scholarly journals Can open-defecation free (ODF) communities be sustained? A cross-sectional study in rural Ghana

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261674
Author(s):  
Caroline Delaire ◽  
Joyce Kisiangani ◽  
Kara Stuart ◽  
Prince Antwi-Agyei ◽  
Ranjiv Khush ◽  
...  

Community-led total sanitation (CLTS) is a widely used approach to reduce open defecation in rural areas of low-income countries. Following CLTS programs, communities are designated as open defecation free (ODF) when household-level toilet coverage reaches the threshold specified by national guidelines (e.g., 80% in Ghana). However, because sanitation conditions are rarely monitored after communities are declared ODF, the ability of CLTS to generate lasting reductions in open defecation is poorly understood. In this study, we examined the extent to which levels of toilet ownership and use were sustained in 109 communities in rural Northern Ghana up to two and a half years after they had obtained ODF status. We found that the majority of communities (75%) did not meet Ghana’s ODF requirements. Over a third of households had either never owned (16%) or no longer owned (24%) a functional toilet, and 25% reported practicing open defecation regularly. Toilet pit and superstructure collapse were the primary causes of reversion to open defecation. Multivariate regression analysis indicated that communities had higher toilet coverage when they were located further from major roads, were not located on rocky soil, reported having a system of fines to punish open defecation, and when less time had elapsed since ODF status achievement. Households were more likely to own a functional toilet if they were larger, wealthier, had a male household head who had not completed primary education, had no children under the age of five, and benefitted from the national Livelihood Empowerment Against Poverty (LEAP) program. Wealthier households were also more likely to use a toilet for defecation and to rebuild their toilet when it collapsed. Our findings suggest that interventions that address toilet collapse and the difficulty of rebuilding, particularly among the poorest and most vulnerable households, will improve the longevity of CLTS-driven sanitation improvements in rural Ghana.

Author(s):  
Sylvia M. Nkatha ◽  
Eric M. Muchiri ◽  
Patrick Kubai ◽  
Jane Rutto

Introduction: Globally, poor sanitation is the cause of childhood diseases. Annually, more than 19,500 people die from diarrhea of which 17,100 are children. Diarrhea, which accounts for 16% of deaths among the children below 5 years, is highly linked to open defecation (OD). Poor excreta disposal remains a major challenge to improved sanitation and hygiene in many communities of Kenya and therefore they continue to practice open defecation. Construction and utilization of a latrine at home is a protective factor for communicable diseases.  About 52% of the population practice proper utilization of latrine in low-income countries. Improper utilization of latrines leads to the contamination of the water sources. Availability of a pit latrine does not guarantee utilization because other factors like functionality and distance influence its use. Furthermore, the availability and use of the latrine depends on maintenance practices of the latrines and cleanliness as well as the quality of housing and household compound. Aims: To analyze the physical and social demographic factors influencing the utilization of pit latrines in Tigania East Sub-County, Meru County, Kenya. Study Design:  The study was a descriptive cross-sectional survey. Place and Duration of Study: The study was carried out in Tigania East Sub-County, Meru County, Kenya shown in Fig. 3. Household survey was carried out between June 2018 and December 2019. Methodology: This was a descriptive cross-sectional survey involving 369 respondents selected by systematic random sampling from different households across the sub-county was utilized. Data collection was done using a structured questionnaire administered in English and a spot observation checklist. All data generated was entered, validated and analyzed using SPSS using SPSS Software Version 23.  Descriptive analysis was done during the calculation of measures of central tendency and proportions. Regression analysis was used in the determination of any association between the socio-demographic factors and the utilization of latrines. Results: Ownership, location and functionality of the pit latrine were positively associated with utilization (OR=2.127, OR=1.53, OR=4.36, P=.00). Households that owned pit latrines were 2 times likely to utilize the pit latrines than those without a pit latrine. Moreover, household size, gender, and employment were positively related to utilization (R=0.502, P=.00). High construction costs challenges were 7 times linked to open defecation practices. Households with less than 6 members were 2.35 times more likely to utilize the pit latrine compared to those with 7-12 members (OR=2.35, X²=13.573, P=.00). Conclusion: Interventions should target households with more than 7 members. A call for partnerships between government and donors to improve household income, water sources, and sanitation practices in Tigania East Sub-County is necessary. A call for funding projects related to pour-flush pit latrines and wet technologies to enhance utilization.


Author(s):  
Velavan A. ◽  
Jyothi Vasudevan ◽  
Arun S. ◽  
Anil J. Purty ◽  
Vincent A.

Background: Increasing longevity of the world’s population has resulted in a shift in the disease patterns prevalent hitherto. The worst affected are the middle and low- income countries including India. The genetic make-up of Indians render them highly susceptible to cardiovascular diseases and diabetes at a much earlier age with resultant higher mortality rates. Thus, low- cost early detection, and innovative, customized preventive strategies are the need of the hour. Methods: In this cross- sectional study, we have used the WHO/ISH risk prediction charts tailor – made for the SEAR D region, to assess the cardiovascular risk of a rural population aged above 40 years. Data regarding multiple cardiovascular risk factors were collected using a pre- defined and pre-tested questionnaire, from 400 participants, including other variables like BP and anthropometric measurements. The data were entered in Microsoft excel and analysed using SPSS- ver16. Results: We found that 14.5% of the population had more than 10% risk of cardiovascular diseases and 41.5% were in stage I or II hypertension. People who belonged to the class II SES, use of oral tobacco, saturated cooking oils and sedentary lifestyle was found to be associated with high CV risk. However the association of CV risk with other risk factors like smoking and BMI was inconsistent. Conclusions: There is an increasing trend of cardiovascular risk in rural areas of Tamil Nadu and risk factors like higher socio economic class, use of oral tobacco, saturated cooking oils and sedentary occupation were found to be associated with high CV risk.


2014 ◽  
Vol 3 (4) ◽  
pp. 267
Author(s):  
Swapan Kumar Roy ◽  
Quazi Zahangir Hossain

Research on biosecurity of poultry workers of Live Bird Market (LBM) in urban and rural areas related to highly pathogenic avian influenza (AI) was undertaken during March-June, 2014 at Keshabpur upazila (22°48´-22°57´N latitude and 89°06´-89°22´E longitude), Jessore, Bangladesh. A non-randomized (purposive) sampling method was applied and a descriptive type of cross sectional study was performed among 72 workers, dividing them into two groups as 36 urban and 36 rural poultry workers of LBM through split-halves variation technique. They were interviewed confidentially in their work place using a structured pretested questionnaire. Among respondents 53%, 75%, 45%, 81%, and 56% of urban and 50%, 42%, 50%, 89%, and 36% of rural residence had attended up to primary school, knowledge about AI through media like TV and radio, used proper personal protective equipment as mask and gloves, washed their hands and equipment after finishing work and cleaned stalls/cages daily and mostly they used water as a cleaning material, respectively. In urban (14%) and rural (36%) workers used the same vehicle to transport poultry and humans. A combined effort is required to enhance knowledge and change behavior among those most at risk in low-income countries and precautions necessary to avoid spreading the virus among poultry and humans.


2014 ◽  
Vol 3 (4) ◽  
pp. 267
Author(s):  
Swapan Kumar Roy ◽  
Quazi Zahangir Hossain

Research on biosecurity of poultry workers of Live Bird Market (LBM) in urban and rural areas related to highly pathogenic avian influenza (AI) was undertaken during March-June, 2014 at Keshabpur upazila (22°48´-22°57´N latitude and 89°06´-89°22´E longitude), Jessore, Bangladesh. A non-randomized (purposive) sampling method was applied and a descriptive type of cross sectional study was performed among 72 workers, dividing them into two groups as 36 urban and 36 rural poultry workers of LBM through split-halves variation technique. They were interviewed confidentially in their work place using a structured pretested questionnaire. Among respondents 53%, 75%, 45%, 81%, and 56% of urban and 50%, 42%, 50%, 89%, and 36% of rural residence had attended up to primary school, knowledge about AI through media like TV and radio, used proper personal protective equipment as mask and gloves, washed their hands and equipment after finishing work and cleaned stalls/cages daily and mostly they used water as a cleaning material, respectively. In urban (14%) and rural (36%) workers used the same vehicle to transport poultry and humans. A combined effort is required to enhance knowledge and change behavior among those most at risk in low-income countries and precautions necessary to avoid spreading the virus among poultry and humans.


2020 ◽  
Vol 1 ◽  
pp. 5
Author(s):  
Audu Onyemocho ◽  
Agwa Moses ◽  
Aboh Kisani ◽  
Omole Namben Victoria ◽  
Anejo-Okopi Joseph

Objective: Rabies, one of the oldest and fatal infectious diseases known to human race, is transmitted by infected dogs. The global target of zero dog-mediated rabies human deaths has been set for 2030; however, the realization of this goal poses challenges in most low-income countries where rabies is endemic due to weak surveillance. Dogs have been increasingly deployed for domestic uses over the years, especially for security purposes. This study assessed the assessment of knowledge and practice of vaccination of dogs against rabies by dog owners. Materials and Methods: A cross-sectional community-based study was employed to study 400 dog owners in Makurdi metropolis through multistage sampling techniques. Sighting of valid dog vaccination card was used as criteria for current vaccination. Bivariate analysis was carried out to establish the relationship between the respondent knowledge of rabies and dog vaccination with significant value set at P < 0.05. Results: The mean age of the respondents was 31 (Â ± 0.8) years, majority of them had tertiary and secondary education (40.0% and 39.0%, respectively), 26.0% were traders, and 50.0% were married. Overall, 73.0% of the respondents had good knowledge score, 61.0% had seen at least a rabid dog in their life time, and 74.0% have a history of dog vaccination, but evidence of up to date vaccination of dogs by owners was seen in only 18.0% of all the vaccination cards sighted. The relationship between the educational status of the respondents, their knowledge score, and their dog vaccination was statistically significant (P < 0.05). Conclusion: Knowledge of rabies among dog owners in Makurdi was good, but the practice of dog vaccination was poor. Educational status was a good predictor of practice. Awareness campaign on dog vaccination should be strengthened and adequate measures should be put in place at the veterinary hospitals in Makurdi for vaccination of dogs.


2019 ◽  
Vol 34 (13) ◽  
pp. 842-850
Author(s):  
Emmanuel Segnon Sogbossi ◽  
Damienne Houekpetodji ◽  
Toussaint G. Kpadonou ◽  
Yannick Bleyenheuft

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.


2010 ◽  
Vol 16 (2) ◽  
pp. 5 ◽  
Author(s):  
Dominic Ignatius Ukpong ◽  
Festus Abasiubong

<p><strong>Background.</strong> The burden of mental illness is particularly severe for people living in low-income countries. Negative attitudes towards the mentally ill, stigma experiences and discrimination constitute part of this disease burden.</p><p><strong>Objective.</strong> The aim of this study was to investigate knowledge of possible causes of mental illness and attitudes towards the mentally ill in a Nigerian university teaching hospital population.</p><p><strong>Method.</strong> A cross-sectional descriptive study of a convenience sample of 208 participants from the University of Uyo Teaching Hospital, Uyo, Nigeria, using the Community Attitudes towards the Mentally Ill (CAMI) scale. Information was also obtained on beliefs about possible causes of mental illness. <strong></strong></p><p><strong>Results.</strong> The respondents held strongly negative views about the mentally ill, mostly being authoritarian and restrictive in their attitudes and placing emphasis on custodial care. Even though the respondents appeared to be knowledgeable about the possible role of psychosocial and genetic factors in the causation of mental illness, 52.0% of them believed that witches could be responsible, 44.2% thought mental illness could be due to possession by demons, and close to one-third (30%) felt that it could be a consequence of divine punishment.</p><p><strong>Conclusions.</strong> Stigma and discrimination against the mentally ill are widespread even in a population that is expected to be enlightened. The widespread belief in supernatural causation is likely to add to the difficulties of designing an effective anti-stigma psycho-educational programme. There is a need in Nigeria to develop strategies to change stigma attached to mental illness at both institutional and community levels.</p>


Author(s):  
Md Hasanuzzaman ◽  
Md Hafizur Rahman ◽  
Md Shafiqul Islam Khan ◽  
Musammet Rasheda Begum ◽  
Farjana Alam ◽  
...  

Background: Over 200 million under-five-children born in low-income countries are at risk of not reaching their development potential and infectious diseases are the leading cause of development deficits in these regions.Methods: A cross-sectional study was conducted to investigate personal and household hygiene practices among 154 mothers and their association with the incidence of infectious diseases among 167 children aged 6 months to 59 months in Patuakhali district, Bangladesh.Results: Only 13.6% of the mothers had proper hand washing knowledge. Besides, 14% and 53.9% of the mothers washed their hands with soap and only with water respectively before feeding their child. About 68.2% of mothers prepared food on the ground and half (49.5%) of the toilet did not have a hand washing location beside it. The risk of childhood infectious disease was significantly associated with hand washing of mothers before feeding a child (OR: 2.3, 95% CI: 1.5-4.1, p<0.05) and hand washing of child before eating (OR: 3.4, 95% CI: 1.8-5.7, p<0.05).Conclusions: Hand washing agents were inadequate and compliance to hand washing was poor. Therefore, the continuous focus is needed on the mother's awareness construction to increase the compliance to hand washing practice among mothers as well as their child with soap, especially during child feeding.


2020 ◽  
Author(s):  
Jinyi Kuang ◽  
Erik Thulin ◽  
Sania Ashraf ◽  
Alex Shpenev ◽  
Upasak Das ◽  
...  

People often form perceptions about how prevalent a behavior is in a social group. However, these perceptions can be inaccurate and biased. While persistent undesirable practices in low-income countries have drawn global attention, evidence regarding people’s perception of how prevalent these practices are is scarce. Among those harmful practices, open defecation in India remains a significant public health concern, where it perpetuates the vicious cycle of disease and poverty. In this study, we focus on measuring the perceived prevalence of open defecation among respondents in Bihar, India. We examined the bias in perceived prevalence, which is defined as a pattern of deviation from the actual prevalence of open defecation. Results showed that respondents who defecate in the open overestimate the prevalence of open defecation, whereas those who consistently use toilets underestimate it. This finding suggests a false consensus bias in the perceived prevalence of open defecation. Scholars, policymakers, and program implementers who seek to correct misperceptions about open defecation by broadcasting real prevalence should be aware of biases in the perceived prevalence and address them in behavior change interventions.


Author(s):  
Giovana Z. Mazo ◽  
Felipe Fank ◽  
Pedro S. Franco ◽  
Bruna da Silva Vieira Capanema ◽  
Franciele da Silva Pereira

The objective was to analyze the impact of social isolation on moderate physical activity and factors associated with sedentary behavior of older adults during the COVID-19 pandemic. This was a cross-sectional study involving 111 older adults (aged 71.0 ± 6.87 years). The data were collected at two time points: in November 2019 and in June 2020. There was a decline in moderate physical activity when the minutes/week were compared before and during social isolation (p < .001). Sedentary behavior was associated with the condition of living alone. Older adults who lived alone were 3.29 times more likely to spend 4 hr or more in sedentary behavior than those who lived with a partner (95% confidence interval [1.01, 10.74]). Government agencies must establish PA-related health promotion strategies, especially in developing and low-income countries. Therefore, home exercises need to be encouraged to prevent the consequences of this pandemic period.


Sign in / Sign up

Export Citation Format

Share Document