Page 1


emography can be defined, in simple words, as the scientific study of the huma n population. This form of scientific study is usually focused on the changes taking place in population size, the composition and the distribution of the population . For this, demog raphy deals with fertility, mortality, marriage , migration and soci al mobility. Since health of the community as a whole is directly influenced by the demograp hic patterns, demographic tools serve an important role to get a composite view of the community.

D

CHAPTER

nNO

DEJ{!f路O~R 路 路,p,jH,rr . _~n ~\.J:. tA ~. .. . .


, . 5 •

Demography Population and sample size:

Naub ise VDC has 1696 households occupied by a total popula tion of 16,090. A total number of 340 households with a popula tion of 2058 was considered for our survey.

Household 1696 340

Total sample

Population 16090 2058

Ethnic composition of Naubise :

35%

30% 25%

20% 15%

10% 5% 0%

~

3~

------------

~ ' -"L

-

Bahun

Chhetri

n, Newar

Tama ng

1 .

~

SDK+ others

Na ubisc

voe: Community Diagnosis Field Report. 2003

-

,


-6-

Demography

Age and sex distribution

AGE GROUP

0-4

POPULATION MALE FEMALE TOTAL 92 96 188

PERCENTAGE ('!o ) MALE FEMALE TOTAL 4.4 7 4.66 9.1 3

5-9

126

132

258

6.1 2

6.41

12.53

10-14

120

124

244

5.83

6.02

11.85

15-1 9

118

136

316

5.73

6.60

12.33

20-24

114

132

246

5.53

6.41

11.94

25-29

84

64

148

408

3.10

7.18

30-34

58

64

122

2.81

3.10

5.91

35-39

50

58

108

2.42

2.81

5.23

40-44

58

48

106

281

2.33

5.14

45-49

36

38

74

1.74

1.84

3.58

50-54

34

38

72

1.65

1.84

3.49

55-59

32

30

62

155

1.45

300

60-64

38

34

72

1.84

1.65

3.49

65-69

18

14

32

0.87

0.68

1.55

70-74

34

14

48

1.65

0.68

2.33

75+

12

12

24

0.58

0.58

1.1 6

GRAND TOTAL

1024

1034

2058

49.75

50.25

100.00

Naubise

I

voe: Community Diagnos is Field Report, 2003


-7 -

Demography

MAL E

FEMALE

Age Group

I

I

70 ~74

I

~ ~ p,

I 4 5~4 9

I I

I

35-39

I

25~2 Q

2 0~24

15.1 9 10~1 4

I

5~9

I 6

11' ,

:1O~34

I

7

I-,

40_44

5

. '

...

~I

0 _4

4

3

2

%

I

-

2

3

4

5

6

7

The age and sex dist ribution can be best studied with the population pyramid. The population pyramid of Naubise VDC is expansive type, the type seen mostly in developing countries like Nepal. The base is broader than the tip. Some re ma rka ble features of this pyramid are :

Naubisc VDC : Community Diagno sis Field Report. 2003


, ·8 .

Demography

The population age group 0-4 is lower compared to groups 5-9 and 10-14. this might be an indication of the growing popularity of concept of family planning and small family. In the age group 15-19 and 20-24, the male population is comparatively very less than the female population which may be due to migration of young males for studies and work opportunities to Kathmandu. The female population of age group 25-29 is less compared to females of age group 20-24 and 15-24 and their male counterpart. This may be due to the tendency of women to present themselves younger or because women of that age group are getting married and going to their husband's

o

o

home outside Naubise. The male population of group 70-74 is quite big compared to the male population of age groups 65-69 and 75+ . This may be because the old people might not be remembering their age and telling approximately 7074 as their age. In the old age males are found to outlive females which is the case in Nepal and Bangladesh in contrast to other countries. The irregularities as seen in the pyramid may be due to age shifting and small size of our sample.

Household size : Average household size in Naubise was found to be 6.05 per house.

Family typ e: Nuclear family is found to be the most common, followed by joint family.

Family Type

o 9'1. 047%

o Nuclear Family B Joint Family o Extended Family

Naubise VDC : Community Diagnosis Field Report, 2003

.


Demography

-9 -

Sex rat io:

Sex ratio ~ (number of malesj-mo of females )x100 Sex Ratio in naubise VDC was 99 .03 males/100 females Dependency rat io: Considering the age group 15-64 as economically productive and othe rs as dependent on them, the total dependency ratio was foun d to be 62,8 In which child dependency ratio wa s 54,58 and elderly dependency ratio was 8,22 Child woman ratio (CWR I: CW R

~

( no. of child of particular age group )+( total no of women at reproductive age group (15-49) ) x 1000

Considering the age group 15-49 as child bearing age group , the child woman ratio for different age groups were found to be: CW R (0-4) ~ 348 .14 CWR (5-9) ~ 477.77 CW R (10-14) ~ 451.85 FERTILITY Total live births in the past one year in our sample was found to be 56. Crude birth rate {CBR}: CBR was calculated to be 27.2 1 CBR= (total no. of live births in a year found within the sample)+(total no of people in the sample) x 1000 General fertility rate (GFR) : The GFR was calculated to be 103.7 GFR= (total live births within 1year)+(total wome n of reproductive age group ) x1000 Ag e Specific Fertil ity Rate (ASFR I: ASFR is maximum in age group 20-24 followed by 25-29 and 15-19 respe ctively . AQ e No,of women Births ASFR

15-19 136

20-24 132

25-29 64

30-34 64

35-39 58

40-44 48

45-49 38

16 117.64

22 116.66

8 125.00

4 62.50

4 6896

2 4166

0 0

Nauhise VDC: Community Diagnosis Field Report. 2003


, Demography

o

10 -

ASFR = (no. of live births in a year to women of particu lar age group)+ (total no of wome n in that age group) x 1000 Total fertility rat e (TFR) : The TFR of Naubise VDC is 2.912 TFR= 5

~

AS FR+1 000 MORTALITY

A total of 14 dea ths were recorded within our sample in past 1 year. Crude death rate (CDR): The CDR was found to be 6.8 CDR= total no of deaths in past 1 year I total population 01000 Infant mortality rate (IMR): The IMR of Naubise VDC was calculated to be 71.42 per 1000 live births. Neonatal mortality rate (NMR): NMR of Naubise was calculated to be 35.71 per 1000 live births. Post neonatal mortality rat e: In 1000 live births, 35.71 post neonates (28 days- 1 year) were found to be dying each year. Perinatal mortality rate: It was found to be 17.85 per 1000 live births. Perinatal mortality rate= (foetal deaths + deaths unde r 1 week in a year) + (total live Births in same year) x 1000 Unde r 5 mortality rate (U5MR) : The U5MR was found to be 71.42 per 1000 live births. U5MR= (Deaths of children under 5 years in a year)- (total live births In the same year)xl000

Naubise VDC: Community Diagnosis Field Report. 2003

,


- 11 -

Dem ography Maternal mo rtality rate: No case of maternal mortality was found in our sample . •

The above findings were confirmed during focused group discussion

(FGD) with female community health volunteers (FCHV) and trained birth attendants (TBA).

Population growth rate (PGR): The PGR was found to be 2.041 % and at this rate the population of Naubise will double itself in 34.29 years. Mor bid ity: Fever and heada che is most prevalent in Naubise followed by respiratory problems. The morbidity pattern is as follows.

45% V- ~ 40% 35% V30% V25% V20% V15% V~ ~ 1:k9l , 10% VI-I-5% V0%

1...,;,

r'I--

iI

1!'-"

Fever and RespiratoryGI problemMuscle and Eye headache problem joint pain problem

~

Naubise VDC: Community Diagnosis fie ld Report. 2003

TB

Others

I-L..


ociety according to Ginsberg is a collection of individuals united by certain relat ions or mode s of behaviour which ma rk them off from others who do not enter into these relations or who differ from them in behaviour. Oefinrte terr itory, sexual reproduction, comprehensive culture, independence are the characters of socie ty. Socioeconomic status is a determinant factor of the health status of community.

S

CHAPTER

THREE

SOCIOECONOMIC STATfUS


. 12 .

Socioeconomic Status

Ed ucational status

Literacy rate of Naubise VDC was determined to be 60.40%, which appreciable figure compared to that of National data.

IS

an

Male literacy rate: 72.70% Female literacy rate: 48.50% Ethnicitv wise educationa l status

90% 81.03% 80%

7 5:71% ~

68.67%

70% I 60% I -

64.70% ~

5 .16% t--

58.66%

5.42% f-

50% l -

4 .42,"

o Male

f-----

o Female

3 .28%

40% I -

3 .05% 30% I -

f----- I-

20% l -

f-

10% l -

f-

0%

Bahun

Chhetr i

Newar

Tamang

SDK

Naub ise VDC: Commu nity Diagnosis Field Report. 2003


. 13 .

Socioeconomic Status Ethnicity w ise ed ucat ional leve l

FEMALE 35"10

30% 25%

20% 15%

10% 5%

0%

Bahun o Literate

_ Primary

Newar

Chhelri 0 Secondary

_

H~her

Tamang Secondary

SD K

0 Bachelor and above

MAL E 60%

Bahun o t .eeeate

• Prrnary

Chhetri 0 secondary

Newar

Tamang

• t-9Jher Secondary

S DK

0 Bachelor and above

Naubise VDC: Community Diagnosis Field Report. 2 0 ~ 3


"

- 14 -

Socioeconom ic Status

Occupation

In agreem ent to national dat a , agriculture was found to be the major pursuit.

o Agriculture • Busine ss

o Service • Others

82%

SUFFICIENCY OF INCOME In 81.4 % of fam ilies, the income was found to be insufficient even for "hand to mouth" activity thro ughout the year.

70 % 60 % 50% 40 %

30 % 20% 10%

0% ""'o..-JL - _ <6 months

6-12 months

>12 month s

Naub isc VDC : Comm unity Diagnosis Field Report. 2003


\

路15 -

Socioeconomic Status Animal husbandry: 90% of famil ies keep animals. Kitchen garden : 87% (14% sell the products)

Means of communication Radio was found to be the most effective mass media as 69.71% people were availed with it.

70%

60 %

5ll% 40%

30% 20%

10% 0% Non e

Radio onl y

Radi o & TV

Drinking and smoking habits ( in population above 14 yrs.) Newars comprise the largest population group among smokers and drinkers , Bahuns running on the bottom. Ethn icity wise smoking habit

50% 40 %

30% 20% V-

.-

~

~

~

~

i-

10% ~

-,

0%

I--

.Jr

Bah un

f-

Chhetri

Newar

Tamang

Na ubise VDC: Community Diagnosis Field Report. 1003

SDK


\ ' - 16 -

Socioe conomic Status

Ethnicitv wise drinking habit

50%

40%

J.,-- - - - - - ----jF "t- -- - - - - -

30%

20% y -- - - - - -j 10% I ",E:i=:t:::1l:=L---,,,,,,,L~_L O% 짜

Bahun

Chhetri

Newar

Tam ang

SI<D

Sex wise smoking and drinking habit

Smoking Drinkina

Male ( %)

Female (%j

44.65 28.73

27.92 6.67

Naubise VDC: Community Diagnosis Field Report . 2003


epa; being a male dominated society, gender issue is usually coming to the headlines these days. Women are exploited, subjugated, suppressed, oppressed and depressed by their male counter part. People have faith that son is required to open the door to heaven after death. We still have a long way to go to rule out gender discrimination in community level. Regardi ng the gender status, the

N

activity profile , resource profile and action profile are made.

CHAPTER

-

-

= =

6:ENDER STATUS

FOU


·17·

Gender Status

Cooking : Cooking was found mainly to be done by Female (94%) Money Handling: Mainly done by males (74.5%). Burden of Physical work: In 46% of cases. burden of physical work was found more to be on females.

5%

46%

0 Female • Both

o Male

49%

\

Decision making: Dominated by males in 61 % of cases.

5% 34%

Ie Female _ Both

[J

Male

I

-.

Nau bise

voe: Commu nity Diagno sis Field Report. 2003


Gender Status

â&#x20AC;˘ 18 â&#x20AC;˘

Treatment during menstrua t ion : It was found noteworthy in 2.3% of houses where women were kept outs ide the house during men struation .

100%

50 % 0%

~--"'L-

_

_

Outs ide

Sepa rate

Usu al

Reas o ns for requiring son : The enquiry showed religious reasons to playa major role in peop le's desi re for son .

60 %

.

50%

40 %

~

30%

V--

20% V10% V-

0% I-

~ on

-

=

i==Religious

-----i

Support in old age

Social

p= 0-

----....

'Not

required

Naubise VDC; Comm unity Diagnosis Field Report. 2003


E

nvironment is the aggregate of all the external conditions and influences affecting the life and development of an organism, human behaviour and so ciety. -W HO

CHAPTER

.

ENVIR>ONME~T(AL

SANITATION

FIVE


Environmental S anitation

- 19 -

WA TER Water is the ba sic nece ssity of life and source of wa ter, accessibility to source , its

sufficiency and its quality affects the health status of the community. SOURCE OF WATER Piped water is the main source of water in Naubise VDC . Seventy-three percent age of the HHs use it as the wate r source .

80% 60%

:=~~C============

40%

20% Piped Water

River

Kuwa

We ll

DISTANCE TO WA TER SOURCE

10%

32% lO in home _ 15 m ns. 0 20-45 mins _ >45 mins

About sufficiency of water, 71 % of the HHs have sufficient water and the rest (29%) have insufficiency of water. And , 88% of the HHs cover their water containe r.

Naubise VDC: Community Diagnosis Field Report . 2003


路20路

Environmental San itation

DRINKING WATE R PURIFICATION Majority of the HHs perform no tre atment prior to use for drinking purpose

and this certainly influences the health of the commu nity people negat ively. ( high prevalence of GI diseases)

100% 80% 60% 40% 20%

.S?l ?' ?' ?'

0%

~

No any treatment

.AfJI..

Boiling

~ Filter

Chemical treatment

Others

TOILE TS HHs with toilet are really low in number. There is high prevalence of open defae cation .

10% 28%

o No Toilet iii Pit lat rine

[] Sanitary

Naubise VDC: Community Diagnosis Field Report. 2003


Environmental Sanitation

" 21 "

Reasons for not constructing Toilet About 51% pointed lack of money as the main reason for not constructing

toilet and the other reasons were "not necessary", "no land", "lack of knowledge ". 60%. /- - - - - - - - - - - - - - - 40%

Lack of money

Others(not lack of necessary) knowledge

No land

WASTE DISPOSAL Making fertilizer was found to be the prime method of disposal of the waste (82%).

100%

,",

80% 60% V40 % l> 20% V0%

Making fertihz er

......

~ Bunal

Burning

Throwing Throwmg In the river

troecnminatefy

Naubise VDC: Community Diagnosis Field Report. 2003


, , 路 22 路

Environme ntal San itation

08SER VA TI O :-- CHEC KLIST

TYPES OF HOUSES : It wa s found that majority of the houses were Kachcha .

100%

80% 60% 40%

I;;;~~~;;;;~~~;~

0%.lL--"--------"'~~路

20%

Ka chcha

Kach cha-pakka

Pakka

Criteria :

Kachcha: If roof, floor and walls are ma de up of ston e/ mud, bric k/mud , woo d , bamboo or grass. Kachcha-pakka: If only some of the parts are plastered . Pakka: If roof, floor & walls are plastered . ROOF :

It was found that 79 .11% of the houses we re made of tin , tile, or slate .

o tin/t ile/slate II straw

79%

o RCC/RBC/conc rete

Naubi se VDC : Community Diagno sis Field Report. 200 3


·23·

Environmental San itation

LIGHTING : Only 39.11% houses were found to be satisfactory .

Criteria : Satisfactory: If objects inside rooms are seen clearly. Unsatisfactory: If objects are not seen clearly.

39% 61%

o

sati s factory

eJ unsa tisfac tory

VENTILATION: It was found out that 32.94% of the houses were satisfactory .

o s a ti s fa c t o ry • uns atisfacto ry

Criteria : Satisfactory: If the re are 2 or more windows in a room. Unsatisfactory: If there is less than 2 wind ows.

Naubise VDC: Community Diagnosis Field Report. 2003


路24路

Environmental Sanitation

TYPES OF FUEL: It was found out that most of the people used firewood as the major source of fuel. 88.82% 5.29% 3.82% 2.07%

Firewood Cow duno kerosene LPG

KITCHEN :

Seoarate and smokeless Separate and smoky Attached to the house and smokeless Attached to the house and smoky

0.58% 1.47% 4.4 1% 93.54%

Thus , it was found out that most of the households had smoky kitchen .

CATTLE SHED : It was quite disap pointing since mo re than 75% households have their cattle shed attached to the house.

80% 60% 40% 20%

Attached to house

Less that 25 ft.

Molre than 25 ft.

Naubise VDC : Community Diagnosis Field Report. 2003


,, 路 25 路

Enviro nmental Sanitation

ENVIRONMENTAL SANITATION : Sixty-eight pe rcent of the households we re found to be satisfactory .

Sanitary condition

o Sat isfacto ry iii Unsat isfactory

Naubise VDC: Community Diagnosis Field Report. 2003


CHAPTER

51


, , 路26 路

Person al Hygiene

Bathing Habits : Daily-11% Once a week-62% Twice a week路 13% Others-14%

Materials used for bathing : Soap+water : 87% Wat er only: 13%

Br ushing Hab it: Once daily: 47% Sometimes : 17%

Don't brush : 36% Materials used for brushing : Tooth paste+brush: 87% Dativan: 9 %

Coal : 4% Use of sandal/shoes: Yes: 95% No: 5%

PERSONAL HYGIENE OF SCHOOL CHILDREN We conducted our survey about the personal hygiene of the school children in the different scho ols in different wards, We took 340 Students, among which 204 were boys and the rest 136 were girls.We asked them about their personal hygienes. And following were the results.

Fourty Eight students don't brush their teeth, 255 brush once a day and 37 brush twice a day. Among the stude nts who brush their teeth, 228 use brush and paste, 32 use datiwan and 32 use coal to brush . Brus hing Habit

11"10

10 Once a day D No 0 Twi ce a day I Naubise VOe: Community Diagnosis Field Report. :!003


· 27 ·

Personal Hygiene

Material for Brush ing

11%

o Brush and Paste .Oatiwan

D Coal

As far as hand washing is concerned , 58 students use only water after defecation.Only 218 use soap and 64 use ash. However, before meal , 61 students use soap and 31 use ash. Those who use only water were 194 and 54 donot wash hand s before mea l.

Hand Washing Afte r Defecation

19%

D Soap o Water 17%

D Ash

Hand Wash ing Before Meal

D Soap • Ash D Water • No

57%

Naubise VDC: Community Diagnosis Field Report. 2003


- 28-

Personal Hygiene

We found that 252 students bathe once a week and the rest twice a week .

No. Of Baths a week

D Once l!!I Twlce

After observ ing every students , we found that 236 students had their nail cut and 104 didn 't have their nail cut. Nails

D C", I!I

Not Cut

The tidy student s were 276 and 64 were wearing untidy clothes .

Clothes

19%

o Tidy III Untidy

Naubisc VDC: Community Diagnosis Field Report. 2003


, , ·29 ·

Personal Hygiene

Amo ng boys, 180 had short hair and the rest didn't have their hair cut. And among girls, 130 had their hair combed and only 6 had rough uncombed hair. Hair of Bo y Students

o Long • Short

88%

Hair of Girl Students

4%

o Combed I!I Uncombed

96%

Naubise VDC: Community Diagnosis Field Report. 2003


nowledge, attitude and practice (KAP) plays an important role in the health practices and behaviour of people knowledge literally mean s the real understanding of facts and processes acquired through information and experience . Attitude is the feeling towards someone or something leading to one 's readiness to act in given way. And . practice is the implementation of various activities in certain ways .

K

CHAPTER

SEVEN


- 30-

Knowledge, Attitude and Practice General Knowledge About Diseases

1. Cause of disease Most of them told that the cause of the disease is the waste while a substantial attributed to God/ witches and food habits as well. Cau se of Disease 80% 70% 60% 50% 40 % 30% 20% 10%

O%1::'!!lL---.1~d~~:::JII~~h==L~~ Was te and bad

GodNVitches

sanitation

2. First choice of treatment About 3/5'" of the population preferred to visit HP while the remaining chose going to Dhamis and Jhakris. 3. Concept of disease prevention Many people didn't have any idea while some answered, improving

1

e nvironmental sanit at ions.

60% 40%

20% Don't know

Env. Sa nitation

Wo rship/sacrifice

Naubise VDe: Community Diagnosis Field Report. 2003


路31 .

Knowledge , Attitude and Practice

KAP ON DIFFERENT DISEASES 1. TUBERCULOSIS a. Ca use Although widely heard, many people had no idea and only a few % knew the real cause .

60%

-

50%

I-

40"1. 30%

20%

10"10 ~ 0%

l-

~ ,&!!l

-

Srn:lklngfalcohol

I-

~ """"" Mcrobes

Workload

,ru

c-

"""""

DIrty w ater

'--;

Don't know

b. Mode of transmission More than half of the people were unknown about the mode of transmission whereas few said thro ugh droplets

8掳%L

fl~l1_-

60%

40% 20%

Droplets

Non contagious

Don't know

c. Tre atment of TB Only less than 1/3'路 of people knew medication as the treatment 80"10

60"/0 40% 20%

O%,. \L-

.L_ Med icat ion

W orsh ipfsacr ifice

Don't know

Naubise VDC: Com munity Diagnosis Field Report. 200]


·32 ·

Knowledge, Attitude and Practice 2, LEPROSY a. Cause Majority of people are totally unaware of the disease and its cause s.

,

800;;

I-

, ,

40%

I-

,

20%

----d

0%

Mi crobe s

~

Past sin

...,.....,

, Dirt

Don't know

b. Mode of transmission

80%

60%V- - - - - - - - - - - - - - - - 40%

Jutho

Touch

Non Don 't know contagious

c . Treatm ent of Leprosy About 2/5" of the people knew the correct treatment.

.

60%

,

50%

.n

40°,.1

F'"

'V20°"":,V10"1.,V-

0 ,

I--I--I---

30%

0%,

-'

tv1edicine Worship/sacrifice

I--•

D/J

Don't know

Naubise VDC: Community Diagnosis Field Report. 2003


Knowledge. Attitude and Pract ice

- 33-

3. WORMS a. Cause Ab out 60% attributed it to the eating of sweet foods.

80% 60% 40%

Sweet foods

Dirty food

Eating mud

Don't know

4. HOOKWORM Cause Majority had never heard of it

3.

5.80% 5.30%

o Barefooted â&#x20AC;˘ Dirty waterlfood

o Don't know 88.90%

5. GOITRE Only 13% knew the real cause as lack of iodine. 80% ~--------------------;!~~r60%

40"/"

Lack ofiodine

Water

Lack of salt

Don't know

Naubisc VDC: Community Diagnosis Field Report. 2003

,

.


- 34 -

Knowledge. Altitude and Practice

Type of salts us ed The outcome of our survey gave that 48 % people consumed iodised sa lt while 36% used dhikka and rema ining consumed both . 6.AIDS

Mode of transm ission Desp ite be ing so near to the cap ital. still about 3/5'h were unknown about mode of transmission of AIDS .

3.

50%

40% 30% 20%

:1iiiiiL_ Jt=:=::=J_ -':t:Ie::l _

10% I O% .j..:::

Don't know

Sexual intercourse

Multiple

b. Behaviour with pati ent

~

61%

O%

7%

2%

o Chase away . With love 0 Imprisoning _ Don't know

7. DIARRHOEA

a.Cause The knowledge about diarrhoea and its causes was quite satisfactory.

80%

60% 40%

2째%tdLJt;2:::i;~~~; 0%

Dirty food and

don't know

wate r

Naubi se VOe: Community Diagnosis Field Report. 2003


Knowledge , Atti tude and Pract ice

I

- 35-

b. Preparation of Jeevan Jal Forty percentage of them knew the method of prepari ng Jeevan Jal. 8. PNEUMONIA Seventy-eight percentage of people attr ibuted cold to its cause.

80% 60 % 40%

Cold

Getting wet

Dirt

Don't know

9. MALNUTRITION Only 30 % of mothers asked . knew about malnutrition and very amazingly about 2% of moth ers had belief that touching by pregnant women caus ed malnutrition.

60% 50% 40%

lIII-

30'1.c 20%o

:~ Touc hed by

10'1. 0'1.

pregnant wome n

r

•••

J;;;;

Less breast feeding

Less food

I--

'-' Don't know

10. ANAEMIA a. Cause Hard to believe. but the truth our survey had a result that 11.2% of the survey knew that lack of green vegetables and healthy food . meat and vitamins was the ma in cause of anaemia.

Naubise VDC: Community Diagnosis Field Report . 2003


- 36 -

Knowledge , Att itude and Practice

b. Treatment Same population (11.2%) contributed their thought that eating green vegetables would cure anaemia.

100% 80% 60% 40 % 20% 0%

0 00

~

Green vegetables

asu

Blood

rlIl-

e-,

tv1edication Don't know

11, NIGHT BLINDNESS a. Cause What a pity, majority of the people didn't know the cause of the disease . Only 15% knew the cause of Night-blindne ss, saying lack of Vitamin A leads to Night Blindne ss.

100% 80% 1/'- - - - - - - - - ""2 60% 40 % 1 / ' - - - -- - - - - - 1

20% 0% .jL:l..----'" ~~ vit , A Less food

Don't know

deficiency

Na ubi se VD C: Commu nity Diagnosis Field Report. 2003


I

·37 ·

Knowledge , Altitude and Practice

b. Treatment

Same percentage of the population had an opinion that taki ng Vitamin A capsules would be the best treatment

80"1. 70"/•

60 % 50% 40%

~=============~iE~i== .r-- - - - - - - - - - - .,--- - - - - - - - .,-- - -- - - - -- .,--

-

-

-

-

- --

-

-

30%:~;clt~~;;U

20%

10%

0%

\lit. A capsules

Good diet

Naubisc VDC: Community Diagnosis Field Report. 2003


Knowledge , Attitude and Practice

·38·

UTILIZA TION OF HEALTH POST SERVICES Distance to Health Post

47% g

[] <1/2 hr .

• 1/2· 1 hr . 0 >1 hr.

Health Post Servic es Only 48% are satisfied with the HP serv ices and the rest 52% are unsatisfied because of the following reasons: 40 °A,

-

30'/0,~ 20°;;, ~

-

1 OD ic, ~

0'/0,

-r--r

/""""

lack of medicine

expensive

lack of health worker

Far

Naubisc VDC: Community. Diagnosis Field Report. 2003 .


he term "Maternal and Child Health" refers to the promotive, preventive, curative and rehabilitative health care for mother and children, Mother and child constitute major part of population, Not only this, they are also vulnerable group , And , much of sickness and death among mothers and children are largely preventable, So by improving the health of mothers and children, a big contrib ution can be made to the health of community,

T

CHAPTER

'

EIGH

': v'CL.-<V ERN'J'A' A1Un 'HILF\ _ /__'A' '_, T _- ' _ ~_L ~_" \ l.~j ~i C ,_ J...I; M HEALTH :" /!;. _


, , Materna l and Child Health

- 39 -

1 . Age at marriage Teenage marriage is very common . Ninety percentage of girls are found to marry

before 20 years of age. 10%

10

<16

016-20 [J 20- 35

61%

2, Ag e at first pregnancy Sixty-nine perce ntage of the women get pregnant before the age of 20. " II •

• I li r a I p r . 1111 • n

0;

y

0

...

<2 0

ad > 2

c

3. Ante natal ca re (ANe ) ANC is the care of woman during pregnancy. It is found that 37% of women don't know about it. Out of 63% who visited Health centre for ANC check up, only 17% visite d for more than 4 times . ANC c h e c k up

70%

-

- -

--

63 %

60%

50 %

,, % 30% 20 % 20 %

17 %

10%

0%

.,

,

--

Naubise VDC: Community Diagnosis Field Report. 2003


- 40 -

Maternal and Child Health 4. Reasons for no check ups R ";l s on l l o r "0 c hec k up.

' '''

,, % <0 % 35 '10

30 %

I

,, %

I O l a Ck 0 1 k n o w le d g e

D N o p e rrms sro n _ l a c k c t nme cn n e c c e ,.' b lil ly _ N o t necess ar y

,, % 20 %

,,%

,, %

DS hame

,, %

8% . %

, % 0%

5. Food intake during pregnancy Fifty-seven percentage of pregnant women don't take extra food during pregnancy. W hen asked about the reason, the common answer was poverty. Fifteen percentage of women take less food

Usual

More

Less

57%

28%

15%

6. Smoking/drinking Ninete en percentage of women were found to smoke or drink during pregnancy. Most of these women were from lower socio-economic group. Smok ing /Drinking

19 0 0 %

-.,

CJ y e s

7. Any problems during pregnancy Twenty-seven percent age of women complained of swelling of legs, headache du ring pregnancy.

Naubise VDC : Community Diagnosis Field Report. 2003


路41 .

Maternal and Child Health

B. Iron tablet Fifty percentage of the pregnant women took iron tablet during pregnancy. I r o n t abl et

50 %

50 %

9. Tetanus Toxo id vaccination Sixty-five percentage of the pregnant women got Tf vaccine. T.T. Vacci ne

D Ye s

. N,

10. Workload during pregnancy Seventy-three percentage of women do the usual household work during pregnancy. the workload being the same. 11. Age at weaning Weaning of infants is done quite early. Twenty-six of the infants are given solid foods before the age of 4 months and 43% before 4-6 months.

Naubi se VDC: Community Diagnosis Field Report. 2003


Maternal and Child Health

- 42 -

Age at weaning

,,%

,,%

,,% ",%

I

0>% 30%

30%

2<l%

,,% "'% ,,% ,,%

1

5% 0% L - -

>,

,-,

<'

12. Food used fo r wean ing The most common food used for weaning was lito, made of home-made super-flour. FoOd "WCl lor wMn ing

'0%

..%

"'"

...."'" "'% 1 30%

,,%

I

1

'"

â&#x20AC;˘ ''''

,,%

Lito

Usua l fam ily lood

J aulo

13. Cord cutting practice Cord cutting practice was safe in 70 % cases . T he most commonly used tool was new bra

followed by boiled knife.

Naub ise VDC: Community Diagnosis Field Report. 2003


路 43 路

Maternal and Child Health

14. Place of delivery Thirty-two percentage of the delivery is carried out at Health institutions. Rest is carried out at home. Pla c e o r d e lil/ery

. H e a ll h In 5 li tu te

de live ry

D H om e

de li v ery

'''' 15. Use of safe delivery kit Out of deli veries con ducted by Trained Birth Atte ndant (TBA) , safe de livery kit was used

15% cases. 16. Duration of breast 路feeding Four percentage of the babies we re deprived of breast milk before the age of 4 month s. Durati on o f breast f ee d ing 5'~ --

60%

50%

--

l

r 39%

40 %

I

30% 20 % 10%

4%

0% < 6 m th s

6- 2 4 mths

>2 y rs

Naubise VDe: Community Diagnosis Field Report. 2003


, Maternal and Child Health

,

·44 ·

17. Vaccination The villagers were quite aware about immunization. 96% of the babies were immunized .

4%

96%

18. Cove rage of different vaccine Cov erage of different va cc ine

'•• f

~

••

L

••

~-

." •• I ••

•• .·'1 , .

~

'

OB C G

D DPT· 3 Po lio-3

. OP T· 1 c ouo -t _ M ea sles

DDP T-2 Po lio· 2 OAdd itional Pol io

• Naubise VDC: Community Diagnosis Field Report. 2003


路 45 路

Maternal and Child Health FAMILY PLANNING

W HO defines Family Planning as "a way of thinking and living that is adopted voluntarily upon the basis of knowledge , attitude and responsible decisions by individuals and couples in order to promote the health and welfare of the family group and thus contribute effectively to the social development of a country." Family Planning includes birth control, the proper spacing and limitatio n of birth , sex education, education for parenthood, advice on sterility, marriage counseling , and screening for pathological conditions related to the reproductive

system . AWARENESS OF FAMILY PLANNING

9%

10Yesl II No 91%

We found that 91% of the responde nts had a basic idea of family planning . SOURCE OF INFORMATION

50%

40"1.

~rz~~i1-------f9

30 % 20 % '0% O%,楼-----L_

_

Friends

Health workers

N'edia

Most of the people said that they came to know about family planning thro ugh media followed by friends and health workers.

Naubi se VDC: Community Diagnosis Field Report. 200 3


Maternal and Child Health

- 46 -

USE OF F.P.

40%

l o vesl II No

Though 91% of people said they had heard about F.P., only 60 .4% practiced it. Among the 39.6% who did not use F.P., the majority said they did not use F.P because of shyness. Othe rs said they were planning to use it later, or did not think it was necessary. A few of them said that they were not allowed by their families. METHODS OF FP

60%

>II'

40 % 'ÂŤ

20%

Ai

0%

Depo

OCP

M Norplant

Permanent

Temporary methods were preferred to permanent methods . Among the temporary methods , depoprovera was the most widely used followed by norplant and oral contraceptive pills. The reason for using depo was less side effect, better availability and a long lasting effect. Among the permanent methods laparoscopy was more common than vasectomy.

IDEAL NUMBER OF CHILDDEN : 1 child 4%

2 children 73%

3 children 14.5%

4 children 2%

As man as god gives 6.5%

Naubisc VDC: Community Diagnosis Field Report. ~003


路47路

Maternal and Child Health

Most of the people answering to our question, said that the ideal number

of childre n for a happy family was two . Yet most of them had more than two children. ATIITTUDE TOWARDS BIRTH SPACING

<2years 6%

2-5 years 77%

Most peop le said that 2-5 years of birth spacing would be ideal for a happy fami ly

Naubise VDC: Community Diagnosis Field Report. 2003


- 48-

Maternal and Child Health .. I

I

,

I

I

I

I

I

I

I

I

I

I

I

I

I . I

I

I

I

I

â&#x20AC;˘

I

I

I

I

I

I

I

,

_

FOCUS GROUP DISCUSSION ON MATERNAL AND CH ILD HEALTH th

Date : 6 â&#x20AC;˘ Bhadra , 2060 Time: 12.00 pm Venue : Naubise Health Post Part ic ipants : FCHVs from wards 2, 4 , 5, 6. 7 and 8 TBAs from wa rds 6 and 8 A NM from the health post Objective: 1 . To compare the resu lts of our find ings on issues such as IMR , MMR , NMR 2. To assess the coverage of serv ices provided by FCHVs and TBAs . 3. To know about the cord cutting practices and the use of safe delivery kit (SDK) 4 . To know about the practice of colostrum feeding and prelacteal feed ing . 5. Effectiveness of A NC and immunization . 6. To determine the common FP practices. 7. To see whether the FCHVs , TBAs and A NMs we re thoro ugh ab out their knowledge of MCH and aware of the recent developments in va rious sectors of FP . Fin di ngs : 1. Use of safe de livery kit was low 2. Most of the de liveries were at hom e, assisted by the family members. The FCHVs or TBAs were called only if the re was any compl ication. There was a good practice of colostrum feeding . Prelacteal feed of 3. "gheu chini'" was common in many areas . It was believed that if the chi ld was given ano ther person 's milk , the bad qualities of tha t person would be transferred to the child. Gheu chi ni was believe d to prevent this. The TBAs and FCHVs advocated homemade super flo ur which they 4. pointed out was fresh , cheap, nourishing. easily available and of a better qua lit . FP was rapidly being accepted and Depo followed by Norplant was 5. mostly used . Half of the women population wen t for at least one ANC visit. 6. Going to D/J was still a comm on practice . The common ailments like 7. fever, malnourishment were taken to be cured by the D/J. There were not any mot her's group in our VD C. The one that had 8. been formed the previous yea r had disso lved and a new one was in the process of being fo rmed .

Naubise VOe: Community Diagnosis Field Report. 2003


A

nthropometry is the measurement of the variations of physical dimensions and growth composition of the human body at different age leve ls degree of nutrition , The nutritional status of under- five children were assessed with the help of

differe nt anthropometrical method s.

CHAPTER

. ' . . , ' . 0 " 0 ' ' . r ' " ' . . /' Y ANTHll '~P ' ~M~TR.,'

NINE


, Anthropometry

路49路

Age , height , weight of the 164 children was measured and MUAC of only 124 were me asured , as 40 of 164 were under-one year of age . Tools used for the measurements we re:

1. Shakir's tape 2. Salter's scale 3. Measuring tape for heighU length

MID UPPER ARM CIRCUNFERENCE (MUAC) It gives the measure of degree of wasting of children between 1year and 5 years of age. The reference table used was: MUAC(cm) >13.5cm 12.5-13.5cm <12.5cm

Nutritional status Nonmal(Green) UndernourishedfYellow) Severely malnourished(Red)

And the findings were:

.

70% 60 % V50% V-

40% V-

30%V20 % V10%

0%

V-

1. Normal

~

~ Undernourished Severly malnourished

Gomez 's class ification This method measures the retardation of weight. Here, the weight is expressed as percentage of the same age. That is weight for age (%j = (wt . of the child- wt . of the normal of the same age) x 100

Reference table % weight for age >90% 76%-90% 61%-75% s60 Naubise

Nutritional status Normal Mild under nutrition Moderate under nutrition Severe under nutrition

vne: Com munity Diagno sis Field Report. 2003


- 50-

Anthropometry

o

Normal

• Mild undernutrition o Mode ra te und ernutrition • Severe undern utrition

Waterlow's class ification It is based on weight for height and height for age . Weight for height denotes acut e malnutrition and height for age denotes chroni c

malnutrition . Height for age (%) = (height of the child + height of a normal child of the same age) x 100 . We ight for height (%) = (weight of the child + weight of a no rmal child of the same height) x 100 . Refere nce table Weight heinhtiWastinn\

for Height for age (Stunting)

>90%

>95% 87.5-95 % 80-87 .5% <80%

80-90% 70-80% <70%

Wasted and Stunted

P 4.40

-

Nutritional status Normal Wasted · Stunted Wasted and Stunted

,-

-

0

12.60%

Stunted

I Was ted

35.3 %

I

I

I 46,70%

Nom" I 0 00%

1000%

20.00%

30.00%

40,00%

50.00%

Naubise V DC: Community Diagnosis Field Report. 2003


CHAPTER

TEN


Presentations MHP and Recommendati ons

- 51 -

Introductory Program It was 1:00 pm in the VDC Hall when we had an introductory program on the 27 th of Shrawan , Tuesday. We had invited the local leaders of each ward , representatives from the health post and principals from different schools, in coordination with the VDC secretary. Our objectives were as follows: 1. To introduce our group to the community 2. To make the community aware of the objectives of our field visit

3. To build good rapport with the formal and informal leaders, health post staffs and principals of different schools . 4. To get acquainted with the village by social mapping, a participatory rural appraisal The program had a nice start. There was keen participation from side of everyone. To conduct the mapping , all ward representatives stepped forward . We came to know that there were nine Female Comm unity Health Volunteer s

(FCHVs), one in each ward . The health post was manned with the Health Assistant, Auxiliary Health Worker, Auxiliary Nurse Midwife and Mukh iya . Following were achieveme nts of the program : 1. Promises of help from everyone 2. Suggestion of not going to Maoists-a ffected areas and taking permissi ons from pol ice and army (Baireni Barrack) 3. Collection of voter's lists

4. Rough acquaintance with the village 5. Knowledge about current status of Naubise Health Post

COMMUNITY PRESENTATION Although the plan was to conduct two community presentations there , we we re

able to carry out only the first one(due to certain reasons ) in our field trip. The only com munity presentation was aimed to share our findings about the health status of the comm unity with the leading personalities of the community and to collect their opinions in prioritization of needs of MHP planning. The first community presentation cum interaction Date- 121h Bhadra , 2060 Time- 2 p.rn Venue- VDC meet ing hall

Participants•

I

I,

VDC Chairman and office mem bers.

Chief and members of Leo club, Khanikhola (Naubise)

Me mbers of new activities club

Health post in charge (Mr. Bindeshwor Rai) Naubisc VDC: Community Diagnosis Field Rerun . 2003

.

I..


Presentations MHP and Recommendat ions

·52·

OBJECTIVES • To present the important findi ngs of our househo ld survey, in front of the •

key persons of the community . To discuss abo ut the findings and their implications on the health statu s of

the community and to get the feed back. •

T o prioritize the real needs of the community with the he lp of their felt and

our observed needs. To design and plan MHP.

PROGRAMME 1. PRESENTATION· With 23 very curious and helpful participants the presentation of our findings ran for about successful 2 hours under various headings, as follows, by each of the group members in turn i.e. Demography , MCH and FP, Environmental health and Sanitation , Personal hygiene (specially of school children), socioeconomic status , KAP regarding health and illness and nutritional status of under- 5 children . We used vario us media like diagrams (bar diagram, pie cha rts), graphs and pyramids to make our numerical data more informative

and compre hensive to the community people . This was followed by free discussion on the findings . Some of the participan ts were wise eno ugh to make useful comments and gave us a good suggestion on our odd findings. They were satisfied with the findings in the sense that they found the status being improved . 2. INTERACTION WITH THE YOUTH AND THE LOCAL LEADERS After formally ending the presentation we enter ed the ne xt session of informal

group discussion with the members of different youth clubs and local leaders. As youth are a part and parcel of any health programme we are to conduct. we preferred to discuss with them on their felt needs and on needs prioritisation based on our observed needs . Conside ring our economic and time constraints after about one a nd half hour of discussion , the meeting

ended with an agreement to conduct our MHP.

I I I Naubise VDC: Community Diagnosis Field Repo rt. 2003

I

.1

I.


·53·

Presentations MH P and Recommendations

t\E EDSPRIORlTISATIO;\ FELT NEEDS

• • • • •

• •

OBSERVED NEEDS

Free health services Employment Telephone service Free distribution of drugs Health education (HE) on diseases Control of smoking Secondary schools in all wards

MCH & reproduc tive health education , HE on ch ild nutrit ion and some common diseases -,. Smokeless Chula , Affo rdable health services , HE to smokers & drin kers ,. Gender status >- Toilets ,

(CRITERIA .:. HE on MCH, reproductive health & gender status. .:. HE on child nutrition & some common diseases. .:. HE to smokers and drinkers. .:. Smokeless chul a. .:. Affordable healt h serv ices.

I I I,

.:. Time limitations .:. Knowledge we have .:. Severity/seriousness of problem .:. Feasibility and access ibility .:. Security reasons .:. Interest of the community .:. Cost factors .:. Availability of resources

I I

I Naubisc VDC: Community Diagnosis Field Report. 2003

J.

the


Presentation s MHP and Recommendations

·54·

MHP PLANNING SCHOOL HEALTH PROGRAMME

• • •

Lectures on : (a)MCH and reprodu ctive health (classes 9, 10, 11& 12 to be included ) (b) Malnutrition , anaemia, T.B. , Night blindness, worm infestations. Evaluation via quiz competition and essay writing Sustainability: Periodic assessment of knowledge regarding healthy habits by teachers. Motivati on of participants to create ripple effect.

MASS HEALTH EDUCATION

• • •

On MCH , Reprodu ctive hea lth & KAP on malnutrition, TB , Anemia, Night blindness , Worm infestation Evaluation : Feedback from attendants Sustainability: Motivation of local clubs to co nduct such programs from time to time.

TRAINING OF TRAINERS

I I

• • •

Impart knowledge on MCH & Reproductive health to FCHVs & TBAs . Evaluation: Pre & post tra ining questionnaire. Sustainability: Motivate them to impart their knowledge and make the community aware about the learning .

I I I I Naubise VDC: Community Diagnosis Field Repo rt. :2003


Presentations MHP and Recommendation s

- 55-

Recommendations: -

To VDC : VDC should 1. Improve co-ordination with health post & conduct joint programmes. 2. Motivate local clubs for creating health awareness. 3. Be updated with community problems & needs. 4 . Provide financial support, if possible, for latrine construction & smokeless chu lhos .

To health post: 1. Affordable, accessible and efficient health services should be provided. 2. Regular tra inings & meetings for FGHVs & TBAs shou ld be conducted . 3. Hea lth post should provide necessary drug s to the public. 4 . Heal th post should conduct health awareness for community. 5. Health post should co-ordinate with local clubs and other organizations in their health related programmes.

I

I I I I

To community :. Community should 1. Ac tively participate in different health awareness programmes. 2. Fully utilize available health related facilities 3. Implement san itary habits they are aware of 4 . Use delive ry kits and trained TBAs on hom e deliveries To 10M: 10M should : 1. Work for adeq uacy of logistics . 2. Deve lop provi sions for follow-ups in the respective VD Cs 3. Should provide some training for first aid requisites to the students prior to going to the field.

I I I I

I Naubisc VDC : Comm unity Diagnosis Field Report. 2003

1


56

EPILOG UE

â&#x20AC;˘

We set off for Naubise VDC with lots of enthusiasm and a vision: a common goal - to learn from the community and to offer the little we could give. Starting from the beginn ing, each day was a challenge. Each moment disclosed new secrets, new discoveries of our new homeland , our new community, our friends , and eve n ourselves . ... It was like a new window be ing opened and setting up a wide r horizon.

Those hectic days during data collection: the trudges along the hills and mountains, the n wad ing ac ross the streams and rivers, the sun a nd the rain .. . .

I

And then the hospitality of the villagers, the peaches and the cool cucumbers, the "makai -bhatmas " and the refreshing cup of te as : a ll have adorned the memories of our field trip. Sitting together analyzing the data , sharing our findings and coming up with our results, enthusiastically we planned our MHP. We felt that our hardwork during data collection would really bear fruit when we had done our project, but unfortunately due to the critical condition in the state we had to return without implementing our MHP . However this field trip really proved to be the best learning experience yet and now that we are back we find in ourselves a change that have made us better and more responsible human beings.

I I I

I I

I I

Naubi se vue; Com munity Diagnosis Field Report. 2003


Photo Gallery

Facin!: th e challenge

Wh o are th ose two big children?

Big Rest after a Big Work

Naubise VDC: Comu nity Diagnosis Field Report. 2003


- 58-

Photo Gallery

He)'1 110"' lIea\-")'? (Child or buffalo!! 1!1)

Photo with cool Kanchh a Tanutng Dai

,l f tlJli e)' Sir ill Kttanik hola.

,F' â&#x20AC;˘

Naubise VDC: Com unity Diagnosis Field Report. 2003


路59 路

Photo Gallerv

Roshunl Face

/

L Triumpll Faces.

.

.'

.

Naubise VDC: Comunity Diagnosis Field Report. 2003

/ ,,.01l1.


Photo Gallery

- 60 -

I

-

Smiley Faces 0/ tile Community

I

Heads Chopped OJf!

Naubise VOe: Comunity Diagnosis Field Report. 2003


.' 61

BIBLIOGRAPHY 1. K. Park (2000 ): A textbook of Preventive and Social Medicine, 16th edition , Banarasi as Bhanos Publication , India.

1

2. Hale C, Shrestha I B, Bhattacharya A: Community Diagnosis Manual , HLMC , TU , 10M , 1996 3. Bhende et al: Principles of Population studies :

n

ih

edition .

4. R P Gartoula : An Introduction to medical Sociology and Medical Anthropology. 5. HB Prad ha n: A textbook of Health Education . 6. Adhikari RK and Krantz M: Child Health and Nutrition . 7. Bhandari K.L., Hale C and Mahesh Maskey: Field Training Manual 8. Annual Health Report (MOH/HMG ). 9. Nepal in figures 2003. 10. Handouts of community diagnosis orientation . 11 . Reports of Seniors. 12. Demography and population studies: Srivaastava . 13. Class notes.

Naubise VDC: Community Diagno sis Field Report, 2003


62

Annex

Tribhuva n University Institute Of Medicin e Maharajgunj Campus Maharajgunj , Kathmandu. Community Health Diagno sis Field Program, 2060 (2003)

Communit\' Health Survey Questionnair e VDC : District: Q uestio ner:

Ward:

Date

I. Introducti on: a) Ward no: b) Tole: c) Name of the house ow ner: d) Name of the respo ndent: e) Cast: f) Reli gion: () Nuclear g) Type offamil y: h) Residenc e:

( ) Permanent

2. Family description SN Name Age Sex Drinking

( ) jo inted ( ) Temporary

Relation to house hold

Education

Index : Marital status U - Unmarried

Education I - Illiterate

Occupation A - Agric ulture

M - Married W - Wido w

L - Literate P - Primary education

B - Business S - Service

S - Separated

S - Seco ndary education H.S - Higher secondary DIM ~ Diploma I Master

3. Vita l events a] Birth:

Naubise VDC: Co mmuni ty Diagnosis Field Report. 2003

0- oth ers


63

Annex Has any birth occurred in your family during last year?

()No

() Yes

If yes. Se x Alive dead SN Place of delivery order

Abortion Duration of preg nancy Delivery assi stant Use of delivery kit

b) Morbidity Has anyone in your famil y become ill during the last month , lf yes,

SN

Name Age

Sex

Illne ss / symptoms

e) Mortality Has any death occurred in your family this year ?

() No

() Yes If Yes,

SN

Age

Sex

Reason Remarks

4. Environmental health a) What is the source of water? (a) Spring (b) Well (e) Tap (d) Rive r

(e) Others

b) How far is the source of drinking water from ho me? ( ) At home

( ) 15mins

() 20 - 45 mins

c) Is water adequately supplied? ( j Ycs ()No d) How do you treat drinking wat er? ( ) Untreated ( ) Boiled

( ) Filtered

e) Do you cover the water container?

Naubise VDe: Community Diagnosis Field Report, 2003

Age of mo ther hirth


Annex ( ) Covered

64 ( ) Uncovered

4.2. Il uma n waste di sposal 4.2 .1 Toi let a ) Is there toilet at home? ( l Ye, ():-Jo

If no. wha t is the reason ( ) Unaware

( ) No land

( ) 1\'0 money

b) lf yes. Do all the members use the toilet? (lNo

( j Yes

c ) Do you clean the toilet? ( l Yes ()No If yes. what do you use ? ( ) Wa te r ( ) Phen ol

( ) Surf water

( ) Others

4 .2.3. House hold waste dispo sal a) Ho w do you d ispose house waste? ( ) Manu re ( ) Inci nerat ion I Burn the river

( ) Bury

5. Perso nal hygiene a) I Iw freq uently do you bath ( ) Daily ( ) Once a we ek

h ) What do you use? ( ) Soap ( ) Water on ly

( ) Twice a week

( ) Others

c) How frequently do you brush your teeth ? ( ) Occasionally () Daily

( ) Wcc kly

d) What do you usc? ( ) Dathiwan ( ) Paste I bru sh

( ) Others

e) Do you use slippers? ( j Yes ( ) No

. .

If ves ( ) A lways

( ) Occasionally

( ) Others

6. Utiliza tion of the avai lable health service? a) Ho w long does it take to reach the nearest health institution?

Naubise VDC : Community Diagnosis Field Report. 2003

( ) Through in


Anne x

65

( ) Less than 30 mins

( ) 30 min - one hour

b) Are you satisfied wit health facilities provided there ? () Yes ()No c) If' no, what is the reason'? ( ) Far I Distant

( ) Lack of staff

( ) Lack of drugs

7. Socioeconomic stat us

a) What is your main source of income? ( ) Agriculture ( ) Service

( ) Business

b) Income of one year is sufficient for how many month s?

( ) Less than six months one year

( ) 6 - 12 mo nths

c) Do you have a kitchen garden? () Yes ()No d) If yes . what do you do with its products? ( ) Use oneself ( ) Sell ( ) Others e) Do you rear cattle? ()No ( ) Yes If yes. what do you rear and how many? f) Is there any means of communication? () Yes ()No

If yes . ( ) Radio

() TV

() Others

8. Nutri tional assessment a) What do you take as your daily food? b) Do you take green vegetables? () Yes ( ) No c) How often do you take meat and fish? ( ) Once a week ( ) Twice a week d) Which type of salt do you use? ( ) Salt crystal s ( ) Iodized

( ) Don't take

( ) Others

Naubise VDC : Community Diagno sis Field Report, 2003

( ) more than


66

Annex

Anthropometry under five years SN Name Age/Sex Weight Height MlJAC

9. Ge nder status a) Who takes vital decisions in your family? ( ) Husband ( ) Wife () All b) Who cook s food at home? ( ) Wife ( ) Daughter

( ) Moth er

c) Who takes food last? ( ) Females ( ) Male s

( ) Altogether

d) Is it necessary t to have a son in family ? ( lYes ()No If yes, "'路vhat is the reason? ( ) to look after the aged ( ) to make way to heaven ( ) Social reasons ( ) Others e) Who does more physical work? ( ) Wife and daughters

( ) Husband and sons

f) Who keeps money in the family? ( ) Husband ( ) Wife

( ) Both

g) Where do women stay during menstruation? ( ) Usual place ( ) separate room inside home ( ) outside house ( ) Others 10. Health related ( KAP) 10.1. Disease a) In your opinion what is the cause of disease? ( ) Wastage ( ) Micro- organisms l ) God I Goddess I Witch ( ) Contaminated food and water ( ) Others

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67

Annex h ) Wh ere do you go first when you are sick? ( ) Health post I Hospital ( ) Horne reme dies ( ) Dhami I l hakris ( ) Others c) Do you go to hea lth institutions? ()No ( I Yes d) If no. what is the reason? ( ) Distant ( ) Lack of money ( ) Lack of time ( ) No bel ief ( ) Others c) What do you do to prevent diseases?

( ( ( ( (

) Worship I Offerings ) Maintain personal hygiene ) Immu nization ) Unk nown ) Others

J 0.2 Til

a) I lave you hea rd ofTB? ( ) Yes ( )No b) What is the cause of TB?

( ( ( ( (

) Heavy work ) God I Go ddess ) Waste water ) Micro-organisms ) Others

c) Ilow is TB tra nsmitted? ( ) Eating remains of food (salivary transmission) ( ) By touching ( ) By co ughing I sneezing ( ) Using same th ings d) How can TB be cured? ( ) Drugs ( ) Rest ( ) DJs ( ) No trea tment ( ) Others

Naubise

voe: Community Diagnosis Field Report. 2003


Annex

10.3 LE PROSY a ) How is it transm itted? ( ) Eati ng rem ains o f food eaten by others ( ) Touching ( ) Wastes ( ) Others b) Ho w can lep rosy be trea ted? ( ) No treatment ( ) Wo rsh ips! Offerings ( ) Medicine ( ) Oth ers IDA WO RM INFESTATIO NS a) Have you heard o f it? ( ) Yes ( ) No

b) How is the wo rm infe sted ? ( ) Eating sweets ( ) By birth ( ) Eating soil ( ) Waste food and wate r ( ) Others c ) Ho w can it be treated? ( ) No treatment ( ) No need for trea tmen t ( ) Medicine ( ) Don"t know ( ) O thers d) How can it be preve nted?

( ( ( (

) Not tak ing muc h sweets ) Don't know ) No nee d of prevention ) Others

10.5 HO OK WO RM a) Have yo u heard about it? ( ) Yes ( ) No b ) 11 0 \\' is it infested ? ( ) By birth

Naubisc VDC : Co mmu nity Diag nosis Field Report. 2003


Annex ( ) Walking barefoot ( ) Don't know ( ) Others c) I-Iow can it be treated? ( ) No treatment ( ) Medicine ( ) No need of treatment ( ) Don't know ( ) Others d) How can it be prevented? ( ) Can't be prevented ( ) Using slippers ( ) Don't know ( ) Others 9.6 GOITRE a) Have you heard of it? ( ) Yes ( ) No b) In your opinion, what is the cause of goitre? ( ) Lack of salt ( ) Lack of iodized salt ( ) Don 't know ( ) Others c) How can goitre be treated ? ( ) Tak ing iodised salt ( ) Medicine ( ) Don't know ( ) No need ( ) Others 10.7 DIARRHOEA a) Have you heard of it? ( ) Yes ( ) No b) In your opinion, how is diarrhoea caused ? ( ) Waste food and water ( ) Akha - Lagera ( ) Others c) Have you heard ofORS ?

Naubise VDC: Communi ty Diagno sis Field Report, 2003

69


Annex ( ) Yes

( ) No d) Do you know how to prepare ORS? ( ) Yes

I ) No If Yes . ( ) Correct ( ) Incorrect

10.8 NIGHT BLINDNESS a) Have you heard of it? ( ) Yes

( ) No b) How is it caused? ( ) Deficiency of Vitamin A ( ) Don't know ( ) Akha - Lagera ( ) Others c) What is the major source of V itamin A? ( ) Green vegetables ( ) Taking Vitamin A

( ) Milk ( ) Others d) How can it be prevented? ( ) Green vegetables ( ) Don't know ( ) Others

10.9 ANEMIA a) Hav e you heard of anemia? ( ) Yes

( ) No h) What is the cau se of anem ia? ( ) Deficiency of iron ( ) Don't know ( ) Others c ) Ho w can it be treated ? ( ) Taking green ve getables ( ) Medicine

Na ubise VDC : Comm unity Diagnosis Field Report. 2003

70


Anne x ) Hea lthy food ) Tak ing blood ) Don't know ) Others 10.\0 MALNUTRITION a) Have yo u heard of it? ( ) Yes

( ) No h) What is the cause of it?

( ( ( ( (

) Taking less food ) Don' t know ) Tou ch of pregnant women ) Sins of prev ious life ) Others

c) How can it be preve nted? ( ) Balanced diet ( ) Don't know ( ) Tak ing to health institution ( ) Others 10. 11 COLD I COUGH I PNEUMONIA a) Have you heard of it? ( ) Yes

( ) No b) What is the cause of it?

( ( ( ( (

) Co ld ) God I Goddess ) Dust ) Getting wet in the rain ) Others

c) How is it transmitted? ( ) By air ( )Touc hing ( ) Food and water ( ) Don 't know ( ) Others d) What do you do to your children havin g cold/cough? ( ) Take to healt h institution ( ) Worship God! God dess ( ) Keepin g warm

Naubise VDC: Community Diagnosis Field Report, 2003

71


Annex i ) Others

IO .1 2111V I AIDS al Have you heard of it? ( ) Yes ( ) No

b) How is it tran smitted? ( l Unsafe sex ( ) Sharing syringe ( ) Receiv ing patient' s blood ( ) From diseased mother to her offspring ( ) Don't know ( ) Others c) How can it be prevented? ( I Safe sex ( ) Sex \....ith single partner ( ) Don 't know ( ) Others

d) If there is anybody having AIDS in the village how would you behave towards him? ( ) Kick out from village ( ) Keep closed in one room ( ) Keep a good relation ( ) Others II. MA TER.'lAL AND CHILD HEALTH Name of respondent : Caste: Age: Address : 11.1 PREG NANC Y a) What was your age at the time of marriage? ( ) < 16 yrs ( ) 16- 20yrs ( )2 1 -35yrs ( Âť 35 yrs

What was your age at the first co nceived? ( )< 20 )'rs ( ) 20 - 35 yrs ( Âť35yrs b)

c) Did you consult the health personnel at the first conceive?

Naubise VDC: Co mmun ity Diagnosis Field Report, 2003

72


Annex i ) Others

IO .1 2111V I AIDS al Have you heard of it? ( ) Yes ( ) No

b) How is it tran smitted? ( l Unsafe sex ( ) Sharing syringe ( ) Receiv ing patient' s blood ( ) From diseased mother to her offspring ( ) Don't know ( ) Others c) How can it be prevented? ( I Safe sex ( ) Sex \....ith single partner ( ) Don 't know ( ) Others

d) If there is anybody having AIDS in the village how would you behave towards him? ( ) Kick out from village ( ) Keep closed in one room ( ) Keep a good relation ( ) Others II. MA TER.'lAL AND CHILD HEALTH Name of respondent : Caste: Age: Address : 11.1 PREG NANC Y a) What was your age at the time of marriage? ( ) < 16 yrs ( ) 16- 20yrs ( )2 1 -35yrs ( Âť 35 yrs

What was your age at the first co nceived? ( )< 20 )'rs ( ) 20 - 35 yrs ( Âť35yrs b)

c) Did you consult the health personnel at the first conceive?

Naubise VDC: Co mmun ity Diagnosis Field Report, 2003

72


73

Annex

( ) Yes ( ) No If Yes. then how man)' times? ( ) < -1. time s ( ) 4 times ( ) > -1. times

If No, then why? ( ) Didn' t know ( ) Didn't have time ( ) Didn't think it necessary ( ) Not ed ucated about it ( ) It's far ( ) Felt shy d) Did you eat more during pregnancy? ( ) Yes () No e) Did you have cigarette / wine du ring pregna ncy? ( ) Cigarette ( ) Wine ( ) Both ( ) None f) Did you face any of these problems during pregnancy?

( ( ( ( (

) Headaches ) Swelling of legs ) Asthma ) Noth ing ) Oth ers

g) Did you take iron tablets? () Yes () No h) Did you have IT vaccine ? ( l Yes ( )No I) 1I0w mu ch work did you used to do? ( 1As usual ( ) More

( 1Less

j) How many times did you used to suckle your baby? ( How many times per day? ) ( ) Frequently ( ) When bay cries ( ) When moth er is free

Naubise VDe: Community Diagnosi s Field Report , 2003


73

Annex

( ) Yes ( ) No If Yes. then how man)' times? ( ) < -1. time s ( ) 4 times ( ) > -1. times

If No, then why? ( ) Didn' t know ( ) Didn't have time ( ) Didn't think it necessary ( ) Not ed ucated about it ( ) It's far ( ) Felt shy d) Did you eat more during pregnancy? ( ) Yes () No e) Did you have cigarette / wine du ring pregna ncy? ( ) Cigarette ( ) Wine ( ) Both ( ) None f) Did you face any of these problems during pregnancy?

( ( ( ( (

) Headaches ) Swelling of legs ) Asthma ) Noth ing ) Oth ers

g) Did you take iron tablets? () Yes () No h) Did you have IT vaccine ? ( l Yes ( )No I) 1I0w mu ch work did you used to do? ( 1As usual ( ) More

( 1Less

j) How many times did you used to suckle your baby? ( How many times per day? ) ( ) Frequently ( ) When bay cries ( ) When moth er is free

Naubise VDe: Community Diagnosi s Field Report , 2003


74

An nex

( ) When baby wakes up k } For how much time do you suckle your baby?

( ) > 5 mins

( ) A rou nd 5 mins

( ) 10 mins

I) Do you let your baby suc kle both breast at one tim e? (l Yes (lNo

m) Apart from your milk wh ich milk do you give to your baby'? ( ) Cowl ButT

( ) Bo ttled

( ) Others

11) How do you feed?

( ) Bottle

( ) Bowl and spoon

( ) Others

0) What do you feed yo ur baby apart from yo ur milk?

( ) Lito

( ) C urry

( )Jaulo

p) Wh en had you star ted to give soli d fo od? ( ) < 4 mo nths ( ) 4 - 6 mo nths

( ) > 6 months

q) Which so lid foods do you g ive?

( ) Jaul o

( ) Lito

( ) Us ual food

r l Have you heard of super flour? ( ) Yes ( )1'0 11.2 V ACC INATJO N a) Have yo u vac cinated your child?

( I Yes

( )No

I f No " why? ( ) Didn' t know it ex isted ( ) Wasn't avai lab le ( ) Didn ' t ge t time ( ) Feared it might harm ( ) Others

If Yes " ,..'hen d id yo u finis h yo ur vaccination? ( ) <9 mo nths ( )9 mo nths ( ) I y r( Âť S. No . AGE

SEX

BCG

DPT

PO LIO TT

Naubisc VDe: Community Diagnosis Field ReJXH1" 2003

I vr


74

An nex

( ) When baby wakes up k } For how much time do you suckle your baby?

( ) > 5 mins

( ) A rou nd 5 mins

( ) 10 mins

I) Do you let your baby suc kle both breast at one tim e? (l Yes (lNo

m) Apart from your milk wh ich milk do you give to your baby'? ( ) Cowl ButT

( ) Bo ttled

( ) Others

11) How do you feed?

( ) Bottle

( ) Bowl and spoon

( ) Others

0) What do you feed yo ur baby apart from yo ur milk?

( ) Lito

( ) C urry

( )Jaulo

p) Wh en had you star ted to give soli d fo od? ( ) < 4 mo nths ( ) 4 - 6 mo nths

( ) > 6 months

q) Which so lid foods do you g ive?

( ) Jaul o

( ) Lito

( ) Us ual food

r l Have you heard of super flour? ( ) Yes ( )1'0 11.2 V ACC INATJO N a) Have yo u vac cinated your child?

( I Yes

( )No

I f No " why? ( ) Didn' t know it ex isted ( ) Wasn't avai lab le ( ) Didn ' t ge t time ( ) Feared it might harm ( ) Others

If Yes " ,..'hen d id yo u finis h yo ur vaccination? ( ) <9 mo nths ( )9 mo nths ( ) I y r( Âť S. No . AGE

SEX

BCG

DPT

PO LIO TT

Naubisc VDe: Community Diagnosis Field ReJXH1" 2003

I vr


75

A nnex

FAM ILY PLANNING a) llavc you heard of family planning? ( j Ycs ( )No

If Yes. state the source? ( ) Friends ( ) Health personnel ( ) Med ia ( ) Others

b) Have you opted forany family planning methods? ( ) Yes

( )No

If Yes. slate ( ) Tempo rary ( pills. Dcpo. Copper T. Norplant etc.) ( ) Permanent ( ) Both If No. why? ( ) Religious reasons ( ) Fear I Shame ( ) No t available

( ) Family's incompliance c) According to you . how many children does a happy family need? () 1

()2

()3

d) What should be the gap between two children?

( ) < 2 yr s

()2 -5 vrs

(Âť5yrs

O BS ERV AnON CHEC KLIST

a) Type of house ( ) Kach cha

( ) Kachcha I Pakk a

( ) Pukka

b) Type o f floor ( ) Kaehe ha

( ) Kachc ha I Pakka

( ) Pakka

c) Type o f wa ll ( ) Mud and stone ( ) Stone. mud and cement ( ) Brick and cement ( ) Others

Naubise VDC: Community Diagnosis Field Report. 2003


75

A nnex

FAM ILY PLANNING a) llavc you heard of family planning? ( j Ycs ( )No

If Yes. state the source? ( ) Friends ( ) Health personnel ( ) Med ia ( ) Others

b) Have you opted forany family planning methods? ( ) Yes

( )No

If Yes. slate ( ) Tempo rary ( pills. Dcpo. Copper T. Norplant etc.) ( ) Permanent ( ) Both If No. why? ( ) Religious reasons ( ) Fear I Shame ( ) No t available

( ) Family's incompliance c) According to you . how many children does a happy family need? () 1

()2

()3

d) What should be the gap between two children?

( ) < 2 yr s

()2 -5 vrs

(Âť5yrs

O BS ERV AnON CHEC KLIST

a) Type of house ( ) Kach cha

( ) Kachcha I Pakk a

( ) Pukka

b) Type o f floor ( ) Kaehe ha

( ) Kachc ha I Pakka

( ) Pakka

c) Type o f wa ll ( ) Mud and stone ( ) Stone. mud and cement ( ) Brick and cement ( ) Others

Naubise VDC: Community Diagnosis Field Report. 2003


Annex

76

d) Condition of wa ll ( ) With Lip pot and without crack s ( ) With Lip pot and cracks ( ) Without Lip pot an d cracks ( ) Without Lip pot an d without cracks

e) Type of roof ( J Stone ( ) Tin / tile I slit stone/ ( )Thatch ( ) Rod. cement. concrete ( ) Others t) Lighting

( ) Satisfac tory

( ) Unsatisfactory

g) Venti lation ( ) Sat isfac tory

( ) Unsatisfactory

h) Type of kitchen

( ( ( (

) Separated with no smoke ) Separated with smo ke ) Joined with home with smoke- free stove ) Joined with home but stove with smoke

I) Type of fue l ( ) Wood ( ) G uitha ( ) Gobar gas ( ) Bio gas ( ) LP gas ( ) Kerosene ( ) Electric

j) Type of toilet ( ) Dug I Pit hole

( ) Scientific

( ) Others

k) Animal shed ( ) Attached to hou se ( ) > 25 feet from hou se ( ) < 2 5 feet from hou se I) Kitchen ga rden ( )No

( I Yes

m) Water source

Na ubise VD C : Community Diagnosis Fie ld Report. 2003


Annex

76

d) Condition of wa ll ( ) With Lip pot and without crack s ( ) With Lip pot and cracks ( ) Without Lip pot an d cracks ( ) Without Lip pot an d without cracks

e) Type of roof ( J Stone ( ) Tin / tile I slit stone/ ( )Thatch ( ) Rod. cement. concrete ( ) Others t) Lighting

( ) Satisfac tory

( ) Unsatisfactory

g) Venti lation ( ) Sat isfac tory

( ) Unsatisfactory

h) Type of kitchen

( ( ( (

) Separated with no smoke ) Separated with smo ke ) Joined with home with smoke- free stove ) Joined with home but stove with smoke

I) Type of fue l ( ) Wood ( ) G uitha ( ) Gobar gas ( ) Bio gas ( ) LP gas ( ) Kerosene ( ) Electric

j) Type of toilet ( ) Dug I Pit hole

( ) Scientific

( ) Others

k) Animal shed ( ) Attached to hou se ( ) > 25 feet from hou se ( ) < 2 5 feet from hou se I) Kitchen ga rden ( )No

( I Yes

m) Water source

Na ubise VD C : Community Diagnosis Fie ld Report. 2003


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A Community Diagnosis of Naubise V.D.C  

A Community Diagnosis of Naubise V.D.C