JIJIGA UNIVERISTY

COLLEGE OF MEDICINE & HEALTH SCIENCE

FINAL, TTP PRESENTATION

 JIGJIGA UNIVERSITY
WELCOME TO
TEAM TRAINING PROGRAM PRESENTATION

Prepared By: College of Medicine and Health Science Students, Fafen Health Center TTP
Site from December 27th to January 13th
Advisors: Mr. Mohamed Omer and Mr. Abdulahi Siraje

Jigjiga Ethiopia
Presentation outlines

• Introduction
• Statement of the problem
• Significance of the study
• Objectives
• Methodology
• Result of study
• DISCUSSION
• Conclusion and
• Recommendation
 Introduction
Background:

 Health is human’s greatest possession, neither could someone take it away nor be
attempts to deny it. Things getting worse and worse when there occur something that
endangers human survival. According to The world health organization (WHO) report,

WHO defined health in its broader sense in 1946 as ‘the state of complete physical, mental
and social wellbeing and not merely the absence of disease or infirmity.’

 Basically it is said and understood that promoting the health of each and every individual
is basic for increasing the national life expectancy of the population at large.
CON’T
Team training program (TTP) is one form of community based education (CBE) aimed at helping
the students acquire first hand experiences of working in the community and training at the
health center which provide:-
 promotive,
 preventive,
curative, services.

 TTP in health have two programs, one is in the health center and the other is in the community

 Our initiation to conduct TTP is that the problem faced by the community is also a problem of us
and digging those problem have a valuable significance to take measures for the reduction of
outcomes resulted from the problems.
CON’T

Over 50 different infections are potentially transmitted from an infected person

to a healthy one by various routes involving excreta.

The use of sanitation facilities is known to interrupt the transmission of faco-

oral related disease.

The construction of traditional pit latrine is relatively a simple technology that is

available to control the spread of diarrhea that is prevalent in developing nations.

However, 2.4 billion people, 40% of the total world population, lack improved
sanitation and 80% of these people live in rural areas of the developing world.
f/h background
 Fafan health center 2014 Human power
1 Total # of health professional Male Female

2 Dr

3 H.O

4 BSc nurse

5 Midwifery

6 C. Nurse

7 Druggist
8 Lab
9
10
1 Total
JIGJIGA’S MAP
STATEMENT OF THE PROBLEM

 Though the government of Ethiopia is making a great effort towards the improvement of the
health service coverage of the country, the country’s health care system remains to be a
challenge particularly in
 Somali regional state
 Afar
 Benishangul Gumuz, and
 Gambella
Con’t

 Ethiopia is still one of the countries of the world with low health service coverage.
 Most of the challenges are in the area of environmental maternal and child health related
complications.
 A standard housing condition status and healthy living environment is expected to contain
(include) adequate, acceptable and available water supply, latrine facility and standardized
kitchens. It should also include a safe sanitary disposal of human excreta, appropriate
solid waste storage and disposal management.
 According to EDHS 2016, the most common source of drinking water in urban households
was piped water, used by 97% of urban households. In contrast, only 57% rural households
have access to piped water. 14 % of rural households have access to drinking water from
protected spring.
Significance of the Study
Assessment and early intervention measures are necessary in societies especially in
developing countries, since the societies have less awareness on the transmission of
many infectious disease or the health risks of many hazardous conditions that largely
affects the population, in addition have less awareness on how to control and prevent
these risks before they pose a problem on the population.
Community based survey is believed to be helpful in providing knowledge on the cause
of illness in specific locality.
Con’t

It helps to list out common fatal problems of the community which
needs to be solved, prioritize them, suggests different ways of
intervening the prioritized problem.
In addition it indicates ways of solving the problems faced through
proper planning and implementation.
It enables students work in team in addressing the problem of the
community.
 Objective

General objective
 To assess major health and health related problems to provide promotive, preventive and curative
health care services at Fafan kebele from December 27th to January 13th 2022 GC
Specific Objectives
 To describe socio demographic condition of the community in selected in Fafan kebele from
December 27th to January 13th 2022 GC.
 To identify environmental conditions related to health in the community in zones 02, Fafan kebele
from December 27th to January 13th 2022 GC.
 To determine maternal and child health condition in the community in zones 02, Fafan kebele
from December 27th to January 13th 2022 GC.
METHODOLOGY

Study area and period

 Datable (Fafan) is found in eastern of Ethiopia particularly found in Somali region which is 35
km away from Jigjiga town which is the capital city of Somali regional state. It is the
administrative center of different sub kebeles. It comprises a number of smaller sub kebeles.
 Based on the figures from the central statistical agency in 2009 this Kebele has a total of
population of 23678, of whom 13,070 are men and 10,608 women, while 11449 are urban
inhabitants, a further 12229 are pastoralists. 99.77% of the populations are Islam by religion.
Con’t

Study period

 The Assessment was conducted in Fafan Kebele , zone 02 from December

27th to January 13th 2022 GC.
Study design
Community based cross-sectional study design was used to conduct the
study.
Con’t

Source population
All population residing in Fafan Kebele.
Study population
The study population was the individuals who live in the selected zone 02, in Fafan
kebele.
Study unit
The study unit was individuals who live in the selected house holds in zone 02.
Inclusion and Exclusion Criteria

Inclusive criteria
 All the people who have
Exclusive criteria
 All the people who
 Closed houses
 Who have speaking and hearing problem
 Who have mental health problem
Sample size determination

Single population proportional formula was used to determine the sample size.
n= [Z (α/2)2 p (1-p)]/d2
where
n= sample size
z= level of confidence which is 95% with 1.96 value of z.
p= proportion (p=50)
d= degree of accuracy 5% (0.05)

but due to limited time and resource the university limited the sample size we took was
only 60 HH.
Sampling Technique and Procedure
From the two zones of Fafan kebele, zone 02 was selected by Simple
random sampling technique.
 All the house hold in the zone 02 has been recorded/marked & we
found total house holds of 384.
By using systematic random sampling we mark all 384 houses from 1-
N(1-384 ). And we calculate ‘’k’’ value by K=N/n,
where
N:- total house hold
n:- sample size

Our n=60 & our N=384.

So our K= 6.4 we take 6,this means we have select 60 households
from 384 houses by jumping 6 houses to get next house hold.
The first house hold was selected by simple random lottery method.
 STUDY VARIABLE

Independent variable
Sex
Age
Occupation status
Marital status
Educational status
Religion
 Con’t

Dependant variable
 Housing condition

 Kitchen condition

 Latrine condition

 Use of family planning

 Environmental health condition of the community

 Maternal and child health condition of the community

DATA COLLECTION

The data collection of this study was done using a structured questioner which is
prepared by Jigjiga University faculty of medicine health science. It was prepared in
English language.
 The data was collected by members of the team moving from house to house.
Participant observation methods also used to assure the information taken from
the peoples are accurate. Pencils, pen, rubber and questionnaire papers were used
in the data collection process.
DATA QUALITY CONTROL

To assure the quality of the data-

 Orientation on how to collect the date was given by our advisor to all the group members
before data collection.
 After the collection of the data, questionnaires were reviewed by group members and
comments were incorporated for internal validity.

 The collected data was checked for completeness and corrective measures were taken
accordingly. And finally the overall quality of data collection was monitored.
Data processing and analysis
Data was processed manually by tallying and tabulation of the
findings.
Finally analysis was carried out by calculating frequency,
percentages and mean of data.
SWOT ANALYSIS

STRENGTH
 Motivated students to identify and solve community problems.
 Cooperative students with all concern bodies
 Punctuality
 Having supportive supervisors

WEAKNESS
 In adequate budget for program (materials)
 Shortage of time
 Unavailability of community due to master plan of the kebele.
 Unavailability of some useful information providers like Immunization cards.
Con’t

Opportunity
Presence of community leaders
Presence of cooperative health center staffs
Presence of health extensions workers
Threats
Weather condition
Uncomfortable roads
Unavailability of community members due to their social activities.
OPERATIONAL DEFINATION

Pre-school – children who are 0 -4 years of age and do not start education.
Clean compound – compound in which there is no dispersed solid and
liquid waste
Immunized women – women who are 15 – 49 years of age and completed
TT immunization up to TT5.
Illiterate- who cannot read and write.
NEXT PRESENTER
 Result of the study
Result on socio-demography
A total of 60 households were included in this study; and there are 342 individuals in
the selected households, among which 177 (51.8%) were females and 165 (48.2 %)
were males (Fig 1.). The majority 338 (98.8%) of the population are Muslims, where
the rest of 4 (1.2%) of the population were Christian
RESULT
Age by sex distribution of the community at fafen kebele zone 02 in Dec 27 2021 up to Jan 13
2022

Age Male Female

Frequency Relative frequency Frequency Relative
frequency
<5 17 10,3 26 14.6
5-9 31 18.7 34 19.2
10-14 32 19.3 19 10.7
15-19 16 9.6 33 18.6
20-34 29 17.5 21 11.8
35-44 8 12
45-49 20 12.1 19 10.7
>508/14/2023 12 13 31
 S.No. Category Variable Frequency Percentage
(%)

1. Sex Male 165 48.2

Female 177 51.8

Total 342 100

8/14/2023 32
Religion Muslim 416 98.8

Christian 4

Total 342 100

8/14/2023 33
Educational status Under school 75 2.9

Cannot read & write 98 28.7

Primary school 183 43.2

Secondary school 112 26.4

Higher education 77 18.2

Total 342 100

8/14/2023 34
Occupational status Merchant 112 32.7

Gov. employee 43 12.5

Student 104 30.4

Manual worker 83 24.2

Total 342 100

8/14/2023 35
Marital status (n=) Married 124 36.2

Divorced 40 23

Widowed 15 5.5

Single 164 35.3

Total 342 100

 Table 3. Total birth in the last twelve months offafan kebele ,
zone02, in Dec 27 2021up to Jan 13 2022

Number of births Sex Frequency Relative frequency

Live birth Male 14 ----

Female 25 64.1

Total 39 100

Still birth Male 3 --

Female 6 --

Total 9 100
5.2. Result on Environmental health condition
• The finding of our study revealed that 75 % of the houses have
congregated tin roofing 3.8 % were grass; and 70% of the house
floor was made of cement and concrete and 30 % was made of
soil and mud. From the total 60 households 4% sleep on bed,
93.4% on floor and 2.6% sleep on a traditional bed made of mud.
Housing establishment condition showed that 22 (36.6%) of the
houses were attached to neighbors and 38 (63.4 %) were
separate and have their own compound. During our visit 63.3 %
of the windows were open and 36.7% were closed, and 66.7% of
the houses were found to have ventilation on one direction,
23.3% have cross-directional ventilation and 10% have parallel
ventilation. In the 70% of the households there was enough light
entry.
Conti…
• With regard to the possession of kitchen, 80% have kitchen and
20% have no kitchen. From those who owned a kitchen, 36.6%
was attached with the main house and 63.4% was separated
from the main house. In addition 59.5% of the kitchens had
windows and 40.5% do not have window for ventilation. It was
also found that 19.1% of the kitchens have smoke outlets and
80.9% have no smoke outlet pipes. Concerning the type of fuel
used by the households, most (89%) of them use charcoal and
wood, 4% of them uses electric, 7% use kerosene.
Among the total 60 households 81.7% of them have toilet; of which
95.9% were pit latrines and 4% VIP latrine. From the households
having toilet 80% have no covers only 2.2 % of them were covered
during our visit. 3% of the toilets were communal and 97% of the
toilets were privately owned. With regard to the cleanliness of the
toilets 95.9% were clean during our visit, but 0% of the toilets have
hand washing facility
 Condition of latrines at Fafan kebele, zone 02, in
Dec 27 2021 up to Jan 13 2022

Variable Frequency Percentage (%)

Toilet (n=60) Present 49 81.6

Absent 11 18

Type of toilet (n=49) TPL 47 95.9

VIPL 3 -

Have cover (n=49) Available 3 6.1

No available 46 93.8

Hand washing facility (n=49) available 0 0.0

No available 49 100

General condition of the toilet(n=49) Clean 47 95.9

Not clean 2 4.0

Condition of latrines at Jigjiga town, Kebele 14, Zone 01, 02, 03 in Aug 30 up to September 25
2019
Toilet Freq % Covered fre Presen freq % Presence of freq
during Obs. q % ce of hand %
feces washing
on
floor

Yes: 49 81. Yes: 39 80% Yes: 2 4.0 Yes : 0

6
No: 11 18 No: 10 20 No: 47 95.9 No: 49 100%

Total: 60 10 Total 60 100 Total 49 100 Total 49

0

8/14/2023 42
 Maternal and child health
condition
From 177 women at reproductive age group (15-49 yrs) 85 (48%) were married,
of which 31(17.5%) of them were married below the age of nineteen. Out of the
85 married women almost all of them gave birth within their first year of their
first marriage. The mean and median age at which women of Fafan kebele Zone
02, gave their first birth were 21 and 18 years respectively.
 TT Immunization
As figure 3: shows, that the percentage of child bearing women who took these TT vaccines are 34%
and less.
Among the reproductive age group, 34 used TT1, 26 used TT2, 18 used TT3, 12 used TT4 and 4 received TT5.

40
35 34
30
26
25
20 18
15 12
10
5 4
0
TT1 TT2 TT3 TT4 TT5
 Siteof delivery and assisted person in fafan
kabele Dec 27 2021up to Jan 13 2022
No Variables Frequency %

Home 6

site of delivery Health facility 23 79.3

Total 29 100

Assistance of delivery health professional 23 79.3

TTBA 0

TBA 6

TOTAL 29 100
Morbidity Status
• During the time of our visit there were 23 diarrheal
cases, of which 14 were under five children and 9 were
above the age of five. All of the cases of diarrhea know
the use of ORS and used it for fluid replacement. In
addition there were 18 individuals diseased with
different cases other than diarrhea two weeks before
our visit. From these cases 9 of them suffer from URTI,
5 of them are gastritis, and the remaining suffer from
UTI.
Among 27 under 1 year children, 16(59.2%) of them have immunization card and only 9 of
them have completely vaccinated, whereas the remaining 7 are waiting appointments. 11
of the 27 under 1 child have no immunization card; out of this 4 children have BCG scar. For
those that orally report their child was vaccinated but not having the immunization card,
the reason mentioned by parents for the unavailability of the card during our visit was
misplacement and lost.

18

16
16

14

12
12
11
10
10
vaccinttion card
8 Mothers report
8
Column1
6
6
5 5
4 4
4

0
OPV 0 BCG OPV 1&PENT1 OPV2& PENTA2 OPV3 & PENTA3 MEASLES
DISCUSSION

60 households were interviewed during our study period.

The total population counted was 342 of which 165(48.2%)
were male and 177 (51.7%) were female.
This study attempts to assess the health and health related
conditions of fafanKebele, Zone 02. The parameters used to
assess the health and health related conditions are the
environmental health condition and maternal and child health
conditions of the community.

8/14/2023 48
Thus the finding of this study showed
that the overall housing condition of
the community was found to be
satisfactory, whereas the
environmental health condition and the
maternal and child health conditions
were unsatisfactory.
In a survey conducted in 2005 E.C.jigjiga kebele 05 ketena03 among total of 286
households, 94.7% had latrine from which 48% were covered while 52% are
uncovered, and the 5.3% of households do not have latrine at all, and from
householders who have latrine, 31(16.9%) have cover and the remaining
152(83.1%) haven't cover. From the latrines which have cover 21(67.7%) were
covered during observation and the remaining 10(32.3%) were not covered at the
time of visit and only 17(9.3%) have hand washing facility near by latrine.
Similarly in this study from the total of 60
households 49(81.6%) of them have latrine
andfrom the households having toilet 93.8%
have no covers of which only 4% of them were
covered during our visit. 95.9% were clean
during our visit, but only 0% of the toilets have
hand washing facility.
The finding of the above study is in agreement with our
finding where 43 under-five children, 9 (20.9%) were
breast feed for less than 6 months, 23(53.48%) were
breast feed for greater than 6 month, and 11 (25.58%)
were breast feed for only 6 month. From the total
children who were under 5 years, 35 (81.3%) started
complementary feeding before 6 month and 8(18.7%)
started complementary feeding at 6 month.

8/14/2023 52
In addition during our visit tonsillectomy was done on 12 (27.9%), and
milk tooth extraction was done on 4 (9.3%) of the under 5 children
From the total children who were under 5 years, 55(78.5%) started
complementary feeding before 6 month and 15(21.4%) started
complementary feeding at 6 month.
In the survey conducted in fafan kebele zone 02, among 20 under 1 year
infants, 11(55%) have immunization card and 9(45%) have no card.
Conclusion
From the finding of study we can
conclude that the overall housing
condition of the community is
satisfactory, whereas the
environmental health condition and
the maternal and child health
conditions were unsatisfactory.
Particularly solid waste disposal system and the
utilization of contraceptives, ANC service
coverage, and immunization coverage were well
below the international and national expected
values. In addition we can conclude that there is
insufficiency of solid waste disposal system and
there is high prevalence of diarrheal diseases in
the studied community.
Recommendation
• Based on the findings of the study we recommend the following-
• The RHB and/ or the district health bureau should make efforts
to raise the awareness of the community on
• The advantages of following ANC services
• The proper disposal of wastes
• The benefits of children Immunization
• The benefits of contraceptives and other FP services
• The benefits of keeping good personal and environmental hygiene
 Cont…
• The RHB and/ or the district health bureau should make sure that
the necessary human and material resources are available to
meet the basic community needs
• There should be communication and coordination between the
RHB/district bureau and the municipality regarding waste
disposal system
 The municipality should make sure that
 Temporary waste storage containers are available in
sufficient numbers
 There is timely disposal of wastes from the temporary
containers
Mini projects

• Mini project
For Enhancing hand
washing facility and its
utilization
 Mini project

 We communicated with the regional health bureau and presented the proposal
and formal letter from JJU

 Based on our proposal we had proposed to have 50 jerkans from RHB but
unfortunately they didn’t give us then we decided to purchase 25 jerkans and
bucket in our pocket and we did it
Objectives

General objectives
 To enhance the hand washing facility attached to the toilet in the
catchment area

Specific objectives
 To promote hand washing practice
 To prevent disease transmission
RESULT

1.Different model households were selected to distribute the jerikans and bucket

2. In the presence of the community with in fafem kabele zone 02 health education
were given about enhancing hand washing.

3. proper hand washing practice was demonstrated and 18 jerikans were distributed
for model households, 3 of them we set up fafan health center and 4 for of it
were given fafen schools for hand washing purpose
 Extra activities

1.Pharmacies inspection
Introduction
In fafan kabele there are approximately 13 drug shops and 1 private clinics and in
our catchment area there are 2 drug shops

From these we plan to inspect 6 drug shops but we inspect 5 drug shops
compulsory activities
Objectives

General objective :-

 To inspect the drug shops and clinics in fafen kebele

Specific objectives

 to inspect the general conditions of drug shop.

 to inspect arrangement of drugs in the shop.

 to inspect the presence of expired drug.

 to inspect the presence of illegal drug.

Method

By using our own prepared checklist we have done..

 Inspection of drug shop general condition

 Interview with owner

by checking the purchasing list

Result

From these 5 inspected drug shops the professions of the owner is 3 are druggist
while 2 are clinical nursing and all of them of have license.

Among inspected pharmacies only 3 have refrigerator.

 All of them have shelf and light but only 2 have store.
Recommendation

We recommended BHB collaborating with RHB to identify the level of each drug
shops and prescribed the exact drug that is premised for them according to it’s
level and control them to provide efficient and effective service to the clients.
 2. Hotel inspection

Introduction
• In our catchment area there 10 hotels from these we plan to visit 8
of them but only we visit 5 of them.
• OBJECTIVE
To asses health and health related condition in hotels.
Activities
 Health information about hygiene.
 Inspection of cooking , eating and kitchen
Result

• From 8 hotels we have inspected 5 of them have had washing and

dish.
• During observation all have utensils washing compartment.
4. Activities of sanitation
Blood donation activates
Painting and designing
planting activates
THE END
•
HAVE A NICE GRADUATION
Health education and seations
conducted fafem health center
Acknowledgment
We strongly acknowledge from bottom of our heart.
Our advisors,
JJU College of medicine and health science
 department heads
TTP coordinator
Regional Health bureau
Fafen Kebele administration and fafen HC staffs
Study participant