Tsegaye Bedane Fulassa

Back to MSc Alumni

Country: Ethiopia
Background: Public Health
Research Project: Determinants of community participation on Fand E components of safe strategy for Trachoma control in Hulet Eju Enese Woreda/District, East Gojam zone of the Amhara Regional State, North Western Ethiopia

WHO has adopted a resolution to eliminate blinding trachoma by the year 2020 (WHO, 1997). To accomplish this ambitious goal, WHO recommends the use of the SAFE strategy for countries implementing trachoma control programs. This multi-faceted approach includes surgery for trichiasis cases, antibiotics to treat the community pool of infection, facial cleanliness to reduce transmission, and environmental improvement to reduce transmission from sources such as flies (Bailey and Leitman, 2001; Kuper et al., 2003).

The prevalence of Blindness in Ethiopia was found to be 1.6%. These were 1.2 million blind and about 2.8 million people will low vision in the country. The main causes of blindness and low vision in Ethiopia are cataract, trachoma, other corneal opacities, refractive errors and glaucoma. Trachoma is the second leading infectious cause of blindness (11.5%) in the country (Federal Ministry of Health Ethiopia, 2006b).

The trachoma control programme does not just fight disease; it fights the conditions that perpetuate disease: poverty, poor sanitation, lack of knowledge, and hopelessness.
In Ethiopia, active trachoma and trachomatous trichiasis (TT) are concentrated in the regions of the country with high population density; namely the Amhara, Oromia, and SNNP regional states (Federal Ministry of Health Ethiopia, 2006a).

There are so many challenges faced in the trachoma control program: the huge size of the country, wide scattering of households, lack of communication, few unevenly distributed and de-motivated human resources, inadequate budget for eye care, shortage of facilities/infrastructure, lack of basic equipment/instruments, inadequate ophthalmic research, weak inter and intra-sectored collaboration and coordination and there are many other health problems in trachoma control program (Federal Ministry of Health Ethiopia, 2006b). Nevertheless there are considerable grounds for optimism for the scaling of activities, with greater public sector involvement; the strategic trachoma plan has been revised to take this into account. Government commitment to implement of the SAFE strategy is strong (WHO 2006).

Active community participation in the F and E components of SAFE strategy is crucial in the sustainable prevention and control of trachoma. This study designed to access the practice of environmental sanitation in relation to trachoma and to examine the knowledge/attitude, belief and practice of face washing and environmental sanitation of the communities in the targeted Woreda.

For this purpose, a community based cross-sectional study was designed that employed both qualitative and quantitative research. One hundred household heads were interviewed using a semi-structured, translated (in to local language – Amharic) and pre-tested/standardized questionnaire and five focus groups (of eight to ten participants). Discussions were conducted among community leaders, representatives of women associates, religious leaders, community volunteers, and health extension workers.

This study revealed that the community has brought behavioural change in the prevention of trachoma control by being actively participated in facial cleanliness and environmental improvement. The study result showed that 65% of the household heads respondents explained that the distance to a source of water is less than 30 minutes. 85% of the households had latrines. Regarding facial cleanliness, 80% washed children’s faces two or more times a day and 85% of the respondents had information about trachoma. In addition, the result from focus group discussions revealed that trachoma is their public health problem and discussed that they have problems in the implementation of trachoma control program due to their low socio-economic status.