together with people?

50
A: yes B: No they have separate quarters
2.1. What is the status of the kitchen?
A: Separate room attached to the main house
B: separate room but detached from the main house
C: No kitchen at all
2.2. If no kitchen, then where do you usually cook your food?
A: Inside the house B: Outside the house
2.3. If kitchen is available, how is the general sanitation of the kitchen, utensil and food storage
site?
A: Good B: Fair C: Poor
2.4. What source of energy is used for cooking purpose?
A: Wood and coal B: Electric C: Dung D: If other, specify
2.5. What is the source of water for the house? And is it clean or drinkable? Is it inside or outside
the house?
2.6 Does the house require maintenance?
A: No, house is in good condition
B: Not now, house is in fair condition
C: Yes, the house is in poor condition and requires urgent maintenance
2.7. Any trouble with Rodents and insects inside the house?
A: Yes B: No
2.8. If yes, what measures are taken to prevent such conditions?
Part 3 FOOD SANITATION
1 Which of the following procedures do you implement during food preparation?
a) Washing hands
b) Washing vegetables
c) Proper and adequate cooking
d) Material cleaning frequently
e) Preventing contamination
f) Other……………………
2. What method do you use to preserve food?
a) Refrigerator

51
b) Drying
c) Other……………
Part 4 Water supply
1 Source of water supply: a) pipe water b) underground water c) other specify

2 How much is your daily consumption in liters?

3 What type of container do you use to store the water? …………….
4 for how long you store it?...........
5 do you have cover for a container? A) yes B) no
6 do you clean the container? A) yes B) no
7 If yes, how frequent do you clean the container?

Part 5 Waste disposal

1. Is there any scheduled program to collect the waste?
a) Yes b) No
2. What is the final disposal method used for disposing collected waste?
a) Sanitary land field
b) Burning
c) Composting
Other _________________
3. Is there any Problem with insect and other vermin
A) Yes b) No

4. If yes what type a) Housefly fleas b) Bedbugs c) Lice

5. Do you have latrine facility?

a) Yes b) No
6. What is the status of the toilet?
A: Separate room attached to the main house
B: separate room but detached from the main house
C: No toilet at all
7. If yes, what type of toilet do you have?

52
A: Pit latrine B: Water carriage C: If other, specify
8. If separate, how far is the latrine from source of water?
9. What is the location of water source from the latrine?
A: Downhill B: up hill
10. What is the current status of your toilet?
A: Clean and in good maintenance B: Dirty and needs maintenance
11. If Pit, how far is it from the house? ------------meters
13. What is the status of ownership of excreta disposal?
a) Owned by the family
b) Shared or communal
14. If there is no latrine, is there adequate space for construction of a new one?
a) Yes b) No

15. Is latrine construction affordable for the family?

a) Yes B) No
16. What is the waste disposal system of your latrine?
a) Closed
b) Rained to pipes

c) Clearing the septic tank

Part 6 Family planning
1. Do you know about contraceptive?
A. yes
B. no
2. If yes to question number one, which one do know?
A. Pills
B. Implants
C. Injections
D. Condom, diaphragm
E. Others, specify
3. If yes to question number 3, do use any of the methods?

53
A. Yes
B. No
4. If yes to question number 3, specify the type
5. If yes to question number 3, what is the reason you use the contraceptive?
A. Health problem
B. For spacing
C. Financial reasons
D. Others, specify
6. If no to question number 3, what is your main reason?
A. Side effects
B. Cost
C. Don’t know sources
D. Lack of partners consent
E. Not available
7. If no to question number 3, what do you do when you want to space the next pregnancy?

8. How does your partner feel about birth control method?

A. I don’t know
B. He feels positive
C. He is indifferent
Part 7 Pregnancy and delivery
1. Age at first marriage, if ever married
2. Age at first pregnancy, if ever pregnant
3. Total number of
a) Pregnancies
b) Live births
c) Abortions
d) Still births
4. Where did you deliver your last child?
a) Home
b) Clinic

54
c) Hospital
d) Other, specify
5. If it was at home, who attended the delivery?
6. Did you have any health problems during?
a) Pregnancy
b) Delivery
7. Did you go to nearby health center during pregnancy?
8. If yes for above question, why?
a) Regular check up
b) Health problem, specify
9. Did you take any precaution during pregnancy in the following areas?
a) In the kind of work, you do. If yes specify
b) In hygiene

55
1