Advanced Community Health Nursing clinical I

2nd Semester 2015

Community assessment:Ar-Ramtha City

Presenter:Hani Abu Dieh

Introduction

Community core

Community subsystem

Prospective plan

Conclusion

Outlines

Introduction:

Ar-Ramtha City is one of Irbid city; it has wide range of lands, lawns, farm, water sources and surround by many villages. It provide simple life, calm environment, beautiful nature and moderate clime around the year. It has a simple, good and homogenous population.

I selected Ar-Ramtha city for many reasons Ar-Ramtha is the city where I live, give clear view about the beautiful simple life in Village dressed “dress the city” in a quick period.

Community-as-partner model has been used as a framework to conduct this assessment.

History

Demographics and Characteristics

Value and beliefs

Community core

History

Ar Ramtha, also known as Al-Ramtha (Arabic: الرمثا) is a city situated in the far northwest of Jordan. It covers 40 km, and has a population of 120,365 people.

Ar Ramtha is named after a local desert plant, Al Ramath (Arabic: الرمث). During its occupation by the Roman Empire, the city was known as Ramatha.

• During the past the Roman Empire utilized Ar Ramtha as a remote hub to cross-link their colonies.

During the past the Roman Empire utilized Ar Ramtha as a remote hub to cross-link their colonies.

. During the Islamic expansion, Ar Ramtha, which was in the Houran territory, was a port for Muslim scholars crossing between Syria and Al-Hijaz. Historically and sociologically, the city is the twin to Daraa city in Syria, which is located on just the other side of the border.

Ar-Ramtha districts consist of (5) villages: Shajarah, Ar-Ramthah, Emrawah, Thunibah and Lebwedah, its cover 458 km, and has a population of nearly 150,000. (Municipality, 2013).

Ar-Ramtha city is the center of Ar-Ramtha districts, Located in the “Sahel Horan” area , that far 15 kilometer north of Irbid center, Ar-Ramtha city located between Irbed in south-west, Al-Ar-Ramthah village from west and from north and east is border line with Syria.

In Ar-Ramtha there Major milestones at all levels: industry (Al Hassan Industrial City), education (University of Science and Technology), health (King Abdullah University Hospital).

Demographics and Characteristics

According to Municipality statistics in 2013, the number of residents was 120,000

the average number of family members for each family is 5 Persons and the most families is described by nuclear family type.

The total family numbers are about 15500 families (Municipality, 2013).

52.0%48.0%femalesmales

The main family tribes which reside in Ar Ramtha are:

AL Mayyas (mostly in Al bowetha town) AL Shboul (town of Al shajarah & Ar-Ramtha) Ad-Dardour (west & north and downtown) Al Jahmani (west side and downtown ) AL Zoubi (mostly..North side ) AL Nasr ( down town arownd hesbeh ( chayyal) & at Emrawah town ). AL Abdilaziz (west side and far south west) AL Samarah (around "dab'bet nemer") AL Bashabsheh (North East along the international highway "khat al sham") AL Khazaleh (north) AL Theyabat (south west) AL Shogran (south west) AL Saqqar (south west)

Ethnicity

All families are Muslims and they shared in one homogenous social culture, Jordanian Islamic Arab culture.

Value and beliefs There are 40 Mosques in the city.Sheikh declared that there is a small number of prayers frequenting the Mosque daily.residents believe that social and relative relationship and social collaboration are very important and they get them from their Islamic religion. They share most of norms in sadness and happiness events.

Community subsystemPhysical environment:

It’s a wide range of lands, lawns, farm, water sources.Located in the “Sahel Horan” area , that far 15 kilometer north of Irbid center.

Ar-Ramtha has mild to moderate climate; the geographical distribution of the area of about 550 meters above sea level gives it this moderate climate. Summers are hot and dry at day, moderate at night to cold, and winters are cold.

The most beautiful season is spring where all the different plants grow. Lands covered with green grasses, lawns, flowers and farms which flourish during the spring season.

All houses are supplied by water from the water station by management of ministry of water. Residents suffer from a shortage of water at all time. The rate of water pumping is 1:14 days in all season.

they claiming of water pollution since one months as a result of rusty and old water pipes or unclean water reservoir as stated by Mr. Yousef al-Qadir.

However, most homes buy filtered water for drinking.

Health services

Ar-Ramtha have 2 comprehensive health center and 8 Primary health centers, in addition there are many private medical clinics and laboratories.- The health care center provides primary care, very simple treatments, immunizations, and screening programs for school health one time yearly.

There two hospitals in Ar-Ramtha, Ar-Ramtha governmental hospital and king Abdullah university hospital which Provide comprehensive services to Ar-Ramtha and district.

Social servicesThere is a strong social relationship between Ar-Ramtha populations as a one family, they participate in happy and sad events, and some families from neighborhood villages select Al-Ar-Ramthah to live.

There are in Ar-Ramthah several centers belonging to the youth aimed at skills and capacity development of cultural and, scientific to the young men and women discover talents and abilities in various fields, and Highlight the problems faced by youth, the community and find appropriate solutions. Such as: Ar-Ramthah Youth Cultural Forum, Ar-Ramthah Sports Club, cultural and social, also do programs for children, such as a save ALQRAN ALKAREM,  Conducting educational activities. 

Economic

About 60% are employee (Military and civilian) 15% are unemployed. 5% in Agriculture, and 10% others, (Municipality). The average of income 300 – 550 . Ar-Ramthah is contain several productive projects and market is contains all services (see Table 1), also there many people work in Al Hassan Industrial City, University of Science and Technology and King Abdullah University Hospital.

There are a large number of people from Ar-Ramthah are working outside Jordan in the Arab and European countries, this contributes to the support of the Ar-Ramthah economy

Name of place Number Name of place Number Name of place Number

Brick Factory 5 Carpentry 28Cloths & shoes

shop47

Diary product 32 Internet coffee 29Home appliance

shop43

Bakery & Restaurants

43

Vegetables & fruits

shop56

Appliance

electrical shop26

Supermarkets And

consumer organizations590 pharmacy 27 Book shop 24

Gas station 7 Dental center 5Billiards and

Games Shops16

(Labour units and Business organizations,2013)

Transportation and safety

There Public transportation system in the city.Also many of people in the city use their own cars.Ar-Ramthah Security Center this Center to keep security in the community, provide public education program as crime prevention program are offered to community and school groups.

Road:Ar-Ramtha city has major streets, 1) “Jaber” street connect Ramtha city with Al-Mafraq and lead to Syrian border. 2) “Boshra” street connect Ramtha City with Irbed from west side. 3) “Al-Wehda” Street leads to the center of Ar-Ramtha city, 4) “Al-Sham” Street divides the City into eastern and western section and leads to Syria border. .

Most streets to and from Ar-Ramtha city asphalt; with poor lighting, no traffic signs, narrowed streets, and increase the risk of accidents.

Politics and government

HJGHJand government

Communication

Common meeting places used community center, hall: Ar-Ramthah contain several tribes, most of these tribes have which called “Dewan” their own.

Ar-Ramthah has all of communication ways the Traditional, Modern, Official, Non-official and important communications. Traditional like barber, teachers, retired people, official all sources of media are available in Ar-Ramthah to communicate with the world such as telephone include Umnia, Zain and Orange, television, mail delivery and internet access with modems, are available can reach to home, also from daily newspaper as AL-Rai, AL-Doustor and AL-Ghad and have sport club for football, young center, and culture center.

Recreation :There 3 parks in Ar RamthaThere ”alshallaleh”

Education

The total number of students in all school about (16793) about 1800 in Al-tawjehy and about 2400 in the first class in 22 public schools; 9 secondary female, 9 secondary male and 21 primary schools, 8 private schools and 13 nursery.( Ministry of Education at Ar-Ramtha).

Ar-Ramtha City schools suffer from overcrowding in classrooms as a result of receiving the Syrian Students (11,000 Syrian students in all schools Ramtha Brigade). (Ministry of Education at Ar-Ramtha,).

There are in Ar-Ramtha eight private schools.

Ar-Ramtha students studying in Al-yarmook university, Jordan university of Science and technology, al-balqa’a university in Irbid, and AL-Albayt University in Al-Mafraq city Because of the proximity of these universities.

College in Ar-Ramtha City.

- Major health problem in Ar-Ramtha City community based on assessment:1- Chronic diseases as diabetes mellitus, hypertension, osteoporosis and respiratory disorders show through visit to health centers.2- Smoking and water pipe that appear in various ages especially adolescent age and observed that mostly in secondary school or high level of school.3- School dropout phenomenon especially in male school, as teacher said: recent time appear that increase of phenomenon especially in male school which affect the learning process and education achievement & outcome.

Prospective plan major problems that need to solve by collaboration between government, social services, and community members

Prospective plan:1-Goal: To Improve the health of people with chronic diseases and reduce the prevalence of chronic diseases.1- Objective: To reduce the incidence of chronic disease and related factors (obesity, smoking, unhealthy lifestyle) in a given Ar-Ramtha community by 50% within 2 years, by doing several activities.

Activities:Assess factors contributing to chronic disease.Institute people life education program through school and community groups. Develop community resources to support health promotion program.Identify families in Ar-Ramtha village who are greatest risk (obese, smokers, unhealthy lifestyle). Use the several educational methods for Increase awareness about the chronic diseases among the population of the region, such as (Open discussion, Videos, and Posters about the chronic diseases. Use several methods to improve the skills of the people who suffer from chronic diseases, such as Focus group to share their experiences and skills in control of their diseases. and Home visits to provide ongoing treatment and teaching for chronic disease patients.Develop early detection program through school, clinics, and physicians offices, and promote enforcement of healthy lifestyle program.Establish rehabilitation programs for ill person including regular exercise program, healthy diet, foot care, emotional treatment.

2- Goal: To promote the health of students in all schools in the city.2- Objective: to reduce the incidence of smoking among school students by 50% after 6 month, by doing several activities.

Activities:Assess factors contributing to smoking institute students life education program through school, develop community resources to support health promotion program.Open discussion sessions about the hazard of smoking should be held in schools.Increase control over the students, especially in places side and put strict penalties for smoking in schools.Use Pamphlets and brochures about the hazard of smoking will be distributed among the students to promote their health status.Establish several incentive programs to quit smoking, such as contests and prizes.Establish program to provide prompt treatment for smoker students.Establish rehabilitation programs for smoker students with disease including regular exercise program, healthy diet, provide people life education programs for smoker.

3- Goal: school dropout prevention and improve student’s attendance.3- Objective: to reduce the school dropout among students by 50% after 6 months, by doing several activities.

Activities: •Assess factors contributing to school dropout, by frequent visits to the school.•Collect data about student performance and characteristics related to dropping out in order to identify potential problems early in the student's school experience and thus refer students for specific prevention efforts.• Tracking student attendance, test scores, grades, and behavior referrals, participation in activities, school attitudes and family participation in school events can provide information to identify students most at risk for later dropping out.•Encourage student to have positive attitude and effective communication skills, by give lectures on communication skills in school.•Support activities and strategies to help establish a climate that promotes attendance.•Support activities might include incentives and supports to improve attendance; programs to encourage parent involvement; early intervention for academic difficulties (such as peer tutoring programs).•Encourage the student to attend school regularly and to be involved in at least one extra-curricular activity at school or with groups of students who are currently in school. These activities make the student feel part of the group.•Speak with the parent, school counselor and/or school psychologist to see if the student's goals can be reached in the current school environment.•Seminars and workshops for teacher and support staff can help encourage school involvement for students at risk for dropping out:•Serve as positive role models, developing mentoring programs for at-risk student and families.•Educate students and their parents about consequences of Student dropout in school by use the several educational methods such as (Open discussion, Videos, and Posters about the school dropout).•Consult with parents and other school personnel to determine if the student might have a specific learning or behavior problem interfering with learning. Low achievement, retention in grade and behavioral difficulties are highly predictive of dropping out of school. Assessment of possible learning and behavior problems might help identify special services to help the student find school more successful.

Conclusion

Community assessment is systematic and complex process aimed to identify points affect on community health

Because it is complex, one person can’t do it effectively. So, professional and trained team is needed to accomplish this task effectively.

Community health nurses unable to solve these problems alone, because of most of community problems are extensive problems, so collaboration between residents, stakeholders, and social services should be addressed well to overcome problems.

Ar-Ramtha like other communities has many strength points which will enhance to be more effective, such as (strong relationship, social collaboration and cooperation and honesty, and high educational level), and some weakness points which need to strengthen, such as (increase prevalence of chronic disease, and take unhealthy diet). As a community health nurse, we can play important role to treat or solve some of these weakness point also collaboration between resident and municipality of Ar-Ramtha can play an important role.

References:

Community as partner Theory and Practice in Nursing, Lippincott Williams &Wilkins.McFarlane's J & Anderson E (2008). http://www.moe.gov.jo/Directorates/DirectoratesPage.aspx?DirectoratesID=27.Department of Statistics. (n.d.). Retrieved 5 21, 2013, from website Department of Statistics: http://www.dos.gov.jo/.Ar-Ramtha municipality.Directorate of Education of Ar-Ramtha.Abo tamam secondary school.Ar-Ramtha comprehensive health center.Some people from Ar-Ramtha City:Dr. amjad theiabat (Social activist and member of the municipal council). Mr. Abd elkareem abu elsheeh (Arabic language teacher in abo tamam school). Mr. Mohammad alzoubi (educational directorate of Ar-Ramtha).Sheik Abdullah alzoubi.

Thank you