PREVERLANCES OF SEXUALLY TRANSMITTED DISEASES IN PEOPLE AGED BETWEEN 15 TO 50 YEARS IN HOIMA HOSPITAL, HOIMA MUNICIPALITY BY KASOZI IGA EDWIN (CLINICAL OFFICER TRAININEE) November, 2021 APPROVAL This is to clarify that KASOZI IGA EDWIN carried out this research proposal entitled “Prevalence of sexually transmitted diseases in people aged between 15 to 50 years in Hoima hospital, Hoima municipality” and has been done under my supervision and submitted under my approval. Signature………………………………………………………….. Miss Sr. Josephine Oyella. (SUPERVISOR) Date………………………………………. DECLARATION I KASOZI IGA EDWIN hereby declare that the work presented in this proposal is not my very own and has never been presented for any academic award in any institution Signature……………………………………………….. KASOZI IGA EDWIN UA/DCM/044/18 (RESEARCHER) Date……………………………………. TABLE OF CONTENTS Approval DECLARATION…………………………………………………………………………………………………………………………. i TABLE OF CONTENTS LIST OF ACROYNYMS…………………………………………………………………………………………………………………… ii DEFINITION OF TERMS CHARPTER ONE: INTRODUCTION BACKGROUND OF STUDY STATEMENT OF THE PROBLEM GENERAL OBJECTIVES SPECIFIC OBJECTIVES RESEARCH QUESTIONS SIGNIFICANCE OF THE STUDY SCOPE OF THE STUDY CHARPTER TWO: LITERATURE REVIEW DISTRIBUTION OF STDs ACCORDING TO DEMOGRATIC CHARACTERISTICS MONTHLY DISTRIBUTION OF STDs CHARPTER THREE: METHODOLOGY STUDY DESIGN STUDY AREA STUDY POPULATION SAMPLE SIZE DETERMINATION SAMPLING TECHNIQUE SAMPLING PROCEDURE DATA COLLECTION METHOD DATA COLLECTION TOOLS DATA COLLECTION PROCEDURE QUALITY CONTROL DATA ANALYSIS AND PRESENTATION ETHICAL CONSIDERATIONS LIMITATIONS OF STUDY DESEMINATION OF RESULTS REFFERENCES APPENDIX I CONSENT FORM APPENDIX II:QUESTIONAIRES APPENDIX III: BUDGET APPENDIX IV: WORK PLAN APPENDIX V: A MAP SHOWING THE LOCATION OF LIST OF ACRONYMES RPR : Rapid Plasma Reaction GUD : Genital Ulcer Diseases STD : Sexually transmitted Diseases STI : Sexually Transmitted Infections MOH : Ministry of Health WHO : World Health Organization PHC : Primary Health Care AIDS : Acquired Immune Deficiency Syndrome HIV : Human Immune Virus NGU : Non Gonococcal Urethritis PID : Pelvic Inflammatory Disease VCT : Voluntary Counseling and Testing BV : Bacterial Vaginosis ELISA : Enzyme Linked Immuno-Sorbent Assay ARV : Anti-retro Viral HBV : Hepatitis B Virus HSV : Herpes Simplex Virus PCR : Polymerase Chain Reaction TOM : Tubal-Ovarian Mass HPV : Human Papiloma Virus VDRL: Venereal Disease Research Laboratories RPR : Rapid Plasma Reaction Genital Ulcer Disease UDS : Urethral Discharge Syndrome LGV: Lymph Granuloma Veneria ART: Anti-retro viral Therapy MOH : Ministry of Health OPD : Out Patient Department ENT : Ear Nose and Throat MICH : Material Child Health US : United states DEFINITION OF TERMS Ectopic pregnancy : Is the implantation of the fertilized ovum outside the uterus Orchitis : Is the inflammation of the testis Prostatis : Is the inflammation of the epidermis and testis Urethral Stricture :is the narrowing of the urethra. Infertility :is the inability of the couple to achieve pregnancy after sexual intercourse without contraceptive for one year repeated Balanitis :is the inflammation of the glans penis and the prepuce Buboes:these are localosed swelling or enlarged lymph glandsinthe groin and femerol area. Bartholin’s absceess:this is a complicationof gonoria or chalamydia linfection of the Bartholin’sgland in women presents as an extremely painfullswelling at vaginal introitusss Prepuce :foreskin covering the glans penissssssssssssss Chapter one: Introduction 1.1Background to the study Sexually transmitted diseases are infectious diseases caused by one or more microorganisms that are mainly transmitted from one person to another during unprotected sexual intercourse. The risk of transmission of sexually transmitted diseases from one infected person to another varies according to the causative organism of the particular STI. For instance as many as one out of two sexual partners of a patient with gonococcal urethritis may be infected after a single act of sexual intercourse. On the other hand, the risk of transmission of HIV after a single act of sexual intercourse in the absence of the other STI lesions may be as low as 0.1 to 1 percent. (Ministry of Health 2018). Sexually transmitted diseases can also be defined as infections that are transmitted from one person to another through sexual contact and close body contact with infected body fluids. (World Health Organization 2019). There are more than 30 different kinds of sexually transmitted diseases that are spread through vaginal, anal and oral sex, some can be spread by kissing or passed from a woman to her developing fetus during pregnancy or child birth. STDs are also called venereal diseases (VD) and usually present with the following signs and symptoms: Urethral or vaginal discharge in urethritis, vaginitis and rarely cervicitis, Sores or wounds in the mucous membrane or skin of or near the genitalia (genital ulcers), abnormal swelling of the lympnodes or groin (buboes) and abnormal growth of genital parts of other neighboring areas in both men and women (warts). STDs which usually present with urethral or vaginal discharge are either caused by gonococcal or non-gonococcal urethritis usually of men and trichomonal infection. Genital sores or lumps near the genitalia which are usually sexually transmitted have a large number of causes, but the most common in the tropics is syphilis others include lymphogranuloma inguinale , chancroid or soft sore Herpes genitalis and condylomata accumulate or venereal warts. Genital warts also show abnormal growth of the genital parts or the neighboring area of both sexes. (Sexually Transmitted Infections and sexually Transmitted Diseases textbook 2011). However, most people with STIs such as gonococcal and non-gonococcal cervicitis, syphilis, HIV and many others may be asymptomatic or mildly asymptomatic for a long period of time, but still infectious and at risk of complications and disease progression. Such people can spread the infection to uninfected sexual partners during sexual intercourse and such contact goes on to develop disease and complications. For this reason, a more inclusive term of sexually transmitted infections "(STI)" is recommended. There are various etiological classifications of STDs, they are grouped into 5 groups according to the causative agents namely:Bacterial STIs, this category includes, gonorrhea, syphilis, chancroid, LGV, non-gonococcal genital infection and bacterial vaginosis. Viral STIs for example genital herpes, viral warts, HIV and HBV. Protozoal STIs for example trichomoniasis. Fungal infections for example genital candidiasis and ring worms. Infections for example pubic lice and scabies. However, sometimes sexually transmitted infections can be endogenous. These include vaginal candidiasis and bacterial vaginosis. These are part of the endogenous reproductive tract infections knowledge of this is important for the point of view of the patient's education and partner management. (Ministry of Health 2018). STDs is a worldwide problem with higher incidence in developing countries due to the following. Inadequate treatment; Disruption in tradition sex education for adolescents; Labour migration from one place to another without a fixed sexual partner; Unemployment within the urban setting leading to sexual favors for money and this leads further spread when they return home; Polygamy and Inadequate sensitization of the Communities about STD, their route of transmission and preventive methods. ln Uganda, the infection is throughout the country because of poverty, camp settlement, inadequate treatment, stigma attached to the diseases, ignorance, increasing cases of rape, lack of screening facilities and enough medical workers. Particularly in Hoima, STDs are more common in the city this is due to the movement of people from the rural areas to urban areas looking for soft life", commercial sex workers, high rate of alcohol consumption, over population. The STDs are not age specific but the majority of the people infected are between 15 to 50 years of age. Control of STDs in the community can be done through making correct diagnosis, giving effective treatment, counseling clients when first seen in the hospital to modify their sexual behavior, giving health education to avoid contact and prevention of transmission through the ABCs (Abstinence, Being faithful to sexual partner and use of Condoms) and carrying out surveillance (Uganda Clinical guidelines 2016). The complications of STDs are long term outcomes of untreated or poorly treated STDs. Most STDs are associated with serious complications that can be avoided if early and appropriate treatment is provided to patients. The STI complications include those for gonococcal and non-gonococcal genital infection, complications vary according to sex and anatomical site affected. In males they are urethral stricture, seminal vasculitis, epididymo architis and reduction of spermatozoa in semen and male Infertility. In females, there is pelvic inflammatory disease (PID), Tubo ovarian masses (TOM), irregular and painful heavy menstrual bleeding, ectopic pregnancy and secondary infertility. Complications in babies are Ophthalamia Neonatorum with the risk of corneal ulcer and blindness. Complications due to syphilis are: - Secondary syphilis (4 weeks to month) which is characterized by non-itchy skin rash extending to the palms and soles, alopesia, enlarged discrete lympnodes especially behind the ears (post auricular) and above and behind the elbows in wet areas, flat topped swellings (syphilitic warts). Latent syphilis, this may occur from the two years and characterized by asymptomatic infection and may be detected by blood test VDRL or RPR. Late syphilis, skin, characterized with lesions referred to as gummata, bone, leading to swelling and thickening of affected bones, eyes characterized by iritis and choroidorectinitis, aortic valve incompetence and aortic aneurysm, general paralysis of the insane and loss of sensation of the feet leading to painless sores of the feet, macerated still birth, premature delivery, intrauterine foetal growth Syphilis and pregnancy, late abortion, intrauterine foetal death with retardation, live child born with congenital syphilis and transmission of HIV to the unborn child. Other STIs are also associated with complications that may include:Genital ulcers which lead to fibrosis of the affected organs, venereal warts due to HPV are associated with cancer of the cervix; HBV can cause chronic hepatitis that may predispose to hepatocellular carcinoma and LGV Management of STD depends on identifying particular disease causing the symptoms using laboratory procedures, clinical experience and syndromic approach. (MOH Uganda 2018). 1.2 Statement of the problem Sexually transmitted diseases form the second largest percentage next to malaria amongst the diseases diagnosed in Ugandan hospitals. It forms about 40 percent of the diagnosed conditions amongst out patients department OPD (MOH 2017, report). It has been reported that STDs are more observed mostly in the 20 to 24 years old age group followed by 25 to 29 and 15 to 19 years old. Sexually transmitted diseases remains a public health problem worldwide with its serious complications which includes abortion, infertility, ectopic pregnancy, foetal death. Pelvic inflammatory disease, urethral stricture, Prostatitis on increase everywhere. It is estimated that about 300 million people worldwide are seen with STD annually According to Medical encyclopedia, about 80 percent PID worldwide is caused by STIs majorly Trichomonas vaginalis, Chlamydia and gonorrhea. This research study will therefore seek to determine the prevalence, distribution of STDs by sex, ages, and location. 1.3 General of objective. To assess the prevalence of STDs in Hoima city. 1.3.1 Specific Objectives To determine the distribution of STDs by sex To determine the distribution of STDs by age. To establish the distribution of STDs by location. To establish the monthly distribution of STDs. 1.3.2 Research Questions. What are the demographic characteristics of patients diagnosed and treated with STDs in Hoima hospital? What is the monthly distribution of STD cases in Hoima hospital? 1.4 Significance of the study. This information will help to generate solution towards preventing STDs. To form a basis for other researchers who are interested in the same topic. It is aimed at updating the medical personnel in Hoima hospital and the whole public about the prevalence of STDs. To identify persons at greater risk of getting STDs. The researcher will develop a deeper insight into the field of conducting research. 1.5 Scope of the study To assess the prevalence of STDs in Hoima hospital found in Hoima city. It will include all male and female patients who will be diagnosed and treated at Hoima hospital with STDs between the age group of 15 to 50 years including pregnant women, lactating mothers. It will exclude all patients with STDs but below 15 and those above 50 years of age. It will also exclude some minority tribes in Hoima municipality like southsudanese, conglese,Madi,Kakwa,Indians,Arabs,Somalis especially those who can hardly share a common language with the researcher because of language barrier and very high cost of hiring interpreters. The researcher will exclude homosexuals and lesiabians regardless of their willingness and eligibility to participate in research because of the researcher’s faith in his beliefs which compel him from such associations. Chapter Two: Literature Review Sexually transmitted diseases are infectious diseases caused by one or more microorganisms that are mainly transmitted from one Infected Person to another during unprotected sexual intercourse. The risk of transmission of STIs from one infected person to another varies According to the causative organism of a particular STI. For instance, as many as one out of sexual partners of a patient with Gonococci urethritis may be infected after a single act of sexual Intercourse. On the other hand the risk of sexual transmission of HIV after a single act of sexual intercourse in the absence of other STI lesions may be as low as 0.1-1%. There are over 20 different types of STIs. The most common presentations of these STIs are; a discharge from the penis (urethritis), a discharge from the vagina (vaginitis and rarely cervicitis), sores or wound on the genital Part of both men and women (genital ulcer), and abnormal growth on the Genital parts or other neighboring areas in both men and women (warts). Some common STDs include: gonorrhea, genital candidiasis, Trichomoniasjs, chancrojd, herpes genitalis, lymphogranuloma venerium (LGV), granuloma inguinal, syphilis, non-gonococcal urethritis or Cervicitis, bacterial vaginosis. Hepatitis B virus infectious (I-IBV), HIV/AIDS, scabies, venereal warts and ring worm. 2.2 Distribution of STDs according to demographic characteristics. STDs constitute a significant cause of morbidity and mortality worldwide. Particularly in developing countries. However, their importance had not been realized till only recently in the wake of the H1V epidemic. The Burden of STIs is high worldwide in terms of their associated morbidity, Mortality and social economic impact (WHO 2017, Annual Report). In Uganda,STIs and related complications have consistently ranked among the leading cause of outpatient consultation in public health facilities, Accounting for about 20% of adult outpatient consultations in public health Facilities for many years (Ministry of Health 2017,article in New Vision newspaper) At population level, one study in rural Uganda found a high prevalence of STIs with up to 50% of adults 15-49 having at least one STI (Ministry of Health 2017,article in New vision newspaper) According to CDC 2019 Surveillance, it has been estimated that Out of the 19 million STD infections that occur per year in US at least half of them are Among the youth. However, studies done in developed countries show that 50% of the people Develop full blown AIDS in ten years. The rate is thought to be faster in Africa perhaps due to interaction with epidemic infections, infestations, Malnutrition, stress and other factors. Worldwide the epidemic of HIV was first reported in early 1980s in the United States and later in Africa and is now wide spread with more than sixty Million people infected since then of whom at least twenty million people have died. In Uganda H1V epidemic was first detected in 1982 in Rakai district. From This epicenter, the epidemic spread very rapidly throughout the country, so That by early 90s, every district had reported a case of AIDS. It was estimated that at the end of 2002, about two million people in Uganda were infected, with about eight hundred thousand people living with the Infection and over one million deaths. According to the sentinel Surveillance of H1V based on sero prevalence among antenatal mothers Attending selected antenatal clinic surveillance sites, H1V is more prevalent In major urban areas than in rural areas currently estimated at 5 to 10% and then 5% of adults respectively. Than in males of the same age group. This is due to cross generation sex with girls becoming sexually active at earlier age and having sex with older Men. (According to USAID study 2018, article in New York Times). Sexually transmitted diseases affect any sexually active individual, whether He or she had one partner or many sexual partners. It affects both sexes but the raise is high in the age group of 15 to 30 years and more in females than Males, reason being that girls usually have sex earlier than boys and with Older partners who are likely to be carrying the infection. In Hoima district it has been reported that STDS are more observed mostly in the 20 to 24 years old age group followed by 25 to 29 and 15 to 19 years old. (Hoima hospital referral records 2018) 2.1 Monthly distribution STDS. In Uganda STD form the second largest percentage next to malaria amongst the disease diagnosed in hospitals. It forms about 20% of Diagnosed conditions amongst OPD patients per month. (MOH 2018 article in new vision newspapers). Particularly in Hoima no study has been carried out to determine the Prevalence of STD per month. Chapter Three: Methodology 3.1 Study design. A retrospective descriptive study will be used to determine the distribution of STDs by sex, age and location among people aged between 15 and 50 years. 3.2 Study area. This study will be conducted in Hoima hospital in Hoima district. Hoima is a relatively new city located Northwest of Kampala with Kyankwanzi district in the east, Kibale district in the South, Bulisa district in the north, lake Albert to the west. Hoima hospital is a referral hospital and government founded, established in 1935 as district hospital but in 1994 it was upgraded to referral status targeting Greater Bunyoro (Hoima, Kibale, Masindi, Bulisa, Kiryandogo, Kyankwanzi and Kiboga) and has a catchment area of about three million people as estimated by Uganda MOH 2019. It is Located on atleast 12 acres of land. It has atleast 280 staff, with atleast 317 bed capacity. Hoima hospital comprises of the following departments; OPD, Administration department and in patient department. The OPD consists of the eye clinic, dental clinic, dispensary, TB clinic, minor theatre, ART clinic, ENT clinic, diabetic clinic, antenatal clinic, outpatient laboratory, Emergency unit, mother to child health clinic (MCH) and gynecological Clinic. The ART clinic operates every day from 8:30am to 6:30 from Monday to Friday Whereas the STI clinic only operates Tuesdays. The inpatient department comprises the children’s word, medical ward, surgical ward, maternity ward, gynecology and obstetrics wards, and pharmacy, in patient laboratory. Mortuary, Orthopedic department, operation theatres, staff quarters and stores. The natives of Hoima Municipality are Banyoro, Buganda, Banyankole, lugbara, Bakiga and Acholi also exists. The economy of Hoima district is based on Agriculture, business and investments due to oil discoveries in 2000 to 2009 is the economic activity. Other economic activities include: Fishing, cattle keeping. The municipality experiences rainfall throughout the year with most rains in October and January least rains. 3 .3 Study population The study will target people aged between 15 years to 50 years who will be treated with STDs in the OPD department during the period of research. On average atleast 900 people of age group 15 years to 50 years attend OPD services monthly. 3.4 sample size Determination. Using Kish and Leslies (1995) formula for cross sectional studies will be used for determination of the number of participants interviewed. Asamplesizedeterminationwasconductedbyuseofstatisticalformulaforthesamplesizedetermination asfollows: Sample size, n= Z2 Pq d2 (usingKishandLeslie, 1965). Where; N is the desired sample size, Z is normal standard deviation at the required confidence, P is proportion of target population estimated to have the characteristics measured, D is absolute precision (maximum error) and q=1-p.Therefore Z=1.96(standard normal deviation at 95% confidence interval) p=0.5(estimated prevalence 50%) d=maximum error was 9.8% or 0.098 Then 1.962 x0.5x0.5 n= 0.0982 n=100 Therefore there was100 respondents used in the study 3.5 Sampling Techniques A simple random sampling technique will be used by the researcher because selection of respondents will be without bias and it is time saving compared to other sampling technique 3.6 sampling procedure Simple random sampling method will be used to select respondents in the age range of 15years to 50 years who will be accessed when they come for STDs/STIs services during time of conduction of this research from from Hoima referral hospital .Each respondent will be assigned a number that will be placed in the box, from which a number will be picked at random without replacement, such that each respondent has an equal chance of being selected to participate in the study. 3.7Data collection Method Both qualitative and quantitative methods of data collection will be used. Interview method using formal questionnaires will be administered .Also check-lists will be used to review records of STDs cases in the records department of Hoima Referral hospital to collect data.The researcher will introduce himself to the respondents ,read out the objectives of the study ,get consent from them and continue with the study procedure. 3.8Data collection Tools Data will be collected using an interview schedule questionnaires with both open and closed ended questions. Appropriate explanation will be given to ensure understanding of the questions. Standardized checklist will also be used to review records of STDs cases in Hoima referral hospital. 3.9Data collection procedure The respondents will be interviewed using an interview schedule questionnaire. The respondents who know how to read and write, will be allowed to fill the questionnaire on their own. The researcher will also read and interpret the questionnaire to some respondents to limit on the incidence of errors. Those respondents who have difficulty in reading will be assisted by the research assistants. With the help of a records officer in the record department after obtaining permission from Hoima Referral hospital administration the researcher will review records of STDs cases and extract relevant information applicable in accordance to the objectives upon which this research is being conducted 3.10Study Variables In this study, prevalence of STDs is my dependent variable whereas age, sex and location are my independent variables. This is because prevalence of STDs entirely depends on age, sex and location (urban or rural) of individuals 3.11Quality control To ensure validity and reliability, the questionnaire and checklist will be reviewed by the research supervisors and colleagues for clarity prior to the exercise of data collection. The information collected will be presented to the supervisor for verification. A preliminary study will be carried out to test the accuracy and feasibility of the questionnaire. Research assistants will also be trained on how to efficiently and effectively collect data and will be oriented on proper inclusion and exclusion criteria of the study. 3.12Data Analysis and presentation Data will be collected for analysis using questionnaires and checklists and verified Hoima Referred hospital resourceful personnel (doctor, nurse) through checking of records. The scores of the respondents will be tallied, tabulated and entered into an MS excel program for effective storage and retrieval. Data will be entered into the computer statistical program (SSPS) for analyses. Analyzed data will be presented in tables, charts, graphs, percentages and figures. 3.13Ethical Consideration All research related ethical standards will be observed throughout the course of the study, data collection will be after presentation of an introductory letter from the academic registrar Gulu College of Health Sciences to Hoima Referral hospital administration and Hoima Municipality Healthy Officer. Participation will be voluntary and informed consent will be obtained from each participant prior to administering the questionnaire, Confidentiality will be maintained during the sstudy process and no identification information will be collected. 3.14Study limitations i. Financial constraints will have a negative impact on the work since it will require typing, photocopying, transport and facilitating research assistants who will help to translate to those people with whom the research does not share any common language but are within the target group for research.(Lugbara, Alur,Indians,Luos,west Nilers and others) ii. Covid19 limits as gatherings are not allowed and hence meeting girls one by one consumes time. iii. The research will interfere with the researcher’s personal and academic time because it is time consuming. iv. Some respondents may choose to refuse being interviewed as they may not have time for the researcher. 3.15Dissemination of Results The findings from the study will be disseminated as follows; a copy to: 1. Uganda Allied Health Examination Board (UAHEB) 2. Hoima Referral Hospital 3. Gulu College of Health Sciences 4. Hoima Municipality health management Team 5. 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APPENDIX I: CONSENT FORM DEAR RESPONDANT I AM KASOZI IGA EDWIN A 3 YEAR STUDENT OF COLLEGE OF HEALTH SCIENCES PERTAKING A DIPLOMA IN CLINICAL MEDICINE AND COMMUNITY HEALTH CONDUCTING A STUDY ABOUT PREVALENCE OF SEXUALLY TRANSMITTED DISEASES IN PEOPLE AGED BETWEEN 15 TH 50 YEARS AT THIS HEALTH FACILITY IN THIS STUDY YOU WILL BE REQUIRED TO SIGN A CONSENT FORM AFTER UNDERSTANDING THE PROCEDURE ABOUT THE TOPIC OF STUDY. I WILL ASK YOU QUESTIONS ABOUT THE STUDY AND YOUR RESPOSES SHALL BE RECORDED IN THE QUESTIONNAIRE. THE DISCUSSION WILL TAKE ABOUT 10 TO 20 MINUTES.THERE WILL BE NO MATERIAL COMPASATION IN THIS STUDY AND THE FINDINGS WILL DEFINE THE POSSIBLE MEASURES ON HOW SEXUALLY TRANSMITTED DISEASE CAN BE PREVENTED. THE INFORMATION PROVIDED WILL BE HANDLED WITH OTHERMOST CONFIDENTIALITY AND WILL NOT BE SHARED WITH ANY OTHER PERSON. YOUR IDENTITY WILL NOT BE REVEALED ANYWHERE ON THE QUESTIONIARE. YOUR PERTICIPATION IN THIS STUDY IS VOLUNTARY AND YOU HAVE A CHOICE NOT TO PERTICIPATE. YOU ARE ALSO FREE TO OPT OUT OF THE STUDY WHEN YOU ARE TIRED OR NOT INTERESTED. YOU ARE FREE TO ASK ANY QUESTIONS THAT YOU FEEL YOU ARE UNCERTAIN ABOUT THE STUDY BEFORE THE STUDY BEGINS. I CONFIRM THAT ALL THE INFORMATION ABOUT THE ABOVE TOPIC HAS BEEN EXPLAINED TO ME AND TO MY SATISFACTION AND MY QUESTIONS ARE TO BE ANSWERED TO MY OUTERMOST SATISFACTION. I HEREBY ACCEPT TO PERTICIPATE IN THIS STUDY. RESPONDANT’S SIGNATURE……………………………………………………. DATE……………………………… RESEARCHERS SIGNATURE……………………………………………………… DATE……………………………… NO ITEM 1 STATIONARY 2 QUANTITY UNIT PRICE TOTAL COST A PHOTOCOPYING PAPERS 1 REAM 15,000 15,000 B PENS 5 500 2,500 C FILE FOLDER 1 2,000 2,000 D INTERPRETER INTENSIVES 5 20,000 100,000 10 DAYS 2,000 20,000 2 10,000 20,000 INTERNET SERVICES TYPYING, PRINTING AND PHOTOCOPYING A PROPOSAL B QUESTIONAIRE C REPORT 3 15,000 45,000 D BINDING 5 3,000 15,000 E REPORT HARD COVER 5 10,000 50,000 4 MISCELLANEOUS 5 TOTAL 400 50,000 APPENDIX IV: WORK PLAN CONTENT ACTION 1 2 3 4 5 6 7 8 9 10 11 12 Writing proposal Typing proposal Analyzing proposal Submitting proposal to the supervisor Corrections and retyping Constructing and pretesting instruments Data collection Data analysis Report writing Submit report to the supervisor Correct, retyping and binding report Final report submission SEPT OCT NOV DEC JAN FEB MAR APR