CHD Final PowerPoint (ppt)_Group B.pptx

COMMUNITY HEALTH DIAGNOSIS
MANGALA RURAL MUNCIPALITY-01, MYAGDI
GANDAKI PROVINCE
Group: B
Bachelor of Public Health, 6th Semester
School of Health and Allied Sciences
Pokhara University
2021

S.N Name Roll No.
1. Bikram Singh Dhami (Leader) 18370011
2. Aarati K.C. (Vice-Leader) 18370002
3. Aayasha Bhattrai 18370003
4. Anita Pokhrel 18370005
5. Durga Shrestha 18370015
6 Niraj Nagarkoti 18370022
7 Pratima Gahatraj 18370029
8. Rama Paudel 18370031
9. Samjhana Rahibhat 18370034
10. Sushmita Adhikari 18370038
School of Health and Allied Sciences
BPH 6th Semester, Pokhara University, 2021
Group Members [Group-B]
2 August 2022 2
COMMUNITY HEALTH
DIAGNOSIS_Magala Rural Municipality-01,
Myagdi

Introduction
• Community Health Diagnosis is process of
identification and quantification of health problem
within certain community prioritize them and try to
solve them with the use of local resource.
• A comprehensive assessment of the health status of
an entire community in aspect to its social, physical
and biological environment.
• A process of examining the patterns of disease or
health status of the community in order to promote
health, prevent disease and manage services for the
community.
2 August 2022 3
COMMUNITY HEALTH
Myagdi

Contd…
The focus of community diagnosis is on
1. Identification of basic health needs
2. Identification of health problems and different
determinants that affects the health of community
peoples
3. Assist the community to promote their health by
modifying the KAP regarding their health with
their own active participation
2 August 2022 4
COMMUNITY HEALTH
Myagdi

Community Profile
• Location: Gandaki province, Mangala Rural
Municipality-01, Myagdi
• Major ethnic group: Janjati (Magar) & Dalit
• Main Religion: Hindu
• Major Occupation: Agriculture & Foreign
employment
• Social Organization: Schools, Mothers Group,
Youth Club, Community Forest Committee, Health-
post and Coordination Organizations
2 August 2022 5
COMMUNITY HEALTH
Myagdi

Study Location
Mangala RM-01, Kunhun Mangala RM-01, Purngaun
2 August 2022 6
COMMUNITY HEALTH
Myagdi
Social Mapping, Mangala RM-01

Objectives
General Objective
To assess the current health status of the people of
Mangala Rural Municipality ward-01, and identify
the health needs with an appropriate intervention with
the cost-effective and locally available resources.
2 August 2022 7
COMMUNITY HEALTH
Myagdi

Objectives
Specific Objectives
• To determine the demographic structure of the
community
• To assess the KAP regarding various diseases,
Maternal & child health and family planning
• To assess the environmental status of the
community
• To measure and categorize the blood pressure of the
respondents
• To identify Nutritional status of community people
2 August 2022 8
COMMUNITY HEALTH
Myagdi

Contd…
• To find out the accessibility and utilization of the
existing health services
• To identify and mobilize the existing potential local
resources
• To prioritize the identified health problems and
assess the needs
• To conduct the MHP and to offer realistic
recommendations in order to improve health status
of community
2 August 2022 9
COMMUNITY HEALTH
Myagdi

Methodology
• Study area: Mangala Rural Municipality-01,
Myagdi, Gandaki Province
• Study Design: Descriptive cross-sectional Study
design was adopted including both quantitative and
qualitative method for collecting informations
• Sample Size: Sample size was 400
• Study Duration: one month (29th Chaitra, 2077 to
27th Baisakh, 2078)
• Unit of Analysis: Households and Individuals
2 August 2022 10
COMMUNITY HEALTH
Myagdi

Contd…
• Sampling Technique: Stratified proportionate
Sampling followed by Simple random sampling
• Source of Data: Primary and Secondary data was
used in this study
Sources of Data:
1. Primary source: Semi-structured Interview,
Observation, FGD and KII
2. Secondary Source: OPD register,Ward office
report
2 August 2022 11
COMMUNITY HEALTH
Myagdi

Contd…
• Selection criteria:
1. Inclusion criteria:
• Respondents: People of age (18 to 65)
• Maternal & child Health- Pregnant
women/Mother of U5 children and U5 childrens
• Family planning: Eligible couple of 15-49 years
• Immunization information: Children of less than
2 years
2 August 2022 12
COMMUNITY HEALTH
Myagdi

Contd…
2. Exclusion criteria
• People with severe mental illness who are not able
to respond to question asked, hearing and speaking
inability
• Peoples who were recently immigrated to
community (Within past 6 months)
• People who were drunk at the time of interview
2 August 2022 13
COMMUNITY HEALTH
Myagdi

Data Collection Tools and Techniques
Data Collection
Techniques
 Personal Interview
 Focus Group
Discussions [FGD]
 Key Informant
Interview [KII]
 Record review
 Observation
2 August 2022 14
COMMUNITY HEALTH
Myagdi
Data Collection Tools
 Semi-structured
questionnaire
 FGD guideline
 KII Guideline
 Record review format
 Observation checklist
 PRA/PLA

Contd…
Data processing and Analysis
• The collected data were entered in EpiData (v3.1)
and all entered data were transferred into Statistical
Package for Social Sciences (SPSS v21) for further
analysis.
• Descriptive statistics was used and data were
presented on table, bar diagram and pie chart.
Beside this, qualitative data were presented in
narrative form.
2 August 2022 15
COMMUNITY HEALTH
Myagdi

Contd…
Logistics of CHD
The university provided with necessary stationery
along with the transportation services.
2 August 2022 16
COMMUNITY HEALTH
Myagdi

Contd…
Limitations:
• Detailed information may not be extracted due to
limitation in questionnaire
• Results from this study cannot be generalized to
other communities
2 August 2022 17
COMMUNITY HEALTH
Myagdi

Socio-Demographic Information
Socio-demographic information relates to different
demographic and social aspects such as occupational status,
source of income of households, religions, ethnicity, alcohol
consumption, smoking habit etc. This section helps to point
out the different status related to population distribution,
population growth rate and other mortality status.
2 August 2022 18
COMMUNITY HEALTH
Myagdi

Type of family
61%
37%
2%
(N=400)
Nuclear
Joint
Extended
2 August 2022 19
COMMUNITY HEALTH
Myagdi

Main Source of Income
51.00
12.30
7.30 6.00
2.80
20.80
0
10
20
30
40
50
60
Agriculture Services Business Labour Pension Foreign
employment
Percentage
(%)
Source of Income
(N=400)
2 August 2022 20
COMMUNITY HEALTH
Myagdi

Population Pyramid
15% 10% 5% 0% 5% 10% 15%
Less than 4
4-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
More than 60
(N=1800)
Female (%) Male (%)
2 August 2022 21
COMMUNITY HEALTH
Myagdi

Health Education
This section of questionnaire is designed in a way wo measure
the people’s knowledge, attitude and practice related to
different communicable and non communicable diseases like
Tuberculosis, Hypertension, Diabetes, Diarrhoea, Uterine
Prolapse etc including mental health and mental illness.
2 August 2022 22
COMMUNITY HEALTH
Myagdi

Heard about COVID-19
97%
3%
(N=400)
Yes
No
2 August 2022 23
COMMUNITY HEALTH
Myagdi

Knowledge on preventive measures of
COVID-19
73.6
68.1
50.5
11.9 10.6
0
10
20
30
40
50
60
70
80
Use mask and
sanitizer
Washing hands
regularly
Maintain social
distance
Not going out
unnecessarily
Others
Percentage
(%)
Preventive Measures of COVID-19
(N=387)
*Multiple Response item
2 August 2022 24
COMMUNITY HEALTH
Myagdi

Heard about Tuberculosis
54%
46%
(N=400)
Yes
No
2 August 2022 25
COMMUNITY HEALTH
Myagdi

Knowledge on causes of Tuberculosis
47
27.4
11.2
1.4
27
0
5
10
15
20
25
30
35
40
45
50
Smoking an
alcoholism
lack of sanitation
ang hygiene
Microorganism Gods curse Others
Percentage
(%)
Causes of TB
(n=217)
2 August 2022 26
COMMUNITY HEALTH
Myagdi

Knowledge on preventive measures of
Tuberculosis
31.3
18.9
15.7
10.6
6
39.6
4.1
0
5
10
15
20
25
30
35
40
45
Patient
should cover
mouth and
nose while
coughing
Taking
precautions
while in
contact with
TB patient
BCG
vaccination
Well
ventilated
rooms
Intake of
Balanced diet
Don't know Others
Percentage
(%)
Preventive measure of TB
(n=217)
2 August 2022 27
COMMUNITY HEALTH
Myagdi

Knowledge on severe symptoms of
Diarrhoea
35.5
24.5
22.06
17.16
13.5
2.9
8.17
0
5
10
15
20
25
30
35
40
Tiredness Cold hand
and feet
Loose stool Abdominal
Pain
Dryness of
tongue
Loss of skin
elasticity
Others
Percentage
(%)
Knowledge on symptoms of Diarrhoea
(N=400)
2 August 2022 28
COMMUNITY HEALTH
Myagdi

Knowledge on prevention of
Hypertension
65.7
29.2
18.2 17.3
4.3
23.1
6.7
0
10
20
30
40
50
60
70
Percentage
(%)
Preventive measures of HTN
(n=329)
2 August 2022 29
COMMUNITY HEALTH
Myagdi

Status of systolic BP among
respondents
19%
73%
8%
(n=232)
Low Systolic BP
Normal Systolic BP
High Systolic BP
2 August 2022 30
COMMUNITY HEALTH
Myagdi

Heard about Uterine prolapse
96%
4%
(N=400)
Yes
No
2 August 2022 31
COMMUNITY HEALTH
Myagdi

Knowledge on prevention of Uterine
prolapse
87.7
43.3
1.9 1.9
7.5
0
10
20
30
40
50
60
70
80
90
100
Not carryong
heavy loads
Giving birth to less
amount of children
Controlling
overweight
Don't Know Others
Percentage
(%)
Preventive measures of Uterine prolapse
(n=279)
2 August 2022 32
COMMUNITY HEALTH
Myagdi

Heard about Diabetes
66.30%
33.80%
(N=400)
Yes
No
2 August 2022 33
COMMUNITY HEALTH
Myagdi

Knowledge on Prevention of Diabetes
78.9
25.3
16.5
13.4
8.2
0.5
7.7
0.5
0
10
20
30
40
50
60
70
80
90
Reduce
consumption
of High sugar
Taking care
with
increasing age
Regular
Physical
Activities
Consume
Fruits
Avoid
Alcoholism
Worship Gods
and goddess
Others Don’t know
Percentage
(%)
Preventive Measures of Diabetes
(n=265)
2 August 2022 34
COMMUNITY HEALTH
Myagdi

Heard about Asthma
65.50%
34.50%
(N=400)
Yes
No
2 August 2022 35
COMMUNITY HEALTH
Myagdi

Knowledge on prevention of Asthma
66.2
28.1
21.3
11.8
9.5
4.2
21.3
0
10
20
30
40
50
60
70
Avoid
escessive
exposure to
dust and dirt
Avoid
Smoking
Use of
smokeless
stove
Intake of
Balanced
Diet
Rational use
of drugs
Others Don’t Know
Percentage
(%)
Preventive measure of Asthma
(n=262)
2 August 2022 36
COMMUNITY HEALTH
Myagdi

Heard about Mental illness
49%
51%
(N=400)
Yes
No
2 August 2022 37
COMMUNITY HEALTH
Myagdi

Knowledge on Signs and Symptoms of
Mental Illness
60.7
19.9
14.8
11.2
16.2
0
10
20
30
40
50
60
70
Mood swings Excessive Fear Change in eating
and sleeping
pattern
Dilemma Others
Percentage
(%)
Signs and symptoms of Mental Illness
(n=196)
2 August 2022 38
COMMUNITY HEALTH
Myagdi

Source of Information on Mental
Illness
51.53
41.84
14.28
5.1
10.71
0
10
20
30
40
50
60
Percentage
(%)
Source of Information
(n=196)
2 August 2022 39
COMMUNITY HEALTH
Myagdi

Food Supply and Nutrition
In this section, We had tried to understand people’s food
behavior and feeding pattern. Also, Nutritional status of
children and adults of respective community.
2 August 2022 40
COMMUNITY HEALTH
Myagdi

58%
42%
(N=400)
Yes
No
Knowledge on balanced diet
2 August 2022 41
COMMUNITY HEALTH DIAGNOSIS_Magala
Rural Municipality-01, Myagdi

36%
64%
(N=400)
Yes
No
Knowledge on preparation of
Sarbottam Pitho/Lito
2 August 2022 42

93.75
3.75 2
0
10
20
30
40
50
60
70
80
90
100
Six month >6month <6month
Percentage
(%)
Time period
(N=400)
Knowledge on time for exclusive
Breastfeeding
2 August 2022 43

82.25
13.5
1.75 2.5
0
10
20
30
40
50
60
70
80
90
More then usual As usual Less than usual don’t kmow
Percentage
(%)
Frequency of feeding
(N=400)
Feeding pattern during pregnancy
and lactating period
2 August 2022 44

Result of Anthropometric
Measurement
S.N BMI Range Frequency
Percentage
(%)
1. <18.5 7 2.90
2. 18.5-24.9 170 70.54
3. 25.0-29.9 50 20.75
4. 30 or More 14 5.81
2 August 2022 45

Weight of child at the time of Birth
6%
94%
(n=78)
Less than 2500 gm
2500 gm and More
2 August 2022 46
COMMUNITY HEALTH
Myagdi

Safe water and Sanitation
This section is designed to know the status of safe water and
basic sanitation. This section includes Availability of drinking
water, source of drinking water, community practice regarding
water purification and waste disposal.
2 August 2022 47
COMMUNITY HEALTH
Myagdi

Source of Drinking water
82
10.5
5.25
2.25
0
10
20
30
40
50
60
70
80
90
Tap Public Tap Natural Source Khola
Percentage
(%)
Sources of Drinking water
(N=400)
2 August 2022 48
COMMUNITY HEALTH
Myagdi

59%
41%
(N=400)
Yes
No
Purification of water before
drinking
2 August 2022 49

Methods of water purification
employed
53 53
9.4
2.1
0
10
20
30
40
50
60
Boiling Filtration (Using
filter/Cloths)
SODIS Chlorination
Percentage
(%)
Purification Methods
(n= 235)
2 August 2022 50
COMMUNITY HEALTH
Myagdi

Pot used for water storage
37.7
25.3
17.1
14.1
5.8
0
5
10
15
20
25
30
35
40
Gagri Copper Vessel Bottle Bucket Clay pot
Percentage
(%)
Types of Pot
(N=400)
2 August 2022 51
COMMUNITY HEALTH
Myagdi

Type of cooking fuel
93.5
65.4
1.5 0.8
0
10
20
30
40
50
60
70
80
90
100
Fire woods LPG Biogas Stove
Percentage
(%)
Source of fuels
(N=400)
2 August 2022 52
COMMUNITY HEALTH
Myagdi

Management of degradable waste
86.8
9.9
3.3
0
10
20
30
40
50
60
70
80
90
100
Burrying Composite Manure Feeding to animals
Percentage
(%)
Method of degradable waste disposal
(n= 361)
2 August 2022 53
COMMUNITY HEALTH
Myagdi

Maternal and Child Health
In this section, we had focused on the ANC and PNC
visit of mother of under 5 years aged children along
with their status of completion of respective visit.
2 August 2022 54
COMMUNITY HEALTH
Myagdi

Age of mother at the time of first
pregnancy
69%
31%
(n=84)
Less than 20 years
More than 20 years
2 August 2022 55
COMMUNITY HEALTH
Myagdi

Source of Information of ANC Check
among Mother of U5 Children
71.43
15.58
10.39 10.39
6.49 5.19
15.58
0
10
20
30
40
50
60
70
80
Percentage
(%)
Source of Information
(n=77)
2 August 2022 56
COMMUNITY HEALTH
Myagdi

Knowledge on Reasons for ANC
Check-up
64.9
33.8
29.9
19.5
14.3
0
10
20
30
40
50
60
70
To find out condition
of foetus
Iron tablet T.D Vaccination Intake of folic Acid To findout
complications
Percentage
(%)
Reasons for ANC Check-up
(n=77)
2 August 2022 57
COMMUNITY HEALTH
Myagdi

ANC check-up during last pregnancy
97%
3%
(n=77)
Yes
No
2 August 2022 58
COMMUNITY HEALTH
Myagdi

Times of ANC Check-up done during
last pregnancy
55%
14%
31%
(n=77)
4 Times
Less than 4 Times
More than 4 times
2 August 2022 59
COMMUNITY HEALTH
Myagdi

Place of delivery of recent child
87%
7%
6%
(n=77)
Government HF
Private HF
Home
2 August 2022 60
COMMUNITY HEALTH
Myagdi

Visit for PNC Check-up
45%
55%
(n=77)
Yes
No
2 August 2022 61
COMMUNITY HEALTH
Myagdi

Place of PNC Check-up
65.7
14.3
11.4
5.7
2.9
0
10
20
30
40
50
60
70
Health post PHC-ORC FCHV (Home
Visit)
Hospital Others
Percentage
(%)
Health facility
(n=35)
2 August 2022 62
COMMUNITY HEALTH
Myagdi

Frequency of Diarrhoea among U5
children within past one year
70
11 10.3
5.95
3.57
0
10
20
30
40
50
60
70
80
Never 1 times 2 times 3 times 4 & >4 times
Percentage
(%)
Frequency of Diarrhoea
(n=84)
2 August 2022 63
COMMUNITY HEALTH
Myagdi

Family planning
In this section we tried to assess the people’s knowledge and
practice regarding the family planning and contraceptive
methods.
2 August 2022 64
COMMUNITY HEALTH
Myagdi

Heard about Family planning
70%
15%
15%
(n=287)
Yes
No
No Response
2 August 2022 65
COMMUNITY HEALTH
Myagdi

Methods of family planning used by
eligible respondent/Couples
40
22
12
10
7
5 4
0
5
10
15
20
25
30
35
40
45
Dipo Condom Norplant Pills Male
sterilization
Female
sterilization
IUCD
Percentage
(%)
Methods of Family planning
(n=100)
2 August 2022 66
COMMUNITY HEALTH
Myagdi

Side effects of family planning
Methods
29.03
25.8
22.58 22.58
12.9
0
5
10
15
20
25
30
35
Change in Weight
(Gain/Loss)
Heavy bleeding Tiredness Headache Others
Percentage
(%)
Side effects
(n=31)
2 August 2022 67
COMMUNITY HEALTH
Myagdi

Unmet need for family planning
24%
76%
(n=91)
Yes
No
2 August 2022 68
COMMUNITY HEALTH
Myagdi

Observation Checklist
The surrounding environment along with the normal standard
of housing of each household we visited was observed in order
to find out the living condition of the village people.
2 August 2022 69
COMMUNITY HEALTH
Myagdi

6%
31%
63%
(N=400)
Kachhi
Pakki
Kachhi-Pakki
Type of house
2 August 2022 70

62.90
21.30
13.30
1.00 0.30 1.30
0
10
20
30
40
50
60
70
Percentage
Type of fuel
(N=400)
Type of major cooking fuel
Type of major Cooking Fuel
2 August 2022 71

Surrounding Environment
9%
91%
(N=400)
Dirty
Clean
2 August 2022 72

Type of Toilet Facility
95.31
2.9 1.04 0.8
0
20
40
60
80
100
120
With flush (Septic
Tank)
SImple With flush (Sewage) Public Toilet
Percentage
(%)
Type of Toilet
(n=384)
2 August 2022 73
COMMUNITY HEALTH
Myagdi

Focus Group Discussions
Topic: Child Marriage
Objectives:
• To understand the major causes of child marriage
from under 20 years girls and Mothers group
perspective
• To explore knowledge and perception about
consequences and preventive measures of child
marriage among both the groups.
2 August 2022 74
COMMUNITY HEALTH
Myagdi

Contd…
1. Focus Group- I Girls of age less than 20 years
• Number of participants: 10
• Age group: 15-20 years
• Time: 12:30 to 1:30 (18th Baisakh)
• Location: Nar Singh Basic School Payupata,
Mangala RM-01, Myagdi
2. Focus Group- II Mother’s Group
• Number of participant: 12
• Target population: Mothers
2 August 2022 75
COMMUNITY HEALTH
Myagdi

Contd…
• Time: 11:30 to 12:30 (18th Baisakh)
• Location: Samaj Kalyan Youth Club’s Hall
Conclusions:
1. The major cause of child marriage is
love/attraction happened at adolescent period
which is encouraged by use of mobile phones.
2. Most of the participants were aware about the
consequences of the child marriage.
3. There was poor knowledge on laws related to
child marriage.
2 August 2022 76
COMMUNITY HEALTH
Myagdi

Need Identification and Prioritization
• Prioritization of actionable program for intervention
was done by prioritization tool pair wise ranking to
select major health problems in the coordination of
FCHVs, health workers, teachers, Local leaders and
community member.
2 August 2022 77
COMMUNITY HEALTH
Myagdi

FELT NEEDS
1. Personal Hygiene
and sanitation
2. Waste Management
3. Purity of drinking
water
4. Alcoholism,
Smoking and
Tobacco
consumption
5. Road
6. Hypertension
7. Overweight and
Obesity
8. Child Marriage
9. Early Pregnancy
10. Knowledge on
NCDs
11. Mobile Addiction
REAL NEEDS
1. Child Marriage
2. Personal Hygiene
and Sanitation
3. Hypertension
4. Alcoholism,
smoking and
tobacco
consumption
5. Overweight and
Obesity
6. Knowledge on other
NCDs
OBSERVED
NEEDS
1. Child Marriage
2. Personal Hygiene
and Sanitation
3. Waste Management
4. Hypertension
5. Alcoholism,
smoking, tobacco
consumption
6. Overweight and
Obesity
7. Knowledge on TB
8. Knowledge on
NCDs
2 August 2022 78
COMMUNITY HEALTH
Myagdi

Pair wise Ranking
S.N Health Issue 1 2 3 4 5 6 7 Total
1. Child Marriage 2 1 1 1 1 1 6
2. Personal hygiene
and sanitation
2 4 2 2 2 6
3. Smoking/Alcoholism 4 5 3 7 2
4. Hypertension 4 4 4 6
5. Overweight and
obesity
5 5 4
6 Uterine prolapse 6 2
7. Knowledge on NCDs 1
2 August 2022 79
COMMUNITY HEALTH
Myagdi

Prioritization Scheme
Child
Marr
iage
Person
al
hygien
e and
sanitat
ion
Smoki
ng/Alc
oholis
m
Hypert
ension
Overwe
ight and
Obesity
Uterine
prolaps
e
Kno
wled
ge on
NCD
s
Resources ++ +++ + ++ + + +
Our
knowledge
+++ +++ + + ++ ++ ++
Cost-
effectivene
ss
+++ ++ + + + + +
Communit
y concern
+++ ++ + ++ + + ++
2 August 2022 80
COMMUNITY HEALTH
Myagdi

Child
Marri
age
Perso
nal
hygien
e and
sanitat
ion
Smo
king/
Alco
holis
m
Hyper
tensio
n
Over
weigh
t and
Obesi
ty
Uterin
e
prola
pse
Poor
knowl
edge
on
NCDs
Sustainability ++ ++ + + + + +
Magnitude of
problem
+++ ++ + + + + +
Severity of
Problem
+++ + ++ +++ ++ + +
Total Score 19 15 8 11 9 8 8
Rank 1 2 5 3 4 7 6
Note- 3+ for Highest and 1+ for lowest, 1(+)= 1 Score
2 August 2022 81
COMMUNITY HEALTH
Myagdi

Micro Health Project
It is a small project which demonstrates the method of
solving problems of community by developing
awareness and by maximum utilization of local
resources.
For this we had been through these steps
Health Need Assessment and prioritization
1. MHP planning
• Child Marriage awareness program by Mini Lecture
and Drama on Child Marriage
• Blood pressure and Anthropometric Measurement
along with counseling
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Contd…
2. Implementation of MHP
• Blood pressure and Anthropometric measurement
and provided people with a Health Card
mentioning their status with counselling on the site
• A one hour session in the mothers group meeting for
increasing awareness on child marriage through
Mini Lecture
• Drama on Child Marriage
3. Evaluation
• Evaluation at different stages MHP
• Feedback from the stakeholders and participant
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Contd…
Sustainability of MHP
• A commitment from the stakeholders and the health
workers to conduct Blood Sugar Measuring and
regularly monitoring the blood pressure and for
child marriage prevention commitment from
mothers group not to attend marriage of under 20
and a committee of adolescents girls was made
during FGD to monitor the situation and prevent
child marriage.
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Discussion (Major Indicators)
Indicator Community
(%)
National
(%)
1. Crude Birth Rate 20 19.58
2. Crude Death Rate 6.11 6.29
3. Dependency Ratio 31.77 53.0
4. Household with ill
Members
12.8 -
5. Institutional Delivery 87 76
(Annual report, 2019/20)
6. Unmet need of Family
planning
24 23.7
(NDHS 2016)
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Discussion
• In this study, female member (50.20%) was slightly
higher than male member (49.80%) as already been
observed in various studies 1,2.
• This study showed proportion of productive age
group (61.28%) which is slightly higher than
findings from Household survey 2015/16 2
.
• Percentage who currently use tobacco (16.32%)
which was less than STEPS Survey 2019 3 and
current alcohol drinker were (15.43%) which was
also less than STEPS Survey 2019 (23.9%) 3.
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Contd…
• A study conducted by Sharecast Initiative on March
2020 and our study showed almost similar
proportion of participant had heard about COVID-
19.4
• Fifty-four percent of respondent had heard about
tuberculosis among them one third respondent had
misconception that TB is non-communicable
disease. Least respondent were aware about DOTS
• More than two third (73.73%) respondents knew
that Tuberculosis is curable disease which is slightly
less than a study conducted by.5
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Contd…
• Majority (82.3%) of respondent had heard about
Hypertension among them almost two third of
respondent reported consumption of high amount of
salt as the risk factor of hypertension.
• Mean Systolic Blood Pressure (SBP) was 119.40
mm Hg (SD + 18.003) and mean Diastolic Blood 81
Pressure (DBP) was 76.81 mm Hg (SD + 12.22)
which is almost similar to a study conducted by
(Neupane, et al., 2017).6
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Contd…
• More than two third respondent reported that they
had heard about uterine prolapse which is higher
than the study conducted by (Shrestha, et al., 2014)
i.e 47.1%.7
• Proportion of institutional delivery was 87% which
is higher than the finding from annual report
2075/76 and PNC also higher than national figure.8
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Conclusion
• The proportion of male and female were almost
equal where male to female ratio is 0.99. Major cast
Janjati followed by Dalit.
• Majoirity of people had heard about HTN, Diabetes,
Heart disease but were quite unaware about its
complications. Likewise, majority of people had
heard about tuberculosis but were quite unfamiliar
with DOTS. People tend to visit health post rather
than traditional healers like Dhami and Jhakri which
is good practice.
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Conclusion
• The Environmental status/situation is considerably
well. The only problem is of proper non degradable
waste disposal.
• Proportion of high SBP (8.2%) and high DBP
(7.8%) is found almost equal.
• People were quite aware about the need and
importance of ANC and PNC checkup.
• We identified different local resources and utilized
as per need.
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Conclusions
• We identified the real need of community and
prioritize it by prioritization tool pair wise ranking.
To solve the problem, we conducted MHP on Blood
pressure and Anthropometric measurement and
child marriage.
• Finally, we would like to conclude that the health
and nutritional status of community need to be
improved. People should focus on personal hygiene.
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Recommendations
To Health-post
• It would be better if preventive approached
awareness programs focusing on NCDs.
• Free essential drugs and services should be clarified
to community to reduce the level of dissatisfaction.
To Ward office
• Rural Municipality should do the provision of waste
management
• Dietary diversity should be promoted
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Contd…
• Ward office should discourage high alcohol
production within ward.
To college
• It would be better if regular supervision and
guidance should be provided through CHD period.
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Learning Experiences
1. Academic:
• CHD make us realize practical field exposure is
essential to support theoretical knowledge.
• Interlink various disciplines
2. Professional:
• Help to identify community health problem and
prioritize them to take health action to solve the
problem
• Helped to understand value of time and work
scheduling
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Learning experiences
• Helped to learn how to communicate with
community effectively
• CHD taught us the importance of equitable
distribution of Health and other services.
• Effective coordination and cooperation within
different organizations and government agency is
essential.
3. Personal:
• Better operation of Data management software
(SPSS, EpiData)
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Learning experinces
• Communication and Networking skills
• Leadership and Team work
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References
1. Central Bureau of Statistics - National Planning Commission Secretariat,
Government of Nepal, 2011. Nepal - National Population and Housing Census
2011, Kathmandu, Nepal.
2. Central Bureau of Statistics - National Planning Commission Secretariat,
Government of Nepal, 2016. Nepal - Annual Household Survey 2015-2016,
Kathmandu, Nepal.
3. Dhimal, M. et al., 2019. Non-communicable Disease Risk Factors: STEPS
Survey 2019, Kathmandu: Nepal Health Research Council.
4. Adhikari, R., Acharya , M. & Chapagai, B., 2020. Nepali Times. [Online]
Available at: https://www.nepalitimes.com/latest/awareness-high-among-
nepalis-aboutvirus/ [Accessed 17 05 2021].
5. Bhatt, C., Bhatt, A. & Shrestha, B., 2010. Knowledge of Tuberculosis treatment
- A Survey Among Tuberculosis Patients in (DOTS) Program in Nepal. SAARC
Journal of Tuberculosis, Lung Diseases and HIV/AIDS, 7(2), pp. 10-14.
6. Neupane, D. et al., 2017. Awareness, Prevalence, Treatment, and Control of
Hypertension in Western Nepal. American Journal of Hypertension, 30(9
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References
7. Shrestha, B. et al., 2014. Knowledge of uterine prolapse among married
women of reproductive age in Nepal. International Journal of Women's Health
, Volume 6, pp. 771- 779.
8. Department of Health Services, 2077. Annual Report 2075/76 (2018/19),
Kathmandu, Nepal: Department of Health Services, MoHP- Government of
Nepal.
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Annexes
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1. Work plan

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2. Social Mapping
Social Mapping, Mangala Rural Municipality-01

Photo
GALLERY
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Departure to community (2077/12/29)
Departure from community (2078/1/27)
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Social Mapping [2077/12/29], Ward Office, Mangala RM-01
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First Community Presentation (Ward Office, Ward-1)
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FGD I Mother's Group, Samaj
Kalyan Youth Club Hall, Payupata
FGD II (Child Marriage), Under 20 years
girls, Narsingh Basic School, Payupata
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Final community presentation (2078/1/23), Deepshikha Secondary School,
Kuhun Myagdi
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Farewell (Group member with Stakeholders and Health post staffs)
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CHD Final PowerPoint (ppt)_Group B.pptx

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CHD Final PowerPoint (ppt)_Group B.pptx