This is a brief presentation about the findings we got and programs we conducted during our 17 days long Community Health Diagnosis in Panchkhal-6-Kavrepalanchowk.

1. COMMUNITY HEALTH
DIAGNOSIS
PANCHKHAL WARD NO. 6
Presented By:
Group B
Eighth Batch, NAIHS-COM
Roll no:8021,8023,8025,8029-8050 110/5/2019

2. COMMUNITY HEALTH DIAGNOSIS
Community health diagnosis is a comprehensive assessment of
health status of the community in relation to its social, physical and
biological environment.
“Community health diagnosis is a quantitative and qualitative
description of the health of citizens and the factors which influence
their health. It identifies problems, proposes areas for improvement
and stimulates action.” –WHO
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3. GENERAL OBJECTIVES OF CHD
• To advocate about community health with concerned
authority for the best outcome
• To enable students to get information related to health and
health-related determinants
• To study about community profile in relation to health,
demography and socio-economic status
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4. SPECIFIC OBJECTIVES
• Communication with the people in relation to the health problem in
the community in socio-cultural context of the community
• Apply different methods to collect data required for community
diagnosis
• Use different tools of data collection that s required for community
diagnosis
• Analyze and interpret data to identify the problems and ways of their
solution in the community
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5. SPECIFIC OBJECTIVES
• Prioritize the problems based on the observed and felt needs
• Disseminate the findings through community and college
presentation
• Identify the community resources to address the problems
• Implement a Micro health project based on the prioritization of needs
of the community
• Write a report of community diagnosis 510/5/2019

6. OVERVIEW OF WARD NO. 6
Situated 42 km southeast of Kathmandu
covering a total area of 6 sq. km
Borders:
1.East: Danphe khola , Ward No. 11
2.West: Khawa, Ward no. 5
3.North: Jhiku khola , Ward No. 4 and 7
4.South:Dhulikhel Nagarpalika, Ward No. 11
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7. OVERVIEW OF WARD NO. 6
• Total population: 4077
Males: 1922
Females: 2155
• Major castes: Brahmin, Newar, Danuwar,
Chhetri, Dalit
• Major occupations: Agriculture, Student,
Service, Business
• Major religion: Hinduism and Christianity
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8. METHODOLOGY
• Study design – Descriptive cross-sectional
• Sample selection method - Proportionate systematic sampling
• Study area- Panchkhal, Ward no. 6
• Sample size - 380
• Method of data collection
Qualitative Quantitative
Interview (Open-ended
questions)
Interview (Close-ended questions)
FGD Anthropometry
Observation
• Data Analysis and Interpretation 810/5/2019

9. SOCIAL MAP
9
MAJOR PLACES
1.Tinpiple
2.Dhotra
3.Dulalthok
4.Kafledihi
5.Pipaltar
6.Jhinganpur
7.Dhunganabesi
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10. TOOLS AND TECHNIQUES IN DATA COLLECTION
TECHNIQUE TOOLS RESPONDENTS TOPICS COVERED
Transect walk • Pen
• Paper
• Camera
- • Geographic landmarks
• Settlements
• Road maps and other
infrastructures
Social map • Locally available
resources like red
mud, sand, grass,
twigs , water,
bamboo sticks
• water color, fevicol,
paper, cotton etc.
- • Ethnicity
• Geographic distribution
Temples
• Health institutions like
PHCC,FPAN etc.
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11. TECHNIQUES TOOLS RESPONDENTS TOPICS COVERED
Interview Structured
questionnaire
• Household members
• Mothers of
reproductive age
• Eligible couples
• Adolescent females
• General information
• Family details
• Demographic information
• Socio-economic status
• Gender status
• KAP on health and disease
• Environmental health and hygiene
• Utilization of health facilities
• Maternal and child health
• 24 hour diet recall
• Family planning
• Nutrition and immunization status
of children under 5
• Insecticides/Pesticides
• Menstrual hygiene
• Immediate needs 1110/5/2019

12. Technique Tools Respondents Topics covered
Anthropometry • Salter’s scale
• Weighing machine
• Measuring tape
• Shakir’s tape
Children under 5 years
of age
• Mid-upper arm
circumference
(MUAC)
• Height
• Weight
Observation Observation check list • Housing type
• Floor
• Roof
• Walls
• Stove
• Shed
Focused group
Discussion (FGD)
FGD guidelines FCHV
House-wives
Teachers
Working men
Waste management
and household
cleanliness
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13. DEMOGRAPHIC FINDINGS
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14. DEMOGRAPHIC FINDINGS
Indices Obtained figures (CHD
Survey)
National figures (census
2011)
Households sampled 380 1001
Male 1007 1922
Female 1005 2155
Total population 2012 4077
Sex ratio 101.9 males per 100 females 91.6 males per 100 females
Median age 28 years 21.06 years
Average family size 5.29 individuals per
household
4.88 individuals per
household
Child woman ratio 190.3
Dependency ratio 37.43 63.9
Child dependency ratio 25.54 56.7 1410/5/2019

15. DEMOGRAPHIC FINDINGS
Indices Figures obtained (sample) National figures (Census
2011)
Disability rate 1.84 2.00%
Old age Dependency ratio 12.56 7.21
Crude Birth Rate 19.88 22.17
Crude Death Rate 10.93 6.81 deaths per 1000
population
Infant Mortality Rate 0 46.00 deaths per 1000 live
birth
Literacy Rate 81.21 65.90%
Net Migration Rate 0.49 per 1000 population 0.61 per 1000 population
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16. MORBIDITY
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Hemorrhoids

17. GENDER STATUS
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School enrollment of children10/5/2019

18. SOCIO-ECONOMIC STATUS
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19. KNOWLEDGE, ATTITUDE AND PRACTICE
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20. KNOWLEDGE, ATTITUDE AND PRACTICE
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21. KNOWLEDGE, ATTITUDE AND PRACTICE
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22. KNOWLEDGE, ATTITUDE AND PRACTICE
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23. KNOWLEDGE, ATTITUDE AND PRACTICE
23
Awareness about common diseases
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24. ENVIRONMENTAL HEALTH AND HYGIENE
24Pie chart showing methods of water purification10/5/2019

25. ENVIRONMENTAL HEALTH AND HYGIENE
25Pie chart showing solid waste disposal method Pie chart showing liquid waste disposal method10/5/2019

26. UTILIZATION OF HEALTH FACILITIES
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27. MATERNAL AND CHILD HEALTH
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28. MATERNAL AND CHILD HEALTH
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29. FAMILY PLANNING
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30. IMMUNIZATION STATUS
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Age distribution Immunization status of children under 2 years
TotalBCG DPT-Hep B-Hib OPV FIPV MR JE PCV
6W 10W 14W 6W 10W 14W 6W 10W 9M 15M 12M 6W 10W 9M
0-<1mth 4 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
1-<4mth 7 7 7 7 7 7 7 7 2 2 0 0 0 7 7 7 74
4-<12mth 22 22 22 22 20 22 22 22 4 4 22 0 0 22 22 20 244
12-<18mth 10 10 10 10 10 10 10 10 0 0 10 0 10 10 10 10 120
18-<24mth 23 23 23 23 23 23 23 23 3 3 22 0 23 23 23 23 258
Total 66 66 62 62 60 60 57 55 9 9 38 0 29 59 53 40 700
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31. WATERLOW’S CLASSIFICATION
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32. GOMEZ CLASSIFICATION
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24 HOUR DIET RECALL
27.89%
72.10%
Excess calories Deficient calories
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33. MENSTRUAL HYGIENE
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34. OBSERVATION CHECKLIST
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Bar diagram showing type of stove10/5/2019

35. IMMEDIATE NEEDS
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36. A TALK WITH FEMALE COMMUNITY HEALTH
VOLUNTEER(FCHV)
• Interviewee: Kanchi Maya Poudel
• Age: 52 (married)
• Education: Literate
• Services provided by FCHVs: Family planning services
:Maternal and child health promotion
:Provision of general medicines(Zinc,ORS,etc)
:Health education and referral
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37. PUBLIC PRESENTATION
• Date: 25th Bhadra, 2076
• Venue: Sahakari Hall, Tinpiple
• Time: 8:00 am
• No. of participants: 53
• Tools of communication:
• Audio: microphone and speaker
• Visual: Projected slides, charts, diagrams
• Topics covered: Morbidity, demographic data, Knowledge, attitude and
practice, Environmental health and sanitation, utilization of health
services and use of insecticides
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38. FOCUS GROUP DISCUSSION(FGD)
• Date: 26th Bhadra, 2076
• Venue: Youth club, Tinpiple
• Topic: Waste management and Household cleanliness
• Participants: FCHV, household women, Teachers, Working men
• Rationale: Unscientific waste management system
• Conclusion:
• Lack of awareness and ignorance of authority are the major causes behind
unscientific waste management
• Adoption of sustainable waste management (3R principle) is the solution
to reduce production of waste as well as management of waste in a small
scale
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39. SCHOOL HEALTH PROGRAM
39
Name of school Class Topics
Nava Prativa secondary
school
1. Nursery to class 5
2. Class 8 to 10
1.Oral hygiene
2.Health related quiz
competition
Shree Jorpati secondary
school
Class 8 to 10 1. Adolescent problems
2. Menstrual hygiene
It is a plan of activities prepared on the basis of health interests and needs
of all the students and staffs of the school incorporating health, health
instructions and healthful school environments.
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40. VISIT TO PRIMARY HEALTH CARE CENTER
(PHCC)
• Location: Panchkhal Municipality, Ward 6, Dulalthok
• Established on 2063 BS
• Number of essential drugs available: 58
• Available services: General medicine, antenatal care services, 24
hours delivery services, post-natal care, family planning, DOTS
service, medical abortion, laboratory services, immunization
services, and other emergency services
• Other services: PHC-ORC, EPI-ORC, FCHV trainings
• Number of bed: 3; Number of ambulances: 1
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41. MICRO-HEALTH PROJECT (MHP)
MHP is a small scale specific program designed on the basis of
prioritization of real needs of community and enabling them for wise
utilization of available resources
41
Felt needs Observed needs Real needs
Safe drinking water Safe drinking water Safe drinking water
Transportation Transportation Transportation
Safe use of insecticide Safe use of insecticide Safe use of insecticide
Waste management
and sanitation
Waste management
and sanitation
Waste management
and sanitation
Menstrual hygiene Menstrual hygiene Menstrual hygiene
Availability of medicine
in PHCC
Knowledge on KAP of
disease10/5/2019

42. OBJECTIVES OF MHP
• To promote the safe use of insecticides with the use of PPE
(personal protective equipment)
• To raise awareness about short term and long term effects of
insecticides/pesticides
• To encourage people to minimize the use of insecticides/pesticides
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Topic Program
conducted
Time Venue Target
population
Safe use of
insecticides
Street Drama 8:00 a.m In front of Sahakari
hall, Tinpiple
Farmers,
general
public
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43. ONE DAY FREE DENTAL CAMP
• Organizer: NAIHS-COM, Shree Birendra Hospital
• Date : 26th Bhadra, 2076
• Time: 10 A.M to 3 P.M
• Venue: Primary health care center, Dulalthok
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44. CONCLUSION
• Panchkhal ward no. 6 is moderately populated , with majority of
young, literate farmers
• People had basic knowledge about health and common diseases
• The major health related problem was joint pain (20.65%)
followed by respiratory problems(16.30%)
• Major problem of ward no. 6 was excessive use of insecticides
although people were already aware of its adverse effects
• Hence MHP was conducted to aware people about safe use of
insecticides
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45. LEARNING REFLECTIONS
• Communication skills
• Application of theoretical knowledge into practice
• Importance of teamwork
• Utilization of locally available resources
• Coordination with local community and authorities
• Confidence
• Compromise
• Conduction of formal and informal programs
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46. RECOMMENDATIONS
To the PHCC:
To provide essential medicines and appoint adequate health care
personnel
To the municipality:
Address the water shortage and waste disposal problem
To the community:
Adopt proper methods of water purification and waste disposal
To NAIHS-COM:
Provide well functioning equipments
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47. OUR SINCEREST GRATITUDE TO
• NAIHS-COM
• Department of Community Medicine
• Army personnel
• Community people, Panchkhal ward no. 6
• Jhinganadevi primary school
• Shree Jorpati Secondary school
• Nawa Prativa Secondary school
• Tinpiple youth club
• FCHV’s
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48. BIBLIOGRAPHY
• Park’s textbook of preventive and social medicine, K. Park,
24th edition,
• Methods of Biostatistics- B.K Mahajan , Jaypee publications
• ‘A textbook of Health Education & Health Promotion’- Hari
Bhakta Pradhan
• ‘Nepal in Figures’, CBS
• ‘Annual Health Report’, DoHS
• Orientation Programme handouts
• Classroom slides
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49. THANK YOU!!!
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