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      A cross sectional study: latrine coverage and associated factors among rural communities in the District of Bahir Dar Zuria, Ethiopia

      research-article
      1 , , 2
      BMC Public Health
      BioMed Central
      Latrine, Latrine coverage facility, Sanitation

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          Abstract

          Background

          Lack of sanitation facilities is a serious health risk and obliges people to practice open defecation, thereby increasing the risk of disease transmission. The aim of this study was to assess latrine coverage and the associated factors among the rural communities in district of Bahir Dar Zuria, Ethiopia.

          Methods

          A community-based cross-sectional study was conducted on 608 households in district of Bahir Dar Zuria. First, the district was stratified based on the distance from Bahir Dar city. Then, ten kebeles (the smallest administrative units) were selected from the 32 rural kebeles in the district. After the kebeles had been identified, the households were selected by systematic sampling method using existing list of all households as a sampling frame. Intervals (K th)) for selecting households were determined by dividing the number of households with the sample size allocated for each kebele. After determining the K th interval, the first household was selected randomly. The next households were identified systematically onwards by adding cumulatively K th intervals to the first selected household .Data were collected by means of a pretested, standardized questionnaire and observation checklist. Data analysis was carried out using SPSS version 16.

          Results

          Of the 608 households, 355 (58.4%) had pit latrines and only 220 (62.0%) were functional (providing services during data collection). One hundred eighty seven (52.7%) had been constructed two or more years prior to the time of the study and 202 (56.9%) latrines required maintenance. The availability of latrines was twice higher in households with an income of 5000 or more Ethiopian Birr (1USD = 17.5 Ethiopian Birr) per year (adjusted odds ratio [AOR], 1.55; 95% confidence interval [CI], 1.06–2.27) than those who hand an income less than 5000 Birr per year; the availability of latrines was twofold higher in households visited by health professional at least three times a month (AOR, 2.29; 95% CI, 1.33–3.93) than those that received no visits. The latrine coverage was about two times higher in households that were less than 30 minutes walk from a health institution (AOR, 1.57; 95% CI, 1.11–2.22) than households that were over 30 minutes walk. The latrine coverage was lower in households located in distant areas (AOR, 0.53; 95% CI, 0.36-0.77) than in households closer to the city.

          Conclusions

          Latrine coverage in District of Bahir Dar Zuria was far from the national target of 100%. The availability of latrines was affected by income level, frequency of visits by health workers, walking time from local health institutions, and distance from Bahir Dar. Therefore, it is recommended that the frequency of supportive visits be increased and that special attention be given to households in inaccessible areas.

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          Most cited references4

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          Water, sanitation and hygiene for the prevention of diarrhoea

          Background Ever since John Snow’s intervention on the Broad St pump, the effect of water quality, hygiene and sanitation in preventing diarrhoea deaths has always been debated. The evidence identified in previous reviews is of variable quality, and mostly relates to morbidity rather than mortality. Methods We drew on three systematic reviews, two of them for the Cochrane Collaboration, focussed on the effect of handwashing with soap on diarrhoea, of water quality improvement and of excreta disposal, respectively. The estimated effect on diarrhoea mortality was determined by applying the rules adopted for this supplement, where appropriate. Results The striking effect of handwashing with soap is consistent across various study designs and pathogens, though it depends on access to water. The effect of water treatment appears similarly large, but is not found in few blinded studies, suggesting that it may be partly due to the placebo effect. There is very little rigorous evidence for the health benefit of sanitation; four intervention studies were eventually identified, though they were all quasi-randomized, had morbidity as the outcome, and were in Chinese. Conclusion We propose diarrhoea risk reductions of 48, 17 and 36%, associated respectively, with handwashing with soap, improved water quality and excreta disposal as the estimates of effect for the LiST model. Most of the evidence is of poor quality. More trials are needed, but the evidence is nonetheless strong enough to support the provision of water supply, sanitation and hygiene for all.
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            Follow-up of a low cost latrine promotion programme in one district of Amhara, Ethiopia: characteristics of early adopters and non-adopters.

            To verify reported construction of 22 385 household latrines in 2004, after community mobilization, as part of a trachoma control programme in one district of Amhara, Ethiopia, and to explore characteristics of early latrine adopters and non-adopters. We used a two-stage cluster sample survey design to randomly select eight sub-districts and 160 households listed as having built a latrine, and visited them to verify presence and use. Household heads were interviewed to determine latrine cost and knowledge, attitude and practice regarding latrines. Non-latrine adopting neighbours were interviewed for comparison. We estimated district latrine ownership and calculated adjusted odds ratios for factors associated with latrine use. Latrines were present in 87% (95% CI 77-97) of listed households; 90% (81-99) were in use. Among all district residents we estimated ownership as 50.2% (44-56) and use as 45.2% (36-55). Of latrine owners who had built in 2004, 69% (53/77) had spent nothing on their latrine, those who paid spent an average of US$4.0 [standard deviation (SD) US$3.6]; overall the median cost was US$0 and the mean US$0.80 (SD US$1.7). Household heads adopting latrines were 1.9 times (95% CI 1.3-2.8) more likely to have any education and 1.5 times (95% CI 1.1-2.0) more likely to have a larger family than non-adopting neighbours. Cleanliness (48%, 56/116) and health benefits (42%, 49/116) were the most frequently reported advantages of latrines. The latrine promotion programme dramatically increased latrine access and use at very low cost. The method of community mobilization used could be an effective way of reaching millennium development sanitation targets.
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              Characteristics of latrine promotion participants and non-participants; inspection of latrines; and perceptions of household latrines in Northern Ghana.

              To examine characteristics of household heads in two districts of Northern Ghana who had or had not participated in latrine promotion programmes; to inspect latrines; and to explore perceptions of latrine ownership. One hundred and twenty latrine owners and 120 non-owners were randomly selected from all trachoma-endemic villages and interviewed. Structured questionnaires assessed demographics, household data, wealth indicators, and perceptions of latrine ownership. Latrines were inspected. Latrine owners and non-owners were similar demographically, but owners were more likely to report any education or wealth indicators: any education OR = 2.0, (95% CI 1.2-3.4); large family size OR = 4.6 (2.6-8.2); children in school OR = 3.8 (1.3-10.5); and metal roof OR = 9.1 (2.0-40.0). All 120 latrine owners were participating in promotion programmes; no latrines had been self-built without programme support. Inspection showed 73/120 (60.1%) latrines were completed and used. Of the uncompleted latrines 41/47 (87.2%) were more than a year old. Programme participants (regardless of whether they had a completed latrine) had contributed cash (mean 16.74 dollars S.D.18.09) and 117/120 had provided labour and/or construction materials. The most frequently reported advantages of latrine ownership were convenience, cleanliness and health benefits; reported disadvantages were the need for maintenance and cleaning and bad odour. Current latrine promotion programmes do not reach all households equally. Joining a latrine programme was expensive and did not guarantee latrine ownership; this may cause people to lose trust in such programmes. Latrines were perceived to be useful, suggesting unmet demand. Reliable and inclusive programmes that provide low cost latrines may receive community support.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2013
                4 February 2013
                : 13
                : 99
                Affiliations
                [1 ]College of Medicine and Health Sciences, Bahir Dar University, P.O. Box-693, Bahir Dar, Ethiopia
                [2 ]GAMBY College of Medical Sciences, P.O. Box-209, Bahir Dar, Ethiopia
                Article
                1471-2458-13-99
                10.1186/1471-2458-13-99
                3606841
                23374236
                0bddd221-6553-439e-8220-81bd3dc17ee4
                Copyright ©2013 Awoke and Muche; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 2 September 2012
                : 31 January 2013
                Categories
                Research Article

                Public health
                latrine,latrine coverage facility,sanitation
                Public health
                latrine, latrine coverage facility, sanitation

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