INVESTIGATORS; AKELLO FAITH, KALUNGI JONATHAN, MUGALU DENIS EDWARD, BALUKU ANDREW, KUNIHIRA CATHERINE, NABUKALU SSENTONGO ANGELA,

NDAGIRE REGINA NABIKINDU, ORIBA DAN LANGOYA, TUMWESIGIRE SAMUEL,

ABSTRACT
The study was done to carry out a community diagnosis of Nakasongola subcounty,

Nakasongola district a catchment area of Nakasongola HC IV.

Methods used included both quantitative & qualitative.these were questionnaires,interviews,documents review etc.

key informants; LCI, VHT.

Sampling: Household sampling-simple randomized sampling, sample size-120 households,

Sample area; Kalubanga, Matuugo and Buruuli villages.

Demography: 81%- female respondents, 57% of households-mother headed, majority of

household members-below 5 yrs(45.2%), 6-18 (40.5%). Religion; anglicans, Catholics, Muslims, others 47.6%, 21.4% 14.3% ,16.7% respectively. Occupation; peasants(69%), civil savants(11.9%)

Nutrition and food security: Food source; from own garden(61.1%), rest from market.

Availability(meals per day); 3-64.3%, 2-26.2%, 1- 7.1%. Diet-mostly carbohydrates(root tubers, maize & its products.), proteins(animal products).

ABSTRACT CONTD
Sanitation and hygiene: Water source; Tap water(50%),

borehole(40.5%), wells (4.8%). Water treatment; Boiling(54.8%), Chemicals(9.5%). Other aspects; kitchen compound cleanliness rubbish pits.
Health seeking Behavior: Majority from the health facility. The above results were analyzed using Microsoft Excel spread sheet

and presented in form of tables, bar graphs and Pie charts.

INTRODUCTION
Community diagnosis is the comprehensive assessment of the health state of an entire community in relationship to its social, physical and biological environment This assessment was carried out in Nakasongola sub-county , Nakasongola District. Political hierarchy included;district level-Nakasongola District; county-Nakasongola (originally called Buluuli);subcounty-nakasongola; parish-nakasongola town council; villages - buluuli, matuugo, kalubanga. Economically; the people were mainly dependant on agriculture and a few others indulge in trade & commercial activities and others transport & communication services. Socio-culturally;people generally fall among two established kingdoms which include ; the baganda and the baluuli. Originally these were the same kingdom people established in buganda kingdom but a segment of some people broke off as the a Baluuli people in the name of need to have a separate political structure & region demarcation. During the assessment, we used questionnaires and a checklist to obtain information on social demographic factors, nutrition, hygiene, and health seeking behavior. The data collected was then analyzed to come up with a report. Biggest health challenges were ; Malaria, Upper respiratory tract infections, and diarrheal diseases. The major economic activity was farming. The results were analyzed using Microsoft excel and presented in form of tables, bar graphs, and pie charts

Objectives
General objective. To carry out the community diagnosis of nakasongola subcounty. Specific objectives. To determine social demographic characteristics of the community. To assess the nutrition status of the community To assess the sanitation and hygiene. To identify the commonest diseases. To assess the health seeking behavior of the people in the community. To assess the health service delivery system in this community

Methods and tools

Study design:- The study design was a non interventional,

descriptive cross sectional survey. Study population:- The target group was the community and local leaders. Sample size:- 120 participants from different villages of nakasongola subcounty. Sampling technique:- Simple random sampling. Data collection techniques:Primary data:- questionnaires and Checklist. Households were selected at random and interviewed using close ended questionnaires. -Key informants included VHT and LCI chairperson; Secondary data:- Documents used included District records, Hospital records.

Methods and tools contd

Data processing and analysis: Data processing was done

manually by researchers with the help of calculators and computers. The analysis was done by microsoft excel and presented in form of tables, Bargraphs and pie charts.

Results and Discussion

Socio-demography;

The study showed that the majority of the respondents were females(81%) & the rest being males-as men were out for work by the time the surveys were carried out. Also, most families were mother headed (57.1%) implying a heavy burden loaded onto the females financially, that in a long run greatly impacted onto the maternal health. Households were established in a nuclear setting mainly(80%) with the most age distribution below 18yrs as follows;<5yrs-(45.2%) & 6-18yrs-(40.5%). This shows the economical burden laid onto the breadwinners of the households as it was implicated in the poor standard of living evident with general source of income being peasant farming(69%) generating below $3 @ day. Majority of household members were anglicans(47.6%) by religion & a significant others being;catholics(21.4%),moslems(14.3%).this shows majority were christians with spiritual faith that influences their health seeking behaviour as seen in indulging spiritual healing as part of their ways of managing different health aspects

 Nutrition & food security;

Majority of households obtain food from their own gardens (61.9%), others bought food from the market. 64.3% of the households would afford three meals a day, 26.2% had two meals a day, and 7.1% had only one meal per day. Most of the meals were served with root tubers(81%), others being:maize and its products(57.1%), matooke(38.1%) and animal products (31%). The results above depicted that most families had an unbalanced diet in their nutrition. Their meals were majorly protein deficient as shown by the few animal products consumed. They was as a significant Vitamin deficient in their diet shown by absence of vegetables in their diet. However they had a strong food security depicted by the availability and accessibility (grew their own food and even had stores for it.) Cassava and sweet potatoes were dried and preserved as kasedde in preparation for the dry season

Sanitation and Hygiene: Majority of the sampled households use tap water (about 50%),
others obtained it from boreholes (40.5%) and wells (4.8%) especially when there was water shortages. This was a good indicator water safety. However, they were affected by the long distance from the water sources. Water was mainly boiled for consumption (54.8%) and 9.5% used chemicals like water guard tablets. The rest had no means of treatment at all. The water safety accounts for the low prevalence of water borne diseases like Bilharzia and Typhoid as recorded at the health facility. As regards waste management, most households disposed off their rubbish safely in rubbish pits and in their gardens for manure, accounting for the high percentage of observed clean compounds. Human waste was disposed off in regularly cleaned pit latrines accounting for the low prevalence of communicable diseases like cholera, Dysentery, e.t.c

 Health Seeking Behavior:

The study showed that the majority of people in the area (83%) sought health attention from the health facility. A significant number however, sought health attention from traditionalists (14%) and a few from spiritual healers and churches (3%). This implies good health seeking behavior shown by the high numbers of people attending health facility. However, none of these people were found to go for routine medical check ups. Also, this good health seeking behavior is attributed to the short distance to health facilities, therefore easy accessibility to medical services and awareness about the health services provided at the facility such as immunization, safe male circumcision, e.t.c

 Disease burden:

Among the most common diseases affecting people in the area included Respiratory tract infections( 46.2%), and Malaria (44.6%). The prevalence of diarrheal diseases was low ( 0.05%), mainly due to the good general sanitation and hygiene as shown by; Clean compounds, regularly cleaned pit latrines and good waste disposal. The frequency of these endemic diseases esp. malaria was almost every month with a registered highest percentage(57.1%). This is attributed to a variety of factors such as breeding places and bushy areas around their compounds.

Conclusions
Community strengths include : Easy access to medical and social services Good political leadership and communication with the community. Good Health seeking behavior. Good Sanitary conditions of the community. Good food security. Good road networks and communication.

Weakness of the community:

Low levels of income. Poor nutrition Long distance from distance from reliable water sources.

Poor housing facilities; Overcrowded and poor ventilated.

Inadequate mosquito nets and bushes around homes. Ignorance about some essential health practices like routine medical

check ups and water treatment

Recommendations
Health promotion and preventive activities ( like continuous health

education on usage of mosquito nets) should be implemented. A number of outreaches should be done to create more awareness on the essence of routine medical check ups. In order to decongest the households, Family planning methods should be emphasized. Diversification of the economy to improve on economic status of the community. Provide Nutrition education to the community about the imperativeness of the consumption of a balanced diet.

References
DHO offices. Higher local government statistical abstract, Nakasongola

district; 2008 http/en.wikipedia.org/w/index.php?title=nakasongola_district.downlo aded at 20th April 2013 UBOS(2002), Uganda population and Housing census report, Uganda bureau of statistics, Kampala Uganda. WHO; World health report (2002,2004)