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RESEARCH community mobilization ACTS TO IMPROVE SANITATION
ENVIRONMENT for ethnic minorities in especially
difficult REGION OF Dong Hy district, Thai Nguyen
Associate professor. PhD. §µm Kh¶i Hoµn, MSc. Hoàng Associate professor. PhD. §µm Kh¶i Hoµn, MSc. Hoàng Anh TuấnAnh Tuấn
Thai Nguyen medical and pharmacy University, Viet Thai Nguyen medical and pharmacy University, Viet namnam
- Environmental sanitation is one of Environmental sanitation is one of issues that is interested in all over the issues that is interested in all over the world.world. - Implementing environmental - Implementing environmental sanitation well is to improve life sanitation well is to improve life condition and health of rural people, to condition and health of rural people, to contribute to eliminate hunger and contribute to eliminate hunger and reduce poverty. reduce poverty. - Economic, cultural and social - Economic, cultural and social condition in special difficult areas in condition in special difficult areas in Dong Hy is slow, especially about Dong Hy is slow, especially about environmental sanitation behavior… It environmental sanitation behavior… It is necessary to improve environment, is necessary to improve environment, to implement environmental to implement environmental sanitation well. The solution to sanitation well. The solution to mobilize community to take part in mobilize community to take part in improving environmental sanitation improving environmental sanitation behavior is a good heading.behavior is a good heading.
IntroductiIntroductionon
1. To evaluate the real situation of 1. To evaluate the real situation of environmental sanitation of ethnic environmental sanitation of ethnic minority people at 4 difficult hamlets in minority people at 4 difficult hamlets in Dong Hy district, Thai Nguyen province. Dong Hy district, Thai Nguyen province. 2. To develop the model of mobilizing 2. To develop the model of mobilizing community in improving environmental community in improving environmental sanitation behavior for people in Cay Thi sanitation behavior for people in Cay Thi hamlet, Thai Nguyen province. hamlet, Thai Nguyen province. 3. To evaluate the effect of model in 3. To evaluate the effect of model in improving environmental sanitation improving environmental sanitation behavior for ethnic minority people in behavior for ethnic minority people in Cay Thi Hamlet after 2 months to carry Cay Thi Hamlet after 2 months to carry out. out.
Research targetResearch target
- Householders in hamlets Householders in hamlets - Medical personnel in hamlets - Medical personnel in hamlets - Collaborators of population and - Collaborators of population and nutrition nutrition - Officers at medical and - Officers at medical and demorgraphic station demorgraphic station - Senior excutive in the hamlets - Senior excutive in the hamlets Teacchers and pupils at Teacchers and pupils at secondary schools in the hamlets. secondary schools in the hamlets. - Young people in the hamlets.- Young people in the hamlets.
1. Research subjects and 1. Research subjects and methods. methods.
2. Location:2. Location: Dong Hy Distrist and 4 Dong Hy Distrist and 4
communes Cay Thi, Hop Tien, Tan Long, communes Cay Thi, Hop Tien, Tan Long,
Van Lang. Van Lang. 3. The time: From 1/2006 to 12 /2007 4. Research method: Interrupting description and epidemiology interfere. 5. Sample:Sample: Choosing 200 households of Choosing 200 households of
ethnic minority people in remote villages ethnic minority people in remote villages
in each commune (Far from the city in each commune (Far from the city
center about 5km and above). center about 5km and above). 4 communes with 800, real investigated samples are 830)
Sample unit: Choosing household, Sample unit: Choosing household,
choosing one adult in each household choosing one adult in each household
(the head of a household). Choosing (the head of a household). Choosing
randomly by draw lots method .randomly by draw lots method .
Research model is interfering before and after with control group basing on the following outline:
InterfereCây Thị commune (experiment) Figures after interfered
(Figures before interfered)
Non-interfere Hợp Tiến Commune (control ) After figures (Before Figures)
Comparison Comparison
Conducing to develop interfering model with: - Developing Steering Committee that carries out model in Cay Thi hamlet
- Training for members to participate model at basic issues of environmental sanitation communication and activity method in model (training time is 1 week) - The role of members in model.
- Health volunteer, collaborators population, nutrition are the main people who carry out: teachers, pupils, young people , and authority organizations, unions who participate to support.
- The head of hamlet is a person who create good conditions sor members. The head of medical station is responsible to supervise the carrying out tasks of members. The president of the hamlet manages commonly.
- Steering Committee has a meeting with members once a month to examine the rate of progress to carry out model, complement, update some issue of knowledge for members.
- Activity of research group: Supervise 0nce per 2 months to examine the progress of carrying out model and support main issues.
Model activity takes place continuously in 2 years
Information collecting technique. - Quantitative: Interviewing and observing - Qualitative : To analyze the deep aspect of culture, customs of inhabitant’s hygiene and evaluate accepting ability the model of community. Group discussion is the main method.
Evaluating method. - Comparing the changing KAP of environmental sanitation of people in Cay Thi and Hop Tien at the time before and after interfering. - Evaluating interfering results based on effect index and interfering effect.
Data processing method. - Following biomedical statistics methods on computers with the software EPIINFO 6.04
Diagram 1: Model of mobilizing community to take part in improving environment sanitation behavior in Cay Thi commune, Dong hy
Distrist, Thai Nguyen City
Reseach resultSteering Committee for implementation of communal sanitationSteering Committee for implementation of communal sanitation
Communaldepartments
Medical Stations
The communalorganizations
Village health workers Organizations in villages Local leaders
Inhabitants
Graph 1. Training course result of model carrying-out
33,33
66,66
35,71
28,57 30,95
9,52
0
10
20
30
40
50
60
70
Fair, good average weak
Pretest
Postest
Table 1. Concrete activity results of member who participate model
Indicators
Member
Number of sessions transmitted through meetings
Number of communication sessions in households
Number of listeners
Commune health station staff 10 105 198
Village health workers 51 423 982
Women 8 120 379
Youth Union 42 387 1.235
Farmer 8 45 125
Teachers 'plug' 13 78 234
University medical student 24 490 678
The other mass organizations 12 24 132
Total 168 1.672 3.963
Graph 2. Changing KAP of environmental sanitation of Inhabitant in Cay Thi hamlet
19.5
82.5
16
49
9.5
33.5
0
10
20
30
40
50
60
70
80
90
Goodknowledge
Good attitude Good practice
Before interfering
After interfering
Graph 3. Changing behavior of using hygiene work of inhabitants in Cay Thi Hamlets.
47.5
57.5
10.5
37
45
64
17.522.5
0
10
20
30
40
50
60
70
Clean water Hygienictoilet
Bathroom Isolatinghouses and
stables
Before interfering
After interfering
Graph 4. Changing KAP of environmental sanitation of inhabitants
in Hop Tien
16
38
15
20
10
15
0
5
10
15
20
25
30
35
40
goodknowledge
Good attitude Good practice
Before interfering
After interfering
Graph 5 . Changing KAP of environmental sanitation of inhabitants
in Hop Tien
45.36 49
12.0215.5
51.956.5
21.1323.5
0
10
20
30
40
50
60
clean water Hygienic toilet Bathroom Isolatinghouses and
stables
Before interfering
After interfering
Graph 6. Changing KAP of environmental sanitation of inhabitants
in 2 communes after interfered
82,5
38
49
20
33,5
15
0
10
20
30
40
50
60
70
80
90
GoodKnowledge
Good attitude Good practice
Cây Thị
Hợp Tiến
Graph 7. Changing to use hygiene work of inhabitants between 2 communes after
interfered
57.5
49
37
15.5
6456.5
22.523.5
0
10
20
30
40
50
60
70
Clean water hygienic toilets barthroom isolatinghouses and
stables
Cây Thị
Hợp Tiến
Mrs Hue – A cell secretary of Hoan village “ Although the Hoan Village has slow life condition, after carrying out program, the hamlet's Environmental sanitation is improved a lot The program integrates the Yong Union and it is supported by many people. Carrying out the environmental sanitation work based on officers’ instruction. Inhabitants’ awareness is improved. We desire to continue carrying out environmental issue in the local…” .
Mr Phuong – Young union secretary at Khe Can hamlet “Ethnic minority takes up majority, education level is slow, especially the old people. Having the participation of students, all people carry out well. However, Propagandizing is not good. Some people have changing of behavior but majority is not good because some officers are not good model. The integration of hygiene work and propagandizing hasn’t got good effect.
Mr Hien – The head of medical station at hamlet. “The rate of household with safe hygiene work increases so much. Inhabitants support to improve hygiene work 1 part divided 2 parts. Man-made cisterns ensure hygiene, on- site dust-hole. Having participation of union, senior executive. People’s council are good model to carry out, However there are some senior executive are not good model. The subject is needed to deploy in the local.
Result1. The rate of people who have the environmental
sanitation attitude is : Good knowledge : 21,57% ; Good attitude : 18,92% ; Good practice : 9,52%.
2. Model of mobilizing community to communicate environmental sanitation, organizations in the local share responsibility with the public health in improving people’s environmental sanitation behavior, combining the carrying out model with the tasks of each individual and unit… Research model is integrated with CSSKBĐ in commune. In order to carry out the model, it is necessary to develop a commune steering committee. In mobilizing community to develop function, concrete task to ensure the good –working and integrating the environmental sanitation communication and the managing profession for medical station.
Conclusion 3. Activity results of model after 2 years to
carry out at Cay Thi gets the changing in environmental sanitation behavior such as the increasing of knowledge 63%, attitude 33,2% practice 14,5%. The clearest changing in Interfering result is environmental sanitation knowledge (323%), practice (253%) attitude (206%). After interfering , in Cay Thi there is a clear changing about building and using hygiene toilets ( increasing 26,5% household), interfering result is 217,22%.
Recommendation: The model of mobilizing community in improving The model of mobilizing community in improving
environmental sanitation communication is a effective environmental sanitation communication is a effective model to implement the early health care work in model to implement the early health care work in common, for people in ethnic minority in remote common, for people in ethnic minority in remote mountainous areas in general. The model is the solution mountainous areas in general. The model is the solution that need to be researched and applied by authority that need to be researched and applied by authority leaders and public health profession.leaders and public health profession.
