community diagnosis

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    INVESTIGATORS;

    AKELLO FAITH, KALUNGI JONATHAN, MUGALU DENISEDWARD, BALUKU ANDREW, KUNIHIRA CATHERINE,

    NABUKALU SSENTONGO ANGELA, NDAGIRE REGINANABIKINDU, ORIBA DAN LANGOYA, TUMWESIGIRE

    SAMUEL,

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    ABSTRACT

    The study was done to carry out a community diagnosis of Nakasongola subcounty,

    Nakasongola district a catchment area ofNakasongola HC IV.

    Methodsused included both quantitative & qualitative.these werequestionnaires,interviews,documents review etc.

    key informants; LCI, VHT.

    Sampling: Household sampling-simple randomized sampling, sample size-120 households,Sample area; Kalubanga, Matuugo and Buruuli villages.

    Demography:81%- female respondents, 57% of households-mother headed, majority of

    household members-below 5 yrs(45.2%), 6-18 (40.5%). Religion;anglicans, Catholics,Muslims, others 47.6%, 21.4% 14.3% ,16.7% respectively.

    Occupation; peasants(69%), civil savants(11.9%)

    Nutrition and food security: Food source; from own garden(61.1%), rest from market.Availability(meals per day); 3-64.3%, 2-26.2%, 1- 7.1%. Diet-mostly carbohydrates(root tubers,maize & its products.), proteins(animal products).

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    ABSTRACT CONTD

    Sanitation and hygiene: Water source;Tap water(50%),borehole(40.5%), wells (4.8%). Water treatment; Boiling(54.8%),Chemicals(9.5%). Other aspects; kitchen compound cleanlinessrubbish pits.

    Health seeking Behavior: Majority from the health facility.

    The above results were analyzed using Microsoft Excel spread sheetand presented in form of tables, bar graphs and Pie charts.

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    INTRODUCTION Community diagnosis is the comprehensive assessment of the health state of an entire

    community in relationship to its social, physical and biological environment

    This assessment was carried out in Nakasongola sub-county , Nakasongola District. Political hierarchy included;district level-Nakasongola District; county-Nakasongola

    (originally called Buluuli);subcounty-nakasongola; parish-nakasongola town council;villages - buluuli, matuugo, kalubanga.

    Economically; the people were mainly dependant on agriculture and a few othersindulge in trade & commercial activities and others transport & communicationservices.

    Socio-culturally;people generally fall among two established kingdoms which include ;the baganda and the baluuli. Originally these were the same kingdom people establishedin buganda kingdom but a segment of some people broke off as the a Baluuli people inthe name of need to have a separate political structure & region demarcation.

    During the assessment, we used questionnaires and a checklist to obtain information onsocial demographic factors, nutrition, hygiene, and health seeking behavior. The datacollected was then analyzed to come up with a report.

    Biggest health challenges were ; Malaria, Upper respiratory tract infections, anddiarrheal diseases.

    The major economic activitywas farming. The results were analyzed using Microsoft excel and presented in form of tables, bar

    graphs, and pie charts

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    ObjectivesGeneral objective.

    To carry out the community diagnosis of nakasongola subcounty.

    Specific objectives.

    To determine social demographic characteristics of the community. To assess the nutrition status of the community

    To assess the sanitation and hygiene.

    To identify the commonest diseases.

    To assess the health seeking behavior of the people in the community. To assess the health service delivery system in this community

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    Methods and tools Study design:- The study design was a non interventional,

    descriptive cross sectional survey. Study population:- The target group was the community and

    local leaders. Sample size:- 120 participants from different villages of

    nakasongola subcounty. Sampling technique:- Simple random sampling. Data collection techniques:-

    Primary data:- questionnaires and Checklist. Households were

    selected at random and interviewed using close endedquestionnaires.

    -Key informants included VHT and LCI chairperson;Secondary data:- Documents used included District records,

    Hospital records.

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    Methods and tools contd Data processing and analysis: Data processing was done

    manually by researchers with the help of calculators andcomputers. The analysis was done by microsoft excel and

    presented in form of tables, Bargraphs and pie charts.

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    Results and Discussion Socio-demography;

    The study showed that the majority of the respondents were females(81%) & therest being males-as men were out for work by the time the surveys were carried out.

    Also, most families were mother headed (57.1%) implying a heavy burden loadedonto the females financially, that in a long run greatly impacted onto the maternal

    health.Households were established in a nuclear setting mainly(80%) with the most age

    distribution below 18yrs as follows;

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    Nutrition & food security;

    Majority of households obtain food from their own gardens (61.9%),

    others bought food from the market.64.3% of the households would afford three meals a day, 26.2% had

    two meals a day, and 7.1% had only one meal per day.

    Most of the meals were served with root tubers(81%), others being:-maize and its products(57.1%), matooke(38.1%) and animal products

    (31%).The results above depicted that most families had an unbalanced dietin their nutrition. Their meals were majorly protein deficient as shownby the few animal products consumed. They was as a significant

    Vitamin deficient in their diet shown by absence of vegetables in their

    diet.However they had a strong food security depicted by the availability

    and accessibility (grew their own food and even had stores for it.)

    Cassava and sweet potatoes were dried and preserved as kasedde inpreparation for the dry season

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    Sanitation and Hygiene:

    Majority of the sampled households use tap water (about 50%),

    others obtained it from boreholes (40.5%) and wells (4.8%) especiallywhen there was water shortages. This was a good indicator water safety.

    However, they were affected by the long distance from the watersources.

    Water was mainly boiled for consumption (54.8%) and 9.5% usedchemicals like water guard tablets. The rest had no means of treatmentat all.

    The water safety accounts for the low prevalence of water bornediseases like Bilharzia and Typhoid as recorded at the health facility.

    As regards waste management, most households disposed off theirrubbish safely in rubbish pits and in their gardens for manure,

    accounting for the high percentage of observed clean compounds.Human waste was disposed off in regularly cleaned pit latrines

    accounting for the low prevalence of communicable diseases likecholera, Dysentery, e.t.c

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    Health Seeking Behavior:

    The study showed that the majority of people in the area (83%)sought health attention from the health facility.

    A significant number however, sought health attention fromtraditionalists (14%) and a few from spiritual healers and churches(3%).

    This implies good health seeking behavior shown by the highnumbers of people attending health facility. However, none of these

    people were found to go for routine medical check ups.Also, this good health seeking behavior is attributed to the short

    distance to health facilities, therefore easy accessibility to medicalservices and awareness about the health services provided at thefacility such as immunization, safe male circumcision, e.t.c

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    Disease burden:

    Among the most common diseases affecting people in the areaincluded Respiratory tract infections( 46.2%), andMalaria (44.6%).

    The prevalence of diarrheal diseaseswas low ( 0.05%), mainly due tothe good general sanitation and hygiene as shown by; Cleancompounds, regularly cleaned pit latrines and good waste disposal.

    The frequency of these endemic diseases esp. malaria was almostevery month with a registered highest percentage(57.1%). This is

    attributed to a variety of factors such as breeding places and bushyareas around their compounds.

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    ConclusionsCommunity strengths include :-

    Easy access to medical and social services

    Good political leadership and communication with the community.

    Good Health seeking behavior. Good Sanitary conditions of the community.

    Good food security.

    Good road networks and communication.

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    Weakness of the community: Low levels of income.

    Poor nutrition

    Long distance from distance from reliable water sources.

    Poor housing facilities; Overcrowded and poor ventilated.

    Inadequate mosquito nets and bushes around homes.

    Ignorance about some essential health practices like routine medical

    check ups and water treatment

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    Recommendations Health promotion and preventive activities ( like continuous health

    education on usage of mosquito nets) should be implemented.

    A number of outreaches should be done to create more awareness on

    the essence of routine medical check ups. In order to decongest the households, Family planning methods should

    be emphasized.

    Diversification of the economy to improve on economic status of thecommunity.

    Provide Nutrition education to the community about theimperativeness of the consumption of a balanced diet.

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    References DHO offices. Higher local government statistical abstract, Nakasongola

    district; 2008

    http/en.wikipedia.org/w/index.php?title=nakasongola_district.downlo

    aded at 20th

    April 2013 UBOS(2002), Uganda population and Housing census report, Uganda

    bureau of statistics, Kampala Uganda.

    WHO; World health report (2002,2004)