The Perception and Barriers of Peoples to Prevent Noncommunicable Diseases” Through Physical Activities: In the Case of Debre Markos and Fnoteselam Towns, Ethiopia

This study attempted to assess the habits and awareness of people towards physical exercise and its challenges and opportunities in the process of preventing selected NCD. To conduct this study the researchers delimited to Debre Markos and Fnoteselam towns in different respective population groups and offices. The total sample sizes were2200 and a minimum of 600 sample respondents were taken by 10 % rule among this 470 for questionnaire and 130 for interview respondents. Each office has been selected by stratified sampling based on purposively expected availability of information and participants were categorized according to their demographic placement such as sex, age, education and habit of involvement then followed by simple random sampling techniques. In this research, the data collection tools employed questionnaires, interview with focus group discussion and document were analyzed in triangulation manner. The reason why the researchers chooses these methods is to get valuable and reliable data for outshined barriers of physical exercise, causes of prevention of disease (NCD) in the case of Debre Markos and Fenoteselam towns. After that the questionnaires were administered and the data was collected, tailed, analyzed and logical conclusion and recommendation was reported.

chronic respiratory disease (such as chronic obstructed pulmonary disease, asthma), blood pressure (hypertension), cancer, cardiovascular (like heart attack, stroke), diabetes and obesity are serious problems.
To say this, the researchers had seen the Debre Markos and Fenoteselam town community being correlated and evaluated with physical exercise is not that much observed, therefore as the researcher tried to be dig out in our study what were the major barriers in the engagement of physical fitness? Does it poor physical activity or habit behalf of community? Does it hinder the practice of experts with sport ethics problem? Does it awareness problem besides of the benefits of sport practice? Does it related to resource like human, material and facilities (sport infrastructure)? On the contrary the symptom of NCD had been watched since the data obtained from health centers (Debre Markos referral hospital and Fenotselam hospital).When we had seen the importance of physical exercise soon or later different study assures; physical activity is more preferable than taking medication in order to improve the society health condition. To this end the Researchers answer the following Research questions.

RESEARCH QUESTIONS
In order to conduct this research, we the researchers were tried to investigate the following basic research questions.
1. Are there Gym and fitness centers available in Debre Markos and Fnotselam towns?
To what extent the community is aware about the importance of physical exercise related to health? 3. What are the major factors which affects the participation of the community towards regular physical activities? 4. To what extent the community involving in physical exercise in the available sport arena and fitness center?

OBJECTIVES OF THE STUDY 1.4.1. GENERAL OBJECTIVE
The general objective of this research was to investigate the perception of people to prevent non-communicable diseases" through physical activities 1.4.2. SPECIFIC OBJECTIVES 1. To assess the current status of sport arena and fitness centers 2. To assess the communities awareness about the importance of physical exercise to prevent NCD 3. To identify the major barriers of the community towards the effects of involvement of regular physical activities on NCD 4. To assess the perception of community towards the importance of physical exercise in order to prevent NCD

SIGNIFICANCE OF THE STUDY
This study was conducted to identify the major challenges in the practice of physical fitness in Debre Markos and Fnoteselam town community alienated to prevent selected NCD chronic health conditions. Therefore the researchers of this study hopes that the findings of the research would contribute to: To indicate the major barriers of the people habits and sport culture, the importance of exercise to society active life style, healthy and health related issues are timely researchable area since low income country people have not obtained sufficient medical services because the diagnosis and treatment costs are very expensive, To solve the major problem enhancing the practice of physical exercise is became the preferable means and no choice, to give insight for experts within streams; and also To provide scientific findings for policy makers in behalf of prevention program

DELIMATION OF THE STUDY
This study is delimited to Debre Markos and Fenoteselam towns in different respective population groups and offices such as Debre Markos University, Debre Markos town administration offices workers, East gojjam zone office workers, such as East gojjam Zone administration office, East gojjam Zone educational office, Debre Markos city sport office, East gojjam zone sport office, commercial bank and Fenoteselam town (administration office, educational office and sport office) the total sample size 2200 and a minimum of 600 sample respondents were taken by 10 % rule among this 470 for questionnaire and 130 for interview respondents. Again the scope is delimited in terms of NCD were focused on chronic respiratory disease, like; blood pressure, cardiovascular diseases, coronary heart disease, diabetes and obesity have been profound effect in order to conduct our study would be feasible.
A chronic condition or disease-is a human health condition that is persistent or otherwise long-lasting in its effects. The term chronic is usually applied when the course of the disease lasts for more than three months. Common chronic disease include arthritis, asthma, cancer, diabetes and AIDS Chronic respiratory disease-is a quarterly peer-reviewed medical journal that covers research in the field of respiratory disease including chronic obstructive pulmonary lung disease (COLD), respiratory failure and obstructive sleep apnea or chronic airflow limitation (CAL) and chronic obstructive pulmonary disease-is a lung disease defined by persistently poor air flow as a result of breakdown of lung tissue (known as emphysema) and dysfunction of the small airways. High blood pressure (hypertension)-sometimes called arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is elevated. Cardiovascular disease-refers to any class disease that affects the cardiovascular system, particularly vital heart (cardiac disease, vascular disease or the blood vessels(arteries, capillaries and vein)) of the brain, kidney, and peripheral arterial disease. Diabetes-is a condition where the body fails to utilize the ingested glucose properly. Obesity-is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems.

RESEARCH METHODOLOGY 2.1. DISCRIPTION OF THE STUDY AREA
East Gojjam Zone and Fenotselam Towns were found in Amahara Regional state. They are selected as a place where to conduct this research due to its convenience in relation to time, money and work place for the researchers.

RESEARCH DESIGN
All research needs a foundation for its inquiry, and inquiries need to be aware of the implicit world views they bring to their studies. The research design is the road map in any research work which refers to a plan of action that links the philosophical assumption to specific methods. Thus, a descriptive survey method was used because it was the most appropriate for addressing and explored the intended purpose of this study (to assess the perception of people towards physical exercise and associated factors like (lack of time, social factors (sedentary life style and habits of sport practice, culture of sport ethics, lack of interest, fear of injury, lack of skill), associated to resource (fitness scholars, facilities and equipment's (sport infrastructure alienated to urban plan and transportation with work and residence, health and weather condition) and attitude and the effect of physical exercise in prevention of NCD and what looks like in Debre arkos and Fenoteselam towns' community? To this end, timely among many designs of research descriptive survey methods were employed in this research as it can provide sufficient information regarding the subject.

SUBJECT OF THE STUDY
As stated in chapter one the participants of this study would be delimited in Debre Markos and Fenoteselam towns selected sector workers a minimum of 10% rule the proportion of the total sample size(N= 2200), among this we were taken (n=600) sample respondents which means 470(332 male and 138 female) respondents for questionnaires, and 130(87 male and 43 female) for interview, both in Debre Markos and Fenoteselam town separately N1-Debre Markos=1200, N2 Fenoteselam=1000, therefore the proportional formula for the questionnaire and interview is represented by P=Ni X n /N, i=1, 2 P1=N1Xn/N=1200X600/2200=327 and P2=N2 X n/N =1000X600/2200=272.These means first from 600 sample population within this 599 for questionnaire and interview based on place, which means 224 for questionnaire and 103 for interview were taken from Debre Markos town together with Fenoteselam town therefore, 272 for questionnaire and interview within this again 200 for questionnaire and 72 for interview were taken from Fenoteselam town purposively. On the other hand jointly, for questionnaire and interview based on sex, which means 600 (419 male and 181 female) sample population from Debre Markos and Fenoteselam town, we were taken purposively.

DATA COLLECTION TOOLS
In this research, the data collection tools employed questionnaires, interview with focus group discussion and document analysis in triangulation manner. The reason why the researcher chooses these methods is to get valuable and reliable data for outshined barriers of physical exercise and causes of prevention disease (NCD) in the case of Debre Markos and Fenoteselam towns.

QUESTIONNAIRE
A questionnaire is a data collection tool in which written questions are presented that are to be answered by the respondents in both close ended and open ended question form and likert scale because it is the most commonly used method in inquire therefore the respondents are responding their answer with a pre sheet on the given space accordingly.

INTERVIEW
Interviews are a type of survey tools where questions are conducted in face to face or personal contact situation of two parties the interviewee and interviewer. The interview is like a conversion and has the purpose of obtaining information relevant to a particular research theme (Kumar, 1999). The researcher's technique would be employed focus group discussion, semi-structured interview (the purpose of this semi-structured interview is to give the opportunity for the free flow of information between interviewer and interviewee).

SOURCES OF DATA
Documents are obtained from valuable primary and secondary sources of information such as questioner, interview and texts, newspaper, minutes of meetings, articles, letters, diaries, memos or scripts, etc. these were manual or electronics obtained from clients and health centers.

METHOD OF DATA ANALYSIS
In this study, both qualitative and quantitative mixed analytical research methodology procedure would be employed, for reference to this, Flick (2002) as quieted Muluken (2006) suggested that qualitative and quantitative methods should be viewed as corresponding rather than contestant camps. The researchers offered the questionnaires checked by statisticians as pilot test first for data validity and reliability and the questionnaires would be distributed accordance with other tools such as prepared interview, observation and gathering relevant documents from target groups for proper handling of data. The techniques of data collected procedures employed by stratum and purposively utilized based on availability accordance with random sampling and then the responses tabulated and analyzed through percentile score.

.ANALYSIS OF DATA AND INTERPRETATION
The following table here after shows the questionnaire and interview question had been necessary designed to handle with simple percentile score all items and alternatives, would be treated entirely based on the study objectives and our basic research questions. Therefore the respondents respond by Amharic as much as possible, it is managed and translated in to English genuinely and accordingly, the major hindering barriers. To saying this here after the researchers employed certain symbols represents Distributed Questionnaire (DQ), Return Questionnaire Response (RQR), Demographic Information (DI), and Questionnaire (Q), Interview (I),Propose for Interview (PI), Interview Results (IR). This implies that, the life of the respondents in the study lack of the habit of regular fitness programs because of different attitudinal barriers as explained in different parts of the report. Regarding the majority 318(67.65%) of sample respondents replied that personal enabling reasons and other reasons as shown in the interview part of the paper it lacks physical fitness program. Based on respondents', the benefit of exercise could be improved entire health status, self-esteem and mood as well as reducing symptoms of depression and anxiety by 330(70.21%).

Table1. Demographic information
The majority 290(61.70%) of the respondents replied that they were feel free and confidential were participated even in an irregular setting. the primary goal of the respondents' to be engaged in physical exercise, 188(40%) aimed for developing their physical fitness and 210(44.68%) aimed for improving their health conditions. This implies that active individuals have high quality of health status. Concerning about the confidence of inactive individuals comparing with active individuals 321(68.29%) of them replied that they have lower selfesteem and self-management abilities. About their strengthen, 155 (32.97%) respondents said that they lack one or more physical qualities like, lower self-esteem and self-management abilities when they were compare themselves with others.   4. 55(11.70%) of respondents respond that were said, very likely because they want to be get physical exercise but not practically work physical exercise, 96(20.42%) of the respondents respond that were likely, 147(31.27%) of the respondents respond that were somewhat likely, and 172(36.59%) of the respondents responding that were unlikely. This implies there is no lack of interest in Debre Markos and Fenoteselam town the respondents respond that unlikely because they wish to make physical exercise. .57 According to table 5 above, 14(2.97%) of the respondents respond that very likely because there is a lack of any skills of physical exercise, 111(23.61%) of the respondents respond that likely, 112(23.82%) of the respondents respond that somewhat likely, and 233(49.57%) of the respondents respond that unlikely. This implies that in Debre Markos and Fenoteselam town most of the significant respondents responding unlikely response, because of they need to have learned new skills of any sport.  From the above table 6, 13(2.76%) of the respondents responded that were facing psychic health problem, 109(23.19%) of the respondents responded that were having circulatory and breathing or respiratory health problem, 87(18.51%) of the respondents responded that were having obesity, 261(55.53%) of the respondents responded that were free from any health problem. This implies that, more than half of the respondents responding the communities are healthier, 166(35.31%) of the respondents responded that were yes response because the community having the habits of periodical checkup about entire health condition and 304(68.64%) of the significant respondents responded that were said "No" response that means the significant number of people haven't the trends of periodical checkup about the entire health condition. This implies that most of the communities have not enough experience about periodical checkup about entire health status.

SUMMARY,FINDINGS, CONCULUSION AND RECOMMENDATION 4.1. SUMMARY
The major purpose of this study was attempted to the perception of people towards physical exercise and its challenges and opportunities in the process of preventing selected NCDs through physical exercise. To this end the study tries to answer the following basic research questions: 1. Are there Gym and fitness centers available in Debre Markos and Fnotselam towns?
To what extent the community is aware about the importance of physical exercise related to health? 3. What are the major factors which affects the participation of the community towards regular physical activities?
4. To what extent the community involving in physical exercise in the available sport arena and fitness center? To conduct this study the researchers delimited to Debre Markos and Fenoteselam towns in different respective population groups and offices society. And the total sample size 2200 and a minimum of 600 sample respondents were taken by 10 % rule among this 470 for questionnaire and 130 for interview respondents. Each office has been selected by stratified sampling based on purposively expected availability of information and participants were be categorized according to their demographic placement such as sex, age, education and habit of involvement then followed by simple random sampling techniques. In this research, the data collection tools employed questionnaires, interview with focus group discussion and documents would be analyzed in triangulation manner. The reason why the researchers chooses these methods is to get valuable and reliable data for outshined barriers of physical exercise and causes of prevention disease (NCD) in the case of Debre Markos and Fenoteselam town. After that the questionnaires were administered and the data was collected, tailed, analyzed and logical conclusion and recommendation was reported.

FINDINGS
Based on the data analysis the following major findings were obtained:  Lack of awareness about the benefit of physical exercise, poor practice of life style associated to income and routine manual work, cold weather condition, shortages of the expert's, lack of commitment and schedule in order to join in physical exercise at the regular base are among the raised constraints.  The scarcity of facility there is a shortage of facilities and equipment's to invite physical exercise as community level even though having very little access in the sport infrastructure, the community does not uses these infrastructures properly.  The scarcity of equipment there is a shortage of budget and equipment's are the major reasons as constraints.  Lack of skill and attitude there is less participation in the available sport arena and regular physical fitness programs so weak, the reasons are life styles; lack of personal enabling, confidence of inactive individuals comparing with active individuals replied that they have lower self-esteem and selfmanagement abilities for engaging in physical exercise.  Lack of interest this implies there is no lack of interest respondents respond they wish to make physical exercise.  Time barriers the significant respondents were answered time is not the major hindering barrier in order to engaged in physical exercise  Social factor majority of the respondents respond, social factor is not the major barrier in order to engage in physical exercise.  Fear of injury the significant respondents were answered it is not the major barrier in order to involve in physical exercise.  Health factors the findings implies more than half of the respondents responding healthier however the communities have not enough experience about periodical checkup about entire health status

CONCULUSION
On the basis of the findings the researchers were concluded as follows based on the data obtained from the respondents:  The majority of the respondent replied less concerning about their participation in regular physical fitness programs because the lifestyle of the respondents lacks the habit of regular fitness programs, personal enabling reasons like the confidence of inactive individuals comparing with active individuals replied that they have lower self-esteem, low participation in their engagement induce different fears, lack of sleep, lack of skill and fear of injury were attitudinal stated barriers  The respondents were said that," physical exercise is not harmful "so that fear of injury was not the major barrier in order to involve in physical exercise. Regarding to this, most of the significant respondent's responding unlikely response, because of they didn't learn new skills of any sport even though, they wish to make physical exercise.  The respondents respond that the shortage of facilities and equipment's for physical exercise at school or at work place was the major bottleneck factors regarding to engaged in regular physical exercise program.  The respondents were said that, "lack of enough time is not the major hindering barrier because the social activities like family, friends and other social issues highly attached with daily activities rather than to engaged in physical activity.  Respondents replied that the communities have no experience for periodical checkup about entire health status so the cost of preventing is very less when comparing with the cost of curing and they justified that preventing is less complicated and cost minimized.
 Lack of interest this implies there isno interest in Debre Mmarkos and Fenoteselam town the respondents respond that unlikely because they wish to make physical exercise.  Time barriers the researchers conclude that the significant respondents were answered that time is not the major hindering barrier in order to engaged in physical exercise  As social factor concluded as, it is not the major barrier in order to engage in physical exercise.  Fear of injury concludes that, fear of injury was not the major barrier in order to involve in physical exercise.  Health associated factors more than half of the respondents responding in Debre Markos and Fenoteselam town the health status implies there is no communities health problem however the communities have not enough experience about periodical checkup about entire health status

RECOMMENDATION
On the basis of the findings and conclusions the following recommendations are drown for proper implementation of effective change of community attitude on the bases of NCDS related to physical activities: The government prepared continues awareness creation stage within the community like:  Physical activity on rode  Preparer the physical activity day per week  Crating the awareness for community about the benefit of physical activity by different media. The government and the concerned body must be work together to inducing about:  Advise the community for brisk walking  Allocate proper annual budget for all physical activity  Establishing sound policy  Create access and availability for different stakeholders like governmental service delivery organization, nongovernmental organization and private sectors to plan and work together for sport facilities and equipment's The Ministry of education revised physical education and sport science curriculum by incorporating physical exercise program related to NCDs in different educational institutions. The fitness coaches and Nutritional coaches should be work together to minimize NCDs ACKNOWLEDGMENT First we the researchers acknowledge Debre markos University because encouraging and supporting through motivation and finance, second we want to acknowledge responding participants, thirdly as a principal researcher I want to be acknowledge all our staffs and co researchers especially Mr. Awoke Tibebu from the beginning of the issue supporting to their continuous commitment with the whole research organ accomplishment.