Community Health Diagnosis, Nilkantha Municipality, Dhading District, Nepal. A Cross-Sectional Study


Academic Paper, 2018

93 Pages


Excerpt

TABLE OF CONTENTS

ACKNOWLEDGEMENT

TEAM MEMBERS

ACRONYMS

EXECUTIVE SUMMARY

TABLE OF CONTENTS

LIST OF TABLES

LIST OF FIGURES

CHAPTER I: INTRODUCTION
1.1 Background
1.1.1 District Profile
1.1.2 Ward Profile
1.2 Rational of the Study
1.3 Objectives of the Study
1.3.1 General Objective:
1.3.2 Specific Objectives:

CHAPTER II: METHODOLOGY
2.1 Study Design
2.2 Study Area
2.3 Site Selection and HH Selection
2.4 Sampling Unit / Study Unit
2.5 Sampling Frame
2.6 Sample Size
2.7 Tools and Technique of Data Collection
2.8 Sampling Technique
2.9 Sampling Procedure
2.10 Data Processing
2.11 Data Analysis and Interpretation for Presentation
2.12 Validity and Reliability
2.13 Literature Review
2.14 Budget and Time Schedule
2.15 Limitations of Our Study
2.16 Ethical Consideration
2.17 Source of Data
2.18 Operational Definition

CHAPTER III: FINDINGS
3.1 Demographic Characteristics
3.2 Socio-Economic Condition
3.3 Environmental Health and Hygiene
3.4 Maternal and Child Health
3.5 Nutrition
3.6 Diseases pattern
3.7 Immunization and Family Planning
3.8 Additional Findings
3.9 Observational Checklist
3.10 SWOT Analysis

CHAPTER IV: CONCLUSION AND RECOMMENDATION
4.1 Conclusion
4.2 Recommendation

CHAPTER V: KEY FEATURES TO SHARE
5.1 Social Mapping
5.2 Work Plan
5.3 Major Activities During CHD

REFERENCES

ACKNOWLEDGEMENT

We would like to extend our special thanks to several people and institutions who have extended their support and helped us achieve this report. We are deeply indebted to all the people of ward 9, in particular, the respondents of Nilkantha Municipality, Dhading, Nepal, who did not only provided the right responses, but also their time, love, and care during the Community Health Diagnosis Program.

We would like to extend our heartfelt thanks to the ward chairperson Mr. Bhoj Prasad Regmi. Thanks also to all the staff of the health post for providing us with health-related information and spaces for health programs. Besides, we are indebted to all the female community health volunteers in ward no. 9, without whom, we could not create a sampling frame. All FCHVs have provided their precious time even during their busy schedule and have shown active participation in all our activities. Therefore, we are very grateful to them. Also, we thank the principal of Future Care Boarding School and Shree Chandeshwori Higher Secondary School, who provided us with spaces in their building for running various health programs. Also, thanks to the principal of Shree Palpa Samari Vanjyang Secondary School who provided us with their valuable assistance during our Micro Health Project.

Thanks to all the Malati Aama Samuha mothers who have made a significant contribution to our program and provided us with the necessary resources for Focus Group Discussion. We are very indebted to Mr. Sunil Thapa Maga r, who managed our residence at an affordable cost.

In addition, we would like to thank our National Academy for Medical Sciences in particular, Mr. Ram Bahadur Shrestha (Principle) and Dr. Birendra Kumar Singh (Head of the Department of Public Health), and our genuine teachers Mr. Binod Regmi, Mr. Nikesh Khanal, and Mr. Pratik Shrestha for their guidance, encouragement, and regular follow-up to the end. Lastly, we would like to salute all those who have helped us directly or indirectly to make our CHD successful.

Krishna Sharma

Team Leader

24 April, 2018

TEAM MEMBERS

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ACRONYMS

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EXECUTIVE SUMMARY

Community health diagnoses usually refer to the identification of health problems in the general population in terms of mortality and morbidity rates and ratio, and to identify their correlates to identify those at risk or those in need of health care. The community health diagnosis program (2018) was successfully implemented in Ward no. 9 of Nilkantha Municipality, Dhading District, Nepal, in accordance with the general objective of assessing the overall health status of people, disease intervention, healthcare service utilization pattern, and the available resources in the community. We concluded some significant health issues were founded such as the use of inadequate water purification methods, improper information on six steps for hand washing, solid waste management, insufficient information about the causes of infectious diseases, lack of knowledge on free healthcare services and their utilization, unhealthy dieting habits, traditional beliefs of non-communicable disease, misinformation about the consequences of malnutrition, disease epidemics, and disasters.

Social and Demographic Characteristics: Out of the total sample population (N=1228) of Nilkantha Municipality, Ward no. 09, the majority of people were Brahmin (33.57%) following by Dalit (22.05%), and Newar (20.13%). The survey revealed majority of the population (96.02%) was Hindu, while 1.03% was Buddhist, and 2.95% was Christian. The percentage of illiterate population was 19.64%, and most of the literate population was educated up to the secondary school levels, which occupies 22.05%. Out of the total 268 sampling households, the majority of them had been involved in agriculture (64.18%) as their primary source of income.

Among the total newborn babies within this year, only 66.67% had registered with a birth certificate. The new population pyramid shows the female population tends to be significantly higher than males above 60 years age group. It indicates, the life expectancy of the female is slightly higher than the male population. This pyramid resembles the pyramid of developing countries, which means more people in the younger age, or dependency ratio is higher.

Environmental Health and Hygiene: Tap water was the major source of drinking water of ward no.9, Nilkantha Municipality of Dhading district, which accounts for 91.04% of the total sample population, 5.60% of the population use Dhungedhara, and only 3.36% use well water. Among 268 sample households, only 30.20% of the total sample population purify the water for drinking purpose, whereas one third (69.80%) of the total sample population use water for drinking without using any purification methods. About 93.28% of the population had a toilet at their home, whereas the remaining 6.71% didn’t have a toilet. Two-thirds (74.40%) of the population had sufficient water for bathing and cleaning the toilet at their home.

Among 268 households, about 85.07% of people knew about personal hygiene, whereas only 14.92% didn’t know about personal hygiene, which indicates that people may have a good hygiene practice. The majority of the population (97.01%) had hand washing practices after using the toilet, but 2.99% of the population didn’t have such practices after using a toilet. The majority of households used firewood (80.59%) for cooking food, 14.17% used Liquid Petroleum Gas, and about 4.47% used bio-gas, while 0.74% used both firewood and gas as a main source of fuel for cooking.

Maternal and Child Health: The majority of mothers (60%) had got married within the 15-19 years of age group. Around 34.29% of 15-19 years of age of mother had their first pregnancy. About 62.86% of respondents had their last new delivery at the hospital, 34.29% had a delivery at the health post, and still, 2.86% had a delivery at home. The majority of women (88.57%) had ANC check-ups during pregnancy and more than half (67.74%) of the respondents who had done ANC check-ups, had done it at the correct time. Among those who had not done ANC check-ups during pregnancy, about 75% of them had not done it due to lack of awareness, and 25% due to the perception of not necessary. Among mothers with under-five children (n=35), only 68.57% of women had to breastfeed the newborn baby within one hour. Among them, 74.29% of mothers had started complementary feeding to the newborn before six months due to insufficient milk or a busy schedule.

Immunization and Family Planning: Among (n=255) married couples who were asked about family planning, the majority of them (85.49%) had heard about family planning while the rest of the 14.51% said they had not heard about it. Out of (n=218) respondents who had heard about the FP, 31.19% said they had heard from the TV/Radio. Among them, only 47.25% had used FP devices. Out of them (n=103) who had used FP devices, 16.50% had used condoms, 6.80% had used Pills, 32.04% had used DEPO, 6.80% had used Implant, 1.93% had used IUCD, 30.10% had used vasectomy, and the remaining 5.83% had used Minilap. This data shows that the majority of couples preferred to use temporary devices of FP. Among (n=35) children aged under five, about 85.71% of children were immunized. According to our survey among children (n=30) who were immunized, we found that 76.67% of them had completely immunized, and 23.33% of them were not completely immunized.

Nutritional Health: Of the 268 respondents interviewed for healthy eating, only 63.81% of them heard about a balanced diet. And only 79.10% of respondents washed their vegetables before cutting and cooking, and 94.40% of respondents used iodized salt at all. Among children (n = 35), 71.43% were given Deworming Tablets by their parents, and the remaining 28.57% were not.

Diseases Pattern: The majority of respondents have heard about Diarrhea, Filariasis, T.B., and HIV/AIDS i.e. 93.28%, 83.20%, 83.58%, and 79.85%, respectively. Only a few numbers of people heard about hepatitis-B (33.95%). Most people also heard about uterus prolapsed, followed by diabetes, cancer, and mental health problems, i.e. 83.20%, 81.34%, 83.95%, and 76.49%, respectively, while the number of people who had never heard of pneumonia and COPD was 27.99% and (32.47%). Most of the women (44.44%) did not go for treatment for uterus prolapsed due to their perception that it was not necessary. In this community, COPD and uterus prolapsed was found as the major health problems.

Conclusion: The community health diagnosis has been conducted successfully in ward no. 09 of Nilkantha Municipality of Dhading district, based on our objective to assess the existing health situation, disease pattern, and the resources. Free healthcare services are provided by health posts however, people don't know about free healthcare services and do not utilize them. It is due to the communication gap between community people and health service providers. Similarly, even most people are unaware of the importance of a nutritional diet, and malnourished people are prevalent. The reason behind this is insufficient knowledge of the dietary pattern, feeding practices, and a balanced diet. People don't have proper habits of handwashing and its importance. In conclusion, an effective community health education program is suggested as necessary in Nilkantha Municipality.

LIST OF TABLES

Table 1: Showing Tools and Techniques of Data Collection

Table 2: Showing Sampling Procedure

Table 3: SWOT Analysis of Nilkhantha Municipality, Ward no. 9, Dhading, Nepal

LIST OF FIGURES

Figure 1: Population Pyramid

Figure 2: New Born Baby within a Year

Figure 3: Birth Registrated Child

Figure 5: Migrated Population

Figure 4: Cast of the respondents

Figure 6: Educational Status of Community

Figure 7: Educational Status of Community

Figure 8: Occupation of Community’s People

Figure 9: Religion status of Community

Figure 10: Main Source of Income of Household

Figure 11: Time duration to consume food production from agriculture

Figure 12: Decision Making in Home

Figure 13: Involvement of People in community’s Works

Figure 14: More involvement of People in community works (Gender Wise)

Figure 15: Showing status of Yearly Income and Expenses in Medicine

Figure 16: Source of Drinking Water

Figure 17: Distance between house and source of drinking water

Figure 18: Status of Water Purification

Figure 19: Process of purification of water

Figure 20: Avialable of Toilet

Figure 21: Types of Toilet

Figure 22: Place for Defecation if there is no Toilet

Figure 23: Reason behind unconstruction of Toilet

Figure 24: Sufficient of Water for Bathing and Cleaning of Toilet

Figure 25: Problems from the Solid Waste and Waste Water

Figure 26: Fule for Cooking Foods

Figure 27: Heard About Personal Hygine

Figure 28: Hand washing practice after using toilets

Figure 29; Timing for practice of hand washing

Figure 30: Materials used for hand washing

Figure 31: Knowledge on steps for hand washing

Figure 32: Habits of Brushing Teeth

Figure 33: Frequency of Brushing Habits

Figure 34; Materials used for brushing teeth

Figure 35: Bathing Habits in a Week

Figure 36: Habits of trimming nails

Figure 37: Age of Mother during Marriage

Figure 38: Age of Mother during First Pregnancy

Figure 39: ANC Checkup during Pregnancy

Figure 40: Duraton of ANC Visit (Correct/Wrong Time)

Figure 41: Place for ANC Visit

Figure 42: Suggestion Given for ANC Visit

Figure 43: Reason for not visiting ANC

Figure 44: Planning for place of last new delivery

Figure 45: Consumption of Iron Tablets during Pregnancy

Figure 46: Consumption of Deworming Tablets during Pregnancy

Figure 47: Heard About Safe Abortion

Figure 48: Delivery Place for Last Newborn Baby

Figure 49: Age of mothers during last newborn baby

Figure 50: Status of PNC Visit

Figure 51: Time duration for PNC Visit

Figure 52: Complications after delivery

Figure 53: Time duration for 1st breast feeding to newborn baby

Figure 54: Frequency of breast feeding within 24 hour

Figure 55: Complementary feeding to newborn baby

Figure 56: Reason for complementary feeding before six month

Figure 57: Heard about balance diet

Figure 58: Main source of food available at home

Figure 59: Washing Vegetables

Figure 60: Types of Salt Used

Figure 61: Knowledge of reason behind worm infestation

Figure 62: Intake of deworming tablet for child

Figure 63: Intake of vitamin A capsule for child

Figure 64: Intake of vitamin A capsule and deworming tablets for child

Figure 65: Rason for not intaking deworming and vit-A tablets

Figure 66: Showing MUAC measurement results

Figure 67: Heard about malnutrition

Figure 68: Reason behind the malnutrition

Figure 69: Heard about the super flour

Figure 70: Knowledge of preparing Sarvottam Pitho

Figure 71: Heard About Communicable Disease

Figure 72: Heard About Non-communicable Disease

Figure 73: Bar diagram of Getting Treatment on Communicable Disease

Figure 74: Reason for Not Treatment of Uterus Prolapsed Cases

Figure 75: Heard about FP

Figure 76: Multimedia to Hear About FP

Figure 77: Showing Percentage of Use of FP Devices

Figure 78: Showing Bar Diagram of FP Devices in Used

Figure 79: Source of receiving FP services

Figure 80: Reason for not using FP devices

Figure 81: Pie chart of showing Immunized children

Figure 82: Reason for Unimmunization of Children

Figure 83: Bar diagram showing knowledge of birth spacing

Figure 84: Social Mapping of ward no. 09, Nilkhantha Municipality, Dhading District

CHAPTER I: INTRODUCTION

1.1 Background

Community Health Diagnosis (CHD) is the process of examining the overall health status of an entire community about its social, physical, and biological environment, including necessary resources in the community. It is also defined as the process of appraising the health status of a community, including assembly of vital statistics and other health-related statistics and information about determinants of health, and the examinations of the relationships of these determinants to health in the specified community (J.M. Last). We had conducted our community health diagnosis in Nilkantha Municipality, ward no. 09 of Dhading district, Nepal from 13th Magh to 13th Falgun, 2074 B.S (27th January to 25th February 2018).

1.1.1 District Profile

State: Province No. 03 (Bagmati Province)

District: Dhading

Headquater: Dhading Besi

Area: 1926 sq. KM

Total Population: 336067 (2011)

Boundaries:

- East: Kathamndu, Rasuwa and Nuwakot
- West: Gorkha
- North: Rasuwa and Tibet
- South: Makwanpur and Chitwan

Major Religion: Hindu

Major ethnicity: Brahaman, Chhetri, Gurung, Tamang, Dalit

Municipalities:

- Dhading Besi Municipality
- Nilkantha Municipality

Nilkantha Municipality is a Municipality in Dhading District in the Bagmati Zone of central Nepal. The municipality was established on 18 May 2014, merging with the existing Nilkantha (Dhading Besi), Sunaula Bazar, Murali Bhanjyang, Sangkosh Village development committees.

1.1.2 Ward Profile

Municipality: Nilkantha Municipality

Ward No. 09

District: Dhading

Boundaries

- North: Arughat
- South: Muralibhanjyang
- East: Sunkhani
- West: Sangkosh

Ward no. 09 Nilakantha municipality is a newly formed municipality. This municipality is composed of the previous six VDCs (Palpa, Jyamere, Nigalpani, Golabhanjyang, Chhap, and Kafalpani).

Total population: 3746

- Total male: 1645
- Total female: 2101

Total household: 880 [ Sources: Muralibhanjhayan Health Post, 2071/72 B.S.*]

Major ethnic group: Brahaman, Chhetri, Gurung, Magar, Newar, Dalit

Major religion: Hindu, Christian, Buddhist

Language: Nepali

Main occupation: Agriculture, labour

Organization: Ward office, Red Cross

Health institutoions: HP, Private Medical (one/one)

Education institutions: Government (High School) and Boarding School (Primary Level)

1.2 Rational of the Study

Most of the rural communities of Nepal still live under the poor accessibility of health care services and the public health status is not satisfactory. The availability of actual data of specific health status of targeted and marginalized rural community’s people of Nepal is not good and is too difficult to get it. Most of the private organizations (NGOs & INGOs) are concentrated in urban/city areas, and the people, who live far from the government’s eyes, are always biased behind the dark of shadow to get health care services. A rapid cost-effective data collection method is necessary for identifying and assessing the possible option of health problems in that community. Therefore, A Community health diagnosis is an appropriate and effective method for identifying rural health problems, planning the programs, and implements those programs in a short period of time. That’s why the CHD was carried out at Nilkhantha Municipality, Ward no. 09 Dhading, Nepal.

1.3 Objectives of the Study

1.3.1 General Objective:

To assess the overall existing health status of the community, it’s determining factors, available resources, accessibility of health care services, its utilization, and find out the possible solution for the problems to conduct a need-based short-term micro health project.

1.3.2 Specific Objectives:

1. To determine the socio-economic , demographic , educational, and cultural characteristic s of Nilkhantha Municipality, Ward no. 9 Dhading district, Nepal.
2. To determine the major factors affecting the health status of that community towards health-seeking behavior, health services utilization, health education, environmental sanitation, and personal hygiene.
3. To determine the accessibility of health services, health delivery system, and health services utilization pattern in the community.
4. To assess the nutritional status of under-five children by anthropometric measurement.
5. To priorities the major health problems and health needs of that community.
6. To assess the knowledge , attitude, and practice of the community in terms of major communicable and non-communicable diseases in that community.
7. To assess the knowledge, attitude, and practice in terms of maternal and child health with immunization status and family planning.
8. To assess the locally available resources and to determine the role of health development organization of the community along with the active participation of community members.
9. To conduct (Plan, Implement, and Evaluate) appropriate Micro Health Project (MHP) directed at solving the health problems together with community members based on their felt needs and observed needs.
10. To present major findings of our community health diagnosis (CHD) to the community people, to give appropriate suggestions and recommendations, and to encourage them in continuation of their good behaviors and making them aware to change unhealthy behaviors .

CHAPTER II: METHODOLOGY

2.1 Study Design

The study design was a descriptive/cross-sectional study, used both qualitative as well as quantitative methods of data collection. The questionnaires and observational checklist were developed in Nepali language, used as quantitative tools, and Participatory Rural Appraisal (PRA) took as a qualitative tool to conduct the field study.

2.2 Study Area

The study was carried out in ward no. 09 Nilkantha Municipality, Dhading district in Nepal. It was a newly formed ward of Nilkantha Municipality, which was made by merging the previous six VDCs (4, 5, 6, 7, 8, and 9) after the division of the federal system.

2.3 Site Selection and HH Selection

The study has been conducted in only the selected places of ward no. 09 Nilkantha Municipality. The list of households was obtained from the self counting with the help of FCHVs of the respective region of ward no. 09 for the purpose of household selection.

2.4 Sampling Unit / Study Unit

In this study, the household was setting as the sampling unit, and the study unit was population. However, the respondents of the targeted group for specific topics of our study were separately distinguished according to the purpose of the study.

2.5 Sampling Frame

We collected the total number of households (N=891) with the help of FCHVs and local community leaders, and clustering was done according to the geography of ward no. 09 Nilkantha Municipality, Dhading District, Nepal. The sampling frame was the list of the total number of households of the selected place.

2.6 Sample Size

The total number of household of Ward no. 9 Nilkantha Municipality was 891 and we took only 268 as a sample size by calculating as shown below;

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2.7 Tools and Technique of Data Collection

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Table 1: Showing Tools and Techniques of Data Collection

2.8 Sampling Technique

- Cluster sampling
- Simple random sampling
- Multistage sampling

2.9 Sampling Procedure

Firstly, we divided Ward no. 9 Nilkantha Municipality into three clusters (A, B, and C) according to the geographical area on the basis of previously constructed administrative division:

Cluster A = Previous ward no. 4 and 5

Cluster B = Previous ward no. 7 and 8

Cluster C = Previous ward no. 6 and 9

After then, we selected the sample of the household from the list of a sampling frame of each cluster and took the sample from each cluster based on the density of household using simple random sampling for the selection of household in each cluster.

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Table 2: Showing Sampling Procedure

2.10 Data Processing

After data collection completion from the entire household, we reviewed all the questionnaires so that they became complete with adequate information. Then, we did the tabulation process to obtain the data, which was very much important for the future analysis and interpretation of data. Coding and editing were done very carefully.

2.11 Data Analysis and Interpretation for Presentation

We followed simple descriptive statistics for data analysis. The result was analyzed by using SPSS (21 version) and Microsoft Excel-2007. MS Word and PowerPoint were also used for documentation and presentation of data. It was presented using bar graphs, pie charts, line graphs, Venn-diagram, and the table, based on the finding of our study.

2.12 Validity and Reliability

Different measures were adopted to make the community diagnosis more valid and reliable. The maintenance of accuracy, quality, and appropriateness of study procedure are important and for this validity and reliability of procedures to be assured. It was done in the following ways:

Three days of practice and other general classes were conducted on various aspects of community health diagnostics such as CHD methods and procedures, potential problems, and their solution by professional teachers and senior students. PRA classes are also held to help students. Rechecking and pretesting of questionnaires, including observational checklists was done by the subject teacher, principal, HOD, and senior students of the college. Pretesting of survey instruments like MUAC tape, weighing balance, measuring tape, etc. was done to determine the practicability of the tools in the field. The complete procedure and method of modeling were strictly followed when calculating sample size to reduce bias and errors in the study. During the data collection, the simple and understandable language was used as much as possible to obtain the correct response from the respondent. It is designed to reduce the bias of the respondents. Regular group meetings were held every three days to reduce their problems and findout immediate solutions to better align with team members, which helps to avoid work stress and bias in the group member. Also, a general discussion of the questionnaire before and after data collection, data planning, and a daily discussion of the process was followed to eliminate potential errors. Literatures review was done over and over again to avoid confusion in the group. Various publications available online were searched and read as evidence. Monitoring and Evaluation: Regular guidance and supervision were provided to faculty teachers during the public health examination .

2.13 Literature Review

The literature review is an important part of any research study. So, the literature reviewing was taken as an integral part of our research study as well. It helps us to be clear in any confusion during the CHD process and improve the methodology.

2.14 Budget and Time Schedule

The total budget of community health diagnosis was self-managed by the group members besides, the stationary provided by the campus. The total time period for the community health diagnosis was provided only one month (Magh-23 to Falgun-13).

2.15 Limitations of Our Study

1. The study was limited to analyze only for the health status of the community, environmental sanitation, maternal and child health and other health related knowledge and attitude.
2. Recall bias might be occurred
3. Due to the small sample size, the findings may not be relevant.
4. Due to peak time for constructing houses of earthquake affected area, our respondent could not provide us enough time and participation.
5. The study was done for partial fulfillment of the BPH curriculum.
6. Time and resource constraint.

2.16 Ethical Consideration

1. An approval letter was received from the college.
2. Permission was taken from the ward office of Ward no. 9 Nilkantha Municipality, Dhading district Nepal. Informal consent was also taken before data collection.
3. Privacy and confidentiality were strictly maintained.
4. The rights of the respondent and our limitation to the respondent were always taken into a consideration.

2.17 Source of Data

a) Primary data

1. Household head
2. Community leaders
3. FCHVs and mother group

b) Secondary data

1. Ward office
2. Health post

2.18 Operational Definition

It includes the meaning of keywords that had been used during community health diagnosis which helps to clarify the confusion of used important words of definition during our field study.

Household: Those who dwell under the same roof and compose as a family.

Educational status:

1. Illiterate: Who cannot read and write.
2. Informal: Education without going to school.
3. Primary level: Who can read and write and who has not gained more than five classes (Formal education).
4. Lower secondary: Those who gained 6 to 8 class formal education.
5. Secondary level: Those who gained 8 to 10 classes of formal education.
6. Higher secondary level: Those who have gained 11 to 12 formal education.
7. Above higher secondary: Those who have study more than certificate level.

Environmental condition around the home:

1. Clean: Waste disposal in a fixed place and no waterlogged area around the home.
2. Medium: Inadequate management of water but no foul smell around the home.
3. Dirty: Water is thrown around the home and bad smell and there may be a waterlogged area around the home.

The light inside the home:

1. Sufficient: At least one or two windows in a home.
2. Insufficient: Either without any windows or small windows.

Types of toilet:

1. Kachhi: Made up of mud, raw materials, and a dry grass roof.
2. Pakki: Made up of cement.
3. Kachhi-pakki: Mix of both types of materials used.

Housing condition:

1. Kachhi: Made up of mud, raw materials, and a dry grass roof.
2. Pakki: Made up of cement.
3. Kachhi-pakki: Mix both types of materials used.

CHAPTER III: FINDINGS

3.1 Demographic Characteristics

The population pyramid clearly shows the age and demographics of people, by showing the numbers or ratings of male and female in each group, which gives a clear picture of the demographic characteristics. The total age group for both groups is about 100 percent of the population. Pyramid of the people of Ward no. 09, Nilkantha Municipality shows that people between the ages of 0-9 and 10-19 years are less than the age of 20-29. It can indicate a high fertility rate.

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Figure 1: Population Pyramid

The female population of the age group of 30-35 is less in comparison to the other age group. It may be due to various complications to the mother during childbearing. Likewise, the female population tends to be a little bit higher than males in the age group above 60 years. It indicates that the life expectancy of the female is slightly higher than the male. This pyramid resembles the pyramid of developing countries that means more people in the younger age group i.e. dependency ratio is high.

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Figure 2: New Born Baby within a Year

Among 27 newborn babies within a year, the percentage of newborn male babies is significantly higher (59.26%) in comparison to the percentage of the newborn female baby (40.74%). It indicates more priority is given to the male than female in every family of Nilkantha 9, Municipality.

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Figure 3: Birth Registrated Child

Among the 27 infants born in a year, the majority (66.67%) of a child born in the year was registered with a birth certificate while the minority (33.33%) of a child born is not registered with a birth certificate. It shows that still most of the children do not register their birth in a year.

Among 268 households, most of the respondent person during our data collection was household head i.e. 47.80%, and about 43.30% were household head’s wife/husband where 9% were others that include household head’s son, daughter and daughter in law and other relatives.

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Figure 4: Cast of the respondents

Figure 5: Migrated Population

Among the 122 respondents, the percentage of temporary migration was found to be higher than the percentage of permanent migration. People have been relocated to job opportunities, education, health services, and other institutions. In the same way, between total migration, the male migration rate of 4.10% is greater than the female migration rate of 0.82% and during the interim migration, the migration rate of 63.11% is also higher than the female migration rate of 31.97% as males were either gone for a job or abroad for foreign employment than females.

Nepal is a land of many languages, religions, and peoples. Caste distribution is a parameter that helps determine social cohesion and organizational basis in the community. The ethnic composition of the people varies greatly between the chosen group. In the sample of the people of 09-Nilkantha Municipality, the majority of the population was Brahmin, which is 33.57%, followed by Dalit (22.05%), and Newar (20.13%), and the minority was Chhetri, which is 4.50%.

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Figure 6: Educational Status of Community

As per the data we collected, most of the population was educated up to a secondary level, which occupies 22.05% among total literates, and the percentage of illiterate was 19.64%. The percentage of people up to S.L.C level is comparably low than other levels (only 6.93%).

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Figure 7: Educational Status of Community

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Figure 8: Occupation of Community’s People

Out of the 1228 total sample populations, most of the population was students and many people are involve in agriculture i.e.24.61% as their main source of income generation. Only 5.40% and 4.47% of total population was involved in business and remittance. So, their economic condition is not good.

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Figure 9: Religion status of Community

Religion is defined as a set of beliefs that guides the people. The result of the survey revealed that (96.02%) majority of the sample populations was Hindu. While 1.03% was Buddhist and 2.95% was Christian.

3.2 Socio-Economic Condition

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Figure 10: Main Source of Income of Household

Out of the 268 total households, majority of the people were involved in agriculture i.e.64.18% as their main source of income generation. People were also found involved in services i.e.9.33%, in labour i.e.16.73% and in business i.e.6.72%. The flow of human resource to foreign countries for employment was also found considerable i.e.2.99%.

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Figure 11: Time duration to consume food production from agriculture

As shown in the above bar diagram, more than half of the household’s production was not adequate for a whole year. About 51% of household’s food year, 12.7%was sufficient for three months, and 3.49% of food production was sufficient for only one month for consumption.

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Figure 12: Decision Making in Home

According to our study, the involvement of male population is higher than female in decision making related to socio-economic activities i.e. 49.63% of ward no.9, Nilkantha municipality while 30.97% female were involved in decision making and 19.40% of the population comprises both male and female who equally involve in decision making related to socio-economic activities at home.

Abbildung in dieser Leseprobe nicht enthalten

Figure 13: Involvement of People in community’s Works

As per the data we collected, it was found that the majority of people i.e.58.96% had less involvement in the community works for its development, only 30.60% of people had more involvement while 10.45% of people had no involvement in any community activities.

Abbildung in dieser Leseprobe nicht enthalten

Figure 14: More involvement of People in community works (Gender Wise)

From above figure, it was found that majority of community development activities were performed by male and female both altogether. Similarly, female alone performed community activity i.e.39.17% and followed by male with 17.50%.

Abbildung in dieser Leseprobe nicht enthalten

Figure 15: Showing status of Yearly Income and Expenses in Medicine

3.3 Environmental Health and Hygiene

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Figure 16: Source of Drinking Water

Tap water was the major source of drinking water for the people of ward no.9 Nilkantha municipality of Dhading district which accounts for the 91.04% of the total sample population and only 5.60% uses dhungedhara and 3.36% uses well as a source of drinking water.

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Figure 17: Distance between house and source of drinking water

According to our study, majority of population i.e.52.60% had taken only 15 minutes to reach at water source and minority of population i.e.1.90% had taken more than one hour to reach at water source. Only 3.40% had drinking water at their own house, 26.10% had taken 20 minutes to reach at water source and 16% had taken 30 minutes to reach at water resource from their house.

[...]

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Details

Title
Community Health Diagnosis, Nilkantha Municipality, Dhading District, Nepal. A Cross-Sectional Study
Course
Public Health
Authors
Year
2018
Pages
93
Catalog Number
V990578
ISBN (eBook)
9783346369741
ISBN (Book)
9783346369758
Language
English
Keywords
Community Health Diagnosis, Community Diagnosis, Nepal, Public Health
Quote paper
Krishna Sharma (Author)Kanchab Khatakho (Author)Beepana Rimal (Author)Devyanee Neupane (Author)Subin Tamang (Author)Dhani Singh Thakuri (Author)Asmit Singh Thakuri (Author)Tulsi Pokhrel (Author)Surendra Kumar Bista (Author)Devki kumara Shah (Author), 2018, Community Health Diagnosis, Nilkantha Municipality, Dhading District, Nepal. A Cross-Sectional Study, Munich, GRIN Verlag, https://www.grin.com/document/990578

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Title: Community Health Diagnosis, Nilkantha Municipality, Dhading District, Nepal. A Cross-Sectional Study



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