Dataset Information

Exploring barriers to the adoption and utilization of improved latrine facilities in rural Ethiopia: An Integrated Behavioral Model for Water, Sanitation and Hygiene (IBM-WASH) approach.

ABSTRACT:

Background

Even though evidence shows that access to and use of improved latrines is related to healthful families and the public, obstacles to the adoption and use of improved latrine facilities remain. Globally, not many inquiries appear to have been carried out to satisfactorily inform us regarding the multi-level barriers influencing the adoption and utilization of improved latrines facilities. Related studies in Ethiopia are even fewer.

Methods

Two qualitative data gathering methods, viz., key informant interviews and focus group discussions, were employed to collect data for this study. A total of fifteen focus group discussions were conducted with members of the community in the rural Wonago district of Ethiopia. Similarly, ten key informant interviews were conducted with water, sanitation, and hygiene officers, and health extension workers responsible for coordinating sanitation and hygiene activities. Open code software 4.03 was used for thematic analysis.

Result

Barriers to adoption and use of improved latrine facilities were categorized into Contextual factors (e.g. Gender, educational status, personal preference for using the field, limited space, population density, the status of land ownership), Psychosocial factors (Culture, beliefs, attitudes, and perceptions of minimal health threat from children's feces), and Technological factors (inconveniences in acquiring materials and cost of constructing a latrine).

Conclusion

There are a series of multi-leveled barriers to the sustained adoption and use of latrines. Providing funding opportunities for the underprivileged and offering training on the engineering skills of latrine construction at the community level based on the contextual soil circumstances could expand the latrine coverage and use. Similarly, taking into account the variability in motivations for adopting and using latrines among our study in Ethiopia and other studies, we implore public health experts to recognize behaviors and norms in their target communities in advance of implementing sanitation interventions.

SUBMITTER: Tamene A

PROVIDER: S-EPMC7799797 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Exploring barriers to the adoption and utilization of improved latrine facilities in rural Ethiopia: An Integrated Behavioral Model for Water, Sanitation and Hygiene (IBM-WASH) approach.

Tamene Aiggan A Afework Abel A

PloS one 20210111 1

<h4>Background</h4>Even though evidence shows that access to and use of improved latrines is related to healthful families and the public, obstacles to the adoption and use of improved latrine facilities remain. Globally, not many inquiries appear to have been carried out to satisfactorily inform us regarding the multi-level barriers influencing the adoption and utilization of improved latrines facilities. Related studies in Ethiopia are even fewer.<h4>Methods</h4>Two qualitative data gathering ...[more]

PMID: 33428677

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Project description:BackgroundLack of latrines remain a widespread health and environmental hazard in many developing countries. Low latrine utilization mostly affects the poor, rural and marginalized communities as the majority of those who do not use improved latrines live in rural areas where 90% of all open defecation takes place. The counterpart to this problem, Community-Led Total Sanitation, and hygiene (CLTSH) is an approach that involves facilitating a process to inspire and empower communities to stop open defecation and to build and use latrines in a participatory manner.ObjectiveThis study was aimed at assessing the Community Led Total Sanitation and Hygiene approach on improvement of latrine utilization in Laelay Maichew District of Central Zone, Northern Ethiopia.MethodsA comparative cross-sectional study was conducted in Laelay Maichew District of Central Zone, Northern Ethiopia from November 2016 to January 2017. The study subjects were randomly selected 388 households from CLTSH implemented kebeles and 388 households from CLTSH non-implemented kebeles. Systematic random sampling technique was used to select households among proportionally allocated sample frame of households. Then, Interview of household heads using semi-structured questionnaire was conducted to collect data. Finally, data were entered and analyzed using SPSS version 20.0. Bivariate Logistic regressions model was used to identify candidates of multiple logistic regressions. Those P-values < 0.25 were considered as candidates to multiple logistic regressions to determine independent factors of latrine utilization. Variables with Odds Ratio at 95% CI and P-value < 0.05 was considered statistically significant. The study obtained approval from Aksum University Institutional Review Board before its commencement.ResultThis study indicated that the level of latrine utilization and latrine availability in CLTSH implemented kebeles were greater than that of CLTSH Non-implemented kebeles. The finding of this study revealed that the rate of latrine utilization in the rural community of Laelay-matches district was about 47.4%, 95% CI (42.9%-51.8%). The majority (71.1%) of household in CLTSH implemented kebeles and (93.5%) of households in CLTSH non-implemented kebeles did not have hand washing facility near the latrine. Households which had no fresh excreta in around latrine were significantly 11.5 times higher than [AOR: 11.5, 95% CI (0.18, 50.2)] utilizing their latrine in CLTSH implemented kebeles.ConclusionThe study showed that the level of latrine utilization in CLTSH implemented and that of CLTSH non-implemented kebeles was low. Therefore, concerted efforts should be made by local and national governmental and non-governmental organization to should be used to promote behavioral change in the communities to implement community-led total sanitation and hygiene for improving latrine utilization.

Project description:Background: Helminthiases are a group of disabling neglected tropical diseases that affect billions of people worldwide. Current control methods use preventative chemotherapy but reinfection is common and an inter-sectoral approach is required if elimination is to be achieved. Household and community scale water treatment can be used to provide a safe alternative water supply for contact activities, reducing exposure to WASH (water, sanitation, and hygiene) -related helminths. With the introduction of ultraviolet light emitting diodes (UV-C LEDs), ultraviolet (UV) disinfection could be a realistic option for water treatment in low-income regions in the near future, to provide safe alternative water supplies for drinking and contact activities such as handwashing, bathing, and laundry, but currently there is no guidance for the use of UV or solar disinfection against helminths.Methodology: A qualitative systematic review of existing literature was carried out to establish which WASH-related helminths are more susceptible to UV disinfection and identify gaps in research to inform future studies. The search included all species that can infect humans and can be transmitted through water or wastewater. Five online databases were searched and results were categorized based on the UV source: sunlight and solar simulators, UV-A and UV-B (long wavelength) sources, and UV-C (germicidal) sources.Conclusions: There has been very little research into the UV sensitivity of helminths; only 47 studies were included in this review and the majority were carried out before the standard protocol for UV disinfection experiments was published. Only 18 species were studied; however all species could be inactivated by UV light. Fluences required to achieve a 1-log inactivation ranged from 5 mJ/cm2 to over 800 mJ/cm2. Larval forms were generally more sensitive to UV light than species which remain as an egg in the environment. This review confirms that further research is required to produce detailed recommendations for household or community scale UV-C LED or solar disinfection (SODIS) of water for preventing helminthiases.

Project description:WHO and UNICEF have proposed an action plan to achieve universal water, sanitation and hygiene (WASH) coverage in healthcare facilities (HCFs) by 2030. The WASH targets and indicators for HCFs include: an improved water source on the premises accessible to all users, basic sanitation facilities, a hand washing facility with soap and water at all sanitation facilities and patient care areas. To establish viable targets for WASH in HCFs, investigation beyond 'access' is needed to address the state of WASH infrastructure and service provision. Patient and caregiver use of WASH services is largely unaddressed in previous studies despite being critical for infection control.The state of WASH services used by staff, patients and caregivers was assessed in 17 rural HCFs in Rwanda. Site selection was non-random and predicated upon piped water and power supply. Direct observation and semi-structured interviews assessed drinking water treatment, presence and condition of sanitation facilities, provision of soap and water, and WASH-related maintenance and record keeping. Samples were collected from water sources and treated drinking water containers and analyzed for total coliforms, E. coli, and chlorine residual.Drinking water treatment was reported at 15 of 17 sites. Three of 18 drinking water samples collected met the WHO guideline for free chlorine residual of >0.2 mg/l, 6 of 16 drinking water samples analyzed for total coliforms met the WHO guideline of <1 coliform/100 mL and 15 of 16 drinking water samples analyzed for E. coli met the WHO guideline of <1 E. coli/100 mL. HCF staff reported treating up to 20 L of drinking water per day. At all sites, 60% of water access points (160 of 267) were observed to be functional, 32% of hand washing locations (46 of 142) had water and soap and 44% of sanitary facilities (48 of 109) were in hygienic condition and accessible to patients. Regular maintenance of WASH infrastructure consisted of cleaning; no HCF had on-site capacity for performing repairs. Quarterly evaluations of HCFs for Rwanda's Performance Based Financing system included WASH indicators.All HCFs met national policies for water access, but WHO guidelines for environmental standards including water quality were not fully satisfied. Access to WASH services at the HCFs differed between staff and patients and caregivers.

Project description:BackgroundLatrine utilization is the actual behavior in a practice of regularly using existing latrines for safe disposal of excreta. Latrine utilization is a common problem in semi-urban areas of developing countries, including Ethiopia. Since the status of latrine utilization and associated factors among semi-urban areas of northeastern Ethiopia, including Alansha in South Wollo Zone is unknown, local data is needed in order to assess the need for planning of intervention programs for the improvement of latrine utilization to support consistent and sustained latrine utilization. This study is designed to address this knowledge gap.MethodsA cross-sectional study was conducted from February to March, 2019 among 401 systematically selected households. Data were collected by trained workers using a pre-tested, structured questionnaire via face-to-face interviews and on-the-spot observations of the latrines. A systematic random sampling method was used to select participant households. Data were entered using EpiData version 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 25.0 for data cleaning and analysis. The wealth index status of participants was estimated using principal component analysis. Data were analyzed using a binary logistic regression model at 95% confidence interval (CI). From the multivariable logistic regression analysis, variables with p-value < 0.05 were taken as statistically significant and independently associated with latrine utilization. Model fitness was checked using Hosmer-Lemeshow test.ResultWe found that the prevalence of latrine utilization among households was 71.8% (95% CI [67.5-76.1%]) while 28.2% (95% CI [23.9-32.5%]) did not utilize latrines. About one-fifth (21.7%) of participant households were found to have a pit latrine with slab and 78.3% (311) used pit latrines without slab. The hygienic condition of the majority (82.9%) of the latrines was dirty and only 17.1% clean. Household family size from one to three persons (AOR: 3.99, 95% CI [1.20-6.24]), presence of primary or secondary school student in a house (AOR: 2.33, 95% CI [1.42-3.83]), number of years since latrine was constructed (≥ 2 years) (AOR: 1.82, 95% CI [1.12-2.95]) and a frequency of daily cleaning of the latrine (AOR: 2.19, 95% CI [1.12-4.28]) were factors significantly associated with latrine utilization.ConclusionSeven out of ten households utilized a latrine. Factors significantly associated with latrine utilization were household family size from one to three persons, presence of primary or secondary school student in the house, time since household latrine had been constructed of two or more years and daily frequency of latrine cleaning. Therefore, it is recommended that measures to promote behavioral change towards further improvement in sustainable and consistent latrine utilization should be carried out based on the evidence of the determinant factors found in this study.

Dataset Information

Exploring barriers to the adoption and utilization of improved latrine facilities in rural Ethiopia: An Integrated Behavioral Model for Water, Sanitation and Hygiene (IBM-WASH) approach.

Background

Methods

Result

Conclusion

Publications

Exploring barriers to the adoption and utilization of improved latrine facilities in rural Ethiopia: An Integrated Behavioral Model for Water, Sanitation and Hygiene (IBM-WASH) approach.

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