1
|
Tesfaw A, Tiruneh M, Mamuye M, Walle Z, Teshager W, Teshome F, Taye A, Dessalegn W, Walle G, Gebeyehu AA. Magnitude and determinants of improved household latrine utilization in Ethiopia: Multilevel analysis of the mini Ethiopian Demographic Health Survey (EDHS) 2019. PLoS One 2023; 18:e0289427. [PMID: 37531358 PMCID: PMC10395897 DOI: 10.1371/journal.pone.0289427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/18/2023] [Indexed: 08/04/2023] Open
Abstract
INTRODUCTION Lack of sanitation is a major global problem mainly for the poor and disadvantaged. According to the 2016 Ethiopian Demographic and Health Surveys (EDHS) report, one out of every three households lack a toilet in Ethiopia and about 56% of rural households use unimproved toilet facilities. We aimed to determine the magnitude of improved household latrine utilization and its determinants in Ethiopia using the mini-Ethiopian Demographic Health Survey (EDHS) 2019 data set. METHOD A secondary data analysis was conducted based on the mini 2019 EDHS data set. A total weighted sample of 8663 households were involved in analysis. After selecting the relevant variables for the outcome variable, we have fitted four different models. The null (empty) model with no independent variables and the second model contained the effects of the individual-level factors on the outcome variable. The third model included the influence of the community-level factors on the response variable, and the final multilevel multivariable logistic regression model examined the effects of individual-level and community-level variables on the outcome variable. The measure of variation was quantified using Intra-Class Correlation (ICC), Median Odds Ratio, and Proportional Change in Variance (PCV). The Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was used to show the strength of association and statistical significance was declared at p value < 0.05. RESULTS The magnitude of improved latrine utilization in Ethiopia was 19.5% with 95% CI (18.6%, 20.3%). The factors: educational status (AOR = 1.67; 95% CI: (1.10, 2.55), highest wealth index (AOR = 3.73; 95% CI: (2.73, 5.12), urban residence (AOR = 3.09; 95% CI: (1.68, 5.67), living in Addis Ababa (AOR = 4.08; 95% CI: (1.03, 16.2) and Dire Dawa (AOR = 8.22; 95% CI: (2.46, 27.42) and Somali regions (AOR = 3.11; 95% CI: (1.15, 8.42) were significantly associated to improved latrine utilization in Ethiopia. CONCLUSION The magnitude of improved latrine utilization was quite low in Ethiopia. Higher wealth index, living in more urbanized areas, and the household head's educational status were all significant predictors of improved latrine utilization. The finding implies a need to increase household's access to latrine facilities and improve latrine utilization, particularly for rural households in the country.
Collapse
Affiliation(s)
- Aragaw Tesfaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mulu Tiruneh
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkalem Mamuye
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Zebader Walle
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wondossen Teshager
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Fentaw Teshome
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Alebachew Taye
- Department of Statistics, College of Natural Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wondimnew Dessalegn
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gashaw Walle
- Department of Biomedical Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Asaye Alemneh Gebeyehu
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| |
Collapse
|
2
|
Atangana E, Oberholster PJ. Assessment of water, sanitation, and hygiene target and theoretical modeling to determine sanitation success in sub-Saharan Africa. ENVIRONMENT, DEVELOPMENT AND SUSTAINABILITY 2022; 25:1-25. [PMID: 36090188 PMCID: PMC9440466 DOI: 10.1007/s10668-022-02620-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
Accessing the status of clean drinking water, sanitation, and hygiene remains a challenge in sub-Saharan Africa (SSA). The current article contributes to the progress made by the WASH initiatives in ten SSA countries in eliminating open defecation by 2030, using theoretical data from 2017 to 2019. The authors used regression trend estimation to observe that rural and urban population growth had a statistically significant detrimental influence on the elimination of open defecation by 2030. According to the predicted data model, by 2030-2035, the urban population of SSA would be 65, 25, and 10 million in all the three categories of income groups. An increase in the number of modern pit users (C1) shows no improvement at the annual rate of change. The unimproved toilets and open-pit latrines (C2 and C3) show a linear growth rate, which expanded over time. Population growth, higher unemployment, and teen pregnancies contribute to this increase. Under current conditions, the curve of modern pit latrine users will increase linearly. Nigeria has the most significant number of spread pit latrine users, which has decreased linearly from 25 to 20% since 2017. It was evident that the power-law trend in Nigeria would increase the usage of unimproved pit latrines and open-pit latrines. Ghana had the highest rate (50%) of open-pit latrine users, while the data show that this situation remained stable (2001-2017). In the Democratic Rep. Congo, annual rates increased linearly from 25 to 33% (2000-2017), while Burundi was one of the countries in the region with the lowest number of open-pit latrine users, although the annual rate has increased from 6.13 to 11.75% since 2017 to 2019. Supplementary Information The online version contains supplementary material available at 10.1007/s10668-022-02620-z.
Collapse
Affiliation(s)
- Ernestine Atangana
- Centre for Environmental Management, University of the Free State Bloemfontein, Bloemfontein, 9300 South Africa
| | - Paul J. Oberholster
- Centre for Environmental Management, University of the Free State Bloemfontein, Bloemfontein, 9300 South Africa
| |
Collapse
|
3
|
Afework A, Beyene H, Ermias A, Tamene A. Moving Up the Sanitation Ladder: A Study of the Coverage and Utilization of Improved Sanitation Facilities and Associated Factors Among Households in Southern Ethiopia. ENVIRONMENTAL HEALTH INSIGHTS 2022; 16:11786302221080825. [PMID: 35237046 PMCID: PMC8883407 DOI: 10.1177/11786302221080825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Improved sanitation facilities offer numerous advantages, ranging from the reduction of diarrheal illnesses and helminth infections to the improvement of psychosocial well-being. At the household level, attaining universal access to improved sanitation facilities demands a thorough understanding of the factors that influence their adoption and use. As a result, the purpose of this study was to assess the availability and utilization of improved sanitation facilities, as well as the factors that influence the adoption and proper use of such a facility among households in the Gedeb district of Southern Ethiopia. METHODS A community-based cross-sectional household survey was conducted from March to April 2019. A systematic random sampling technique was used to select 630 households at random. A pre-tested questionnaire was used to collect the respondents' self-reported data, which comprised socio-demographic, home characteristics, behavioral, and environmental elements. The factors related to the availability and utilization of improved sanitation facilities were identified using multivariable logistic regression. RESULT Improved sanitation facilities were present in 172 (27.3%) of the 630 households surveyed, with 111 (64.5%) of them being used properly. The availability of improved sanitation was associated with educational status [AOR = 2.73, 95% CI (1.59, 4.67)], upper wealth quintile [AOR = 2.18, 95% CI (1.21, 3.93)], ever hearing educational messages about latrines [AOR = 3.9, 95% CI (1.86, 8.18)], favorable attitude toward latrine construction [AOR = 2.81, 95% CI (1.67, 4.74)], and receiving support during construction [AOR = 3.78, 95% CI (2.15, 6.65)]. Furthermore, utilization was associated with the absence of children under the age of 5, knowledge of sanitation-related diseases, and a positive attitude toward latrine use. CONCLUSION Both the availability of improved sanitation facilities and the rate at which they were used properly fell far short of the National Hygiene and Environmental Health Strategy's goals. This study contributes to the body of knowledge on how to improve the availability of improved sanitation in Ethiopia.
Collapse
Affiliation(s)
- Abel Afework
- Dilla University Referral Hospital, Dilla University, Dilla, Ethiopia
| | - Hunachew Beyene
- Department of Environmental Health, College of Medicine and Health Sciences, Hawassa University, Awassa, Ethiopia
| | - Adane Ermias
- Department of Environmental Health, College of Medicine and Health Sciences, Hawassa University, Awassa, Ethiopia
| | - Aiggan Tamene
- Department of Environmental Health, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia
| |
Collapse
|
4
|
Malik MI, Nawaz SMN, Nadeem M. Overcoming open defecation for healthier environment in case of Pakistan. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:19179-19185. [PMID: 33394408 DOI: 10.1007/s11356-020-11919-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 12/01/2020] [Indexed: 06/12/2023]
Abstract
With the growing awareness of the linkage among open defecation (OD), environment, and health, it is important to understand the factors responsible for OD. It is a necessary step toward developing a strategy to end open defecation for ensuring a better environment and human health. There is no such study available for Pakistan. The study, therefore, aims to bridge this gap. Using household data of Pakistan Demographic and Health Survey (PDHS) 2017-2018, an association of OD with potential predictors, analysis of variance, and a logistic regression model are employed to develop the evidence. The results suggest that place of residence, education, poverty status, social norms, geopolitical regions, and living space significantly predict the OD behavior in Pakistan. This study recommends two things: first is to facilitate the households and communities to own latrines, second is to change the behavior through intervention. However, political commitment and effective administration will be key to ascertain ending OD.
Collapse
Affiliation(s)
- Muhammad Irfan Malik
- Department of Economics and Business Administration, University of Education, Lahore (Faisalabad Campus), Faisalabad, Pakistan.
- Punjab Economic Research Institute (PERI), Lahore, Pakistan.
| | | | | |
Collapse
|
5
|
Cassivi A, Tilley E, Waygood EOD, Dorea C. Household practices in accessing drinking water and post collection contamination: A seasonal cohort study in Malawi. WATER RESEARCH 2021; 189:116607. [PMID: 33197683 DOI: 10.1016/j.watres.2020.116607] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 06/11/2023]
Abstract
Lack of access to safe drinking water on premises remains widespread in low- and middle-income countries. Interventions to improve access to safe water at the point of collection are essential, but water safety at the point of consumption is also an important consideration. This research aimed to 1) improve understanding of household practices in collecting water with respect to seasonality, and 2) to further assess risk associated with post-collection contamination from the point of collection to the point of consumption. A seasonal cohort study, including 115 households, was conducted in Malawi. Along with household surveys and observations, samples of water were tested for microbial water quality at four different stages of water collection: water source, collection container, storage container, cup of drinking water. Using E. coli as an indicator of contamination (cfu/100 ml), the risk of post-collection contamination was assessed. The results indicate that most water sources were free from contamination; contamination was proportionally lower in the dry season when more sources were found to be classified as having a very low risk of contamination. However, the level of risk of contamination was more likely to increase following collection in water sources that were initially free from contamination. Results show that the degradation in water quality from the point of collection to the point of consumption was more important in the rainy season, which is likely to be driven by the effect of seasonality on the household environment. Filling the collection container at the point of collection and storage at the point of consumption were found to be critical stages for an increased risk of E. coli contamination. Understanding household practices in accessing and handling water during both rainy and dry season is necessary to target appropriate interventions to reduce post-collection contamination.
Collapse
Affiliation(s)
- Alexandra Cassivi
- University of Victoria, Department of Civil Engineering, Engineering and Computer Science (ECS) 304, PO Box 1700 STN CSC, Victoria BC V8W 2Y2, Canada.
| | - Elizabeth Tilley
- University of Malawi, The Polytechnic, Private Bag 303, Blantyre 3, Malawi; Eawag: Swiss Federal Institute Of Aquatic Science And Technology, Überlandstr. 133, 8600 Dübendorf, Switzerland
| | - E Owen D Waygood
- Polytechnique Montreal, Department of Civil, Geological and Mining Engineering, PO Box 6079, Montréal QC H3C 3A7, Canada
| | - Caetano Dorea
- University of Victoria, Department of Civil Engineering, Engineering and Computer Science (ECS) 304, PO Box 1700 STN CSC, Victoria BC V8W 2Y2, Canada
| |
Collapse
|
6
|
Cassivi A, Tilley E, Waygood EOD, Dorea C. Evaluating self-reported measures and alternatives to monitor access to drinking water: A case study in Malawi. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 750:141516. [PMID: 32846248 DOI: 10.1016/j.scitotenv.2020.141516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/02/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
Monitoring access to drinking water is complex, especially in settings where on premises water supply is not available. Although self-reported data are generally used to estimate coverage of access to drinking water, the relationship between self-reported time travelled and true time travelled is not well known in the context of water fetching. Further, water fetching is likely to impact the quantity and quality of water a household uses, but data and measures supporting this relationship are not well documented. The objective of this study was to appraise the validity and reliability of self-reported measurements used to estimate access coverage. A case study was conducted in Malawi to enhance understanding of the self-reported measures and alternatives available to assess and monitor access to drinking water in view of generating global estimates. Self-reported data were compared with objective observations and direct measurements of water quantity, quality and accessibility. Findings from this study highlight the variations between different measures such as self-reported and recorded collection time and raise awareness with regard to the use of self-reported data in the context of fetching water. Alternatives to self-reported indicators such as GPS-based or direct observations could be considered in surveys in view of improving data accuracy and global estimates.
Collapse
Affiliation(s)
- Alexandra Cassivi
- University of Victoria, Department of Civil Engineering, Engineering and Computer Science (ECS), 304, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada.
| | - Elizabeth Tilley
- University of Malawi, The Polytechnic, 303 Blantyre 3, Malawi; Eawag: Swiss Federal Institute of Aquatic Science And Technology, Überland Str. 133, 8600 Dübendorf, Switzerland
| | - E Owen D Waygood
- Polytechnique Montreal, Department of Civil, Geological and Mining Engineering, PO Box 6079, Montréal, QC H3C 3A7, Canada
| | - Caetano Dorea
- University of Victoria, Department of Civil Engineering, Engineering and Computer Science (ECS), 304, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada
| |
Collapse
|
7
|
Kurscheid J, Laksono B, Park MJ, Clements ACA, Sadler R, McCarthy JS, Nery SV, Soares-Magalhaes R, Halton K, Hadisaputro S, Richardson A, Indjein L, Wangdi K, Stewart DE, Gray DJ. Epidemiology of soil-transmitted helminth infections in Semarang, Central Java, Indonesia. PLoS Negl Trop Dis 2020; 14:e0008907. [PMID: 33370267 PMCID: PMC7793285 DOI: 10.1371/journal.pntd.0008907] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 01/08/2021] [Accepted: 10/21/2020] [Indexed: 11/18/2022] Open
Abstract
Soil-transmitted helminth (STH) infections are endemic in Indonesia. However, prevalence data for many parts of the country are incomplete. The aim of this study was to determine human STH prevalence and knowledge and practices relating to STH risk behaviour, to provide a current view of the status of STH infection in rural communities in Central Java. A cross-sectional survey of 16 villages was conducted in Semarang, Central Java in 2015. Demographic and household data together with information about knowledge and practices relating to STH and hygiene were elicited through face-to-face interviews. Stool samples were collected and examined using the flotation method. Children (aged 2–12 years) also had their haemoglobin (Hb) levels, height and weight data collected, and BMI estimated. Data were analysed using univariate logistic regression analysis. A total of 6,466 individuals with a mean age of 33.5 years (range: 2–93) from 2,195 households were interviewed. The overall prevalence of STH was 33.8% with Ascaris lumbricoides (roundworm) the predominant nematode identified (prevalence = 26.0%). Hookworm and Trichuris trichiura (whipworm) were found in 7.9% and 1.8% of participants, respectively. Females were at increased odds of infection with A. lumbricoides (adjusted OR 1.14, 95% CI [1.02–1.29], p = 0.02). Adults in age groups 51–60 and over 60 years had the highest odds of being infected with hookworm (adjusted OR 3.01, 95% CI [1.84–4.91], p<0.001 and adjusted OR 3.79, 95% CI [2.30–6.26], p<0.001, respectively) compared to 6–12 year olds. Farmers also had higher odds of being infected with hookworm (adjusted OR 2.36, 95% CI [1.17–4.76], p = 0.02) compared to other occupation categories. Poverty (OR 2.14, 95% CI [1.77–2.58], p<0.001), overcrowding (OR 1.35, 95% CI [1.27–1.44], p<0.001), goat ownership (OR 1.61, 95% CI [1.10–2.41], p = 0.02) and the presence of dry floor space in the home (OR 0.73, 95% CI [0.58–0.91], p = 0.01) were all household factors significantly associated with an increased odds of infection. Infection with STH was not significantly associated with the gastrointestinal illness (p>0.05), BMI or Hb levels; however, one third of all 2–12 year olds surveyed were found to be anaemic (i.e. Hb concentrations below 110g/l or 115g/l for children under 5 and 5 years or older, respectively), with a greater proportion of school-age children at risk. Knowledge and behaviour related to hygiene and gastrointestinal diseases varied widely and were generally not associated with STH infection. The study revealed that STH infection remains endemic in Central Java despite ongoing deworming programs. Current control efforts would benefit from being re-evaluated to determine a more effective way forward. Among the major NTDs, STH are one of the most common disabling chronic infections. Currently available drug treatments, whilst considered safe and generally well tolerated, do not confer protection against new infections. In Indonesia, prevalences of STH of up to 90% have been reported but these estimates are based on data from the 1980s and 90s. More up-to-date STH prevalence estimates are urgently needed to help guide future control efforts. A cross-sectional survey was conducted in rural villages in Semarang, Central Java to determine human STH prevalence and associated risk factors. One-third of all cohort participants were positive for STH with prevalences of 26%, 7.9% and 1.8% identified for Ascaris lumbricoides, hookworm and Trichuris trichiura at 7.9% and 1.8%, respectively. Risk of A. lumbricoides infection was higher for females, whilst farmers and adults over 50 had an increased risk of hookworm infection. Poverty, overcrowding in the home and goat ownership were also associated with an increased risk at the household level. Soil-transmitted helminthiases remains a significant health problem in Central Java, Indonesia, exacerbated by limited knowledge about STH, poor sanitation and hygiene and poverty prevalent in the region. Control efforts would benefit from an integrated approach emphasising WASH, health education and chemotherapy. Further studies investigating environmental contamination with STH in and around homes in endemic areas could provide further insight into links between household factors and STH identified in our study.
Collapse
Affiliation(s)
- Johanna Kurscheid
- Department of Global Health, Research School of Population Health, Australian National University, Acton, Australia
- * E-mail:
| | - Budi Laksono
- Yayasan Wahana Bakti Sejatera Foundation (YWBS), Semarang, Indonesia
| | - M. J. Park
- Department of Nursing, College of Nursing, Konyang University, Daejeon, South Korea
| | | | - Ross Sadler
- School of Public Health, Griffith Health, Griffith University, South Brisbane, Australia
| | | | - Susana V. Nery
- Public Health Interventions Group, Kirby Institute, University of New South Wales, Kensington, Australia
| | | | - Kate Halton
- Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | | | - Alice Richardson
- Statistical Consulting Unit, Australian National University, Acton, Australia
| | - Léa Indjein
- School of Veterinary Science, University of Queensland, Gatton, Australia
| | - Kinley Wangdi
- Department of Global Health, Research School of Population Health, Australian National University, Acton, Australia
| | - Donald E. Stewart
- Department of Global Health, Research School of Population Health, Australian National University, Acton, Australia
- School of Medicine, Griffith Health, Griffith University, South Brisbane, Australia
| | - Darren J. Gray
- Department of Global Health, Research School of Population Health, Australian National University, Acton, Australia
| |
Collapse
|
8
|
Impact of the "BALatrine" Intervention on Soil-Transmitted Helminth Infections in Central Java, Indonesia: A Pilot Study. Trop Med Infect Dis 2019; 4:tropicalmed4040141. [PMID: 31817651 PMCID: PMC6958350 DOI: 10.3390/tropicalmed4040141] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 11/28/2019] [Accepted: 12/04/2019] [Indexed: 11/23/2022] Open
Abstract
Many latrine campaigns in developing countries fail to be sustained because the introduced latrine is not appropriate to local socio-economic, cultural and environmental conditions, and there is an inadequate community health education component. We tested a low-cost, locally designed and constructed all-weather latrine (the “BALatrine”), together with community education promoting appropriate hygiene-related behaviour, to determine whether this integrated intervention effectively controlled soil-transmitted helminth (STH) infections. We undertook a pilot intervention study in two villages in Central Java, Indonesia. The villages were randomly allocated to either control or intervention with the intervention village receiving the BALatrine program and the control village receiving no program. STH-infection status was measured using the faecal flotation diagnostic method, before and eight months after the intervention. Over 8 months, the cumulative incidence of STH infection was significantly lower in the intervention village than in the control village: 13.4% vs. 27.5% (67/244 vs. 38/283, p < 0.001). The intervention was particularly effective among children: cumulative incidence 3.8% (2/53) for the intervention vs. 24.1% (13/54) for the control village (p < 0.001). The integrated BALatrine intervention was associated with a reduced incidence of STH infection. Following on from this pilot study, a large cluster-randomised controlled trial was commenced (ACTRN12613000523707).
Collapse
|
9
|
Shadow Puppets and Neglected Diseases (2): A Qualitative Evaluation of a Health Promotion Performance in Rural Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122829. [PMID: 30545057 PMCID: PMC6313519 DOI: 10.3390/ijerph15122829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 12/07/2018] [Accepted: 12/08/2018] [Indexed: 11/17/2022]
Abstract
Performing arts used as a method of spreading health information dates back to the origins of storytelling. However, interventions in developing, non-Western countries typically utilize Western entertainment forms. This qualitative investigation assesses responses to an intervention designed around traditional Javanese shadow puppetry (wayang kulit). Semi-structured interviews provided in-depth responses from a sample (N = 12) of villagers. Responses analyzed both cross-case and within-case, focused on perceptions of the music and storyline, responses to the intervention, and the perceived appropriateness of wayang kulit for disseminating a health message. Wayang kulit was considered to be interesting and easy to remember, but concerns remained regarding the reliability of information provided through the drama. The fusion of traditional and modern music and story elements were perceived positively. Some participants were inspired to improve their hygiene practices, although the lack of motivation, or belief that they were unable to change was noted. The performance was generally received positively in terms of the nature of the intervention, the fusion of traditional and Western music and story elements, as well as the use of wayang kulit to spread health information. The study provides guidance for modifications to the production, prior to scaling up.
Collapse
|
10
|
Abubakar IR. Exploring the determinants of open defecation in Nigeria using demographic and health survey data. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 637-638:1455-1465. [PMID: 29801238 DOI: 10.1016/j.scitotenv.2018.05.104] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 05/08/2018] [Accepted: 05/08/2018] [Indexed: 06/08/2023]
Abstract
There is increasing global attention to the threats of open defecation (OD) to human health and dignity, and the environment. With at least a quarter of Nigerians (25.1%) or 46 million people practicing OD in 2015, Nigeria ranks third in the world in OD prevalence after India and China. This study explores the socio-economic, demographic and geographic factors that influence and determine the practice of OD among Nigerian households. Data was obtained from 2013 Nigeria Demographic and Health Survey and analyzed using descriptive and inferential statistics. The results indicate that about 32% of Nigerian households, 8% in urban areas and 24% in rural areas, practiced OD in 2013. The practice is significantly influenced (p < 0.001) by households' place of residence (χ2 (1) = 2126.2), geo-political region (χ2 (5) = 1962.6) and wealth index (χ2 (4) = 4622.7), as well as by household head's education level (χ2 (3) = 1253.3), ethnicity (χ2 (3) = 1926.2) and gender (t = -7.1992). The article also discusses the implications of the findings for environmental and public health and recommends that facilitating ownership of latrines by households and communities, and behavioral change interventions are necessary towards substantially reducing or eliminating OD in Nigeria.
Collapse
Affiliation(s)
- Ismaila Rimi Abubakar
- College of Architecture and Planning, Imam Abdulrahman Bin Faisal University (formerly University of Dammam), P.O. Box 2397, Dammam 31451, Saudi Arabia.
| |
Collapse
|
11
|
Kurscheid J, Bendrups D, Susilo J, Williams C, Amaral S, Laksono B, Stewart DE, Gray DJ. Shadow Puppets and Neglected Diseases: Evaluating a Health Promotion Performance in Rural Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2050. [PMID: 30235817 PMCID: PMC6164465 DOI: 10.3390/ijerph15092050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 12/25/2022]
Abstract
'Rama and the Worm' is a shadow puppet production targeting neglected diseases in Central Java. It is an entertainment-based intervention study to promote health by reducing the impact of parasitic diseases such as soil-transmitted helminths (STH). The study uses traditional Javanese shadow puppetry (wayang kulit) as a vehicle in village communities to disseminate health messages and promote behaviour change to prevent diseases caused, primarily, by inadequate sanitation and poor hygiene. The health education messages contained in the play, although using traditional characters and themes, required the creation of a completely new narrative script, using characters and plot lines familiar to the wayang kulit repertoire, but placing them in new situations that relate specifically to health promotion objectives. The intervention was piloted in a village in Central Java, Indonesia using a pre/post design with both qualitative and quantitative analysis. A total of 96 male and female villagers, aged between 7 and 87 years, provided both baseline and follow up data. Participant knowledge and behaviours related to gastrointestinal and helminth-related disease were assessed before and after the intervention through a questionnaire administered by interview. Results revealed statistically significant improvements in both knowledge (48.6% pre-intervention score vs. 62.8% post-intervention score, p < 0.001) and behaviour (77.4% vs. 80.6%, p = 0.004) related to gastrointestinal and helminth disease. Findings of the study indicate the wayang kulit performance is an effective health education tool. The results provide proof of concept with scaling up the next step forward. The wayang kulit production provides a significant additional component for an integrated, comprehensive approach to reduction and elimination of STH infection.
Collapse
Affiliation(s)
- Johanna Kurscheid
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, ACT 2601, Australia.
| | - Dan Bendrups
- Graduate Research School, La Trobe University, Melbourne, VIC 3083, Australia.
| | - Joko Susilo
- Music Department, Theatre and Performing Arts, Otago University, Dunedin 9016, New Zealand.
| | - Courtney Williams
- Queensland Conservatorium Research Centre, Griffith University, South Brisbane, QLD 4101, Australia.
| | - Salvador Amaral
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, ACT 2601, Australia.
| | - Budi Laksono
- Yayasan Wahana Bakti Sejatera Foundation (YWBS), Semarang 50183, Indonesia.
| | - Donald E Stewart
- Queensland Conservatorium Research Centre, Griffith University, South Brisbane, QLD 4101, Australia.
- School of Medicine, Griffith Health, Griffith University, South Brisbane, QLD 4101, Australia.
| | - Darren J Gray
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, ACT 2601, Australia.
| |
Collapse
|
12
|
Massa K, Kilamile F, Safari E, Seleman A, Mwakitalima A, Balengayabo JG, Kassile T, Mangesho PE, Mubyazi GM. Contributing to the debate on categorising shared sanitation facilities as 'unimproved': An account based on field researchers' observations and householders' opinions in three regions, Tanzania. PLoS One 2017; 12:e0185875. [PMID: 29107947 PMCID: PMC5673168 DOI: 10.1371/journal.pone.0185875] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 09/21/2017] [Indexed: 12/05/2022] Open
Abstract
Background Health risks associated with poor sanitation behaviours continue to be reported mostly from low-income countries (LICs). Reports show that various factors limit many people from accessing and using improved latrines, forcing some to opt for sharing latrines with neighbours, others practicing open defecation. Meanwhile, debate prevails on whether shared latrines should be categorised as unimproved according to WHO/UNICEF-JMP criteria. We contribute to this debate based on results from a study undertaken in three regions, Tanzania. Materials and methods Data were collected through observations in 1,751 households with latrines, coupled with collection of opinions from heads of such households regarding the latrine-sharing practices. Bivariate and multivariate logistic regression analyses were performed to assess associations between the outcome and possible predictor variables. Results Of all 1,751 latrines, 14.6% were shared. Among the shared latrines, 74.2% were found being generally clean as compared to 69.2% of the non-shared ones. Comparing the shared and non-shared latrines, the non-shared latrines were significantly less likely to be found with floors built with permanent materials (OR = 0.73, 95% CI: 0.55, 0.98); washable floors (OR = 0.69; 95% CI: 0.51, 0.93); and lockable doors (OR = 0.73; 95% CI: 0.56, 0.95). Shared latrines were less likely to have floors with faecal matter, functional handwashing facilities (HWFs), HWFs with running water, and roofs; albeit the differences in all these scenarios were not statistically significant. Respondents expressed desire for improved latrines, but also did not find it wrong to share latrines if cleanliness was maintained. Conclusion Having an ‘improved’ latrine remains important as JMP recommends, but based on our study findings, we argue that possessing a non-shared latrine neither guarantees safety to its users nor its categorisation as ‘improved’. Instead, the state of the latrine, the construction technology used and the behaviours of the users may be more important.
Collapse
Affiliation(s)
- Khalid Massa
- Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania
| | - Fadhili Kilamile
- Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania
| | - Emmanuela Safari
- Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania
| | - Amour Seleman
- Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania
| | - Anyitike Mwakitalima
- Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania
| | - Jonas G Balengayabo
- Ardhi University, School of Environmental Science and Technology, Dar es Salaam, Tanzania
| | - Telemu Kassile
- Sokoine University of Agriculture, Faculty of Science, Morogoro, Tanzania
| | | | - Godfrey M Mubyazi
- National Institute for Medical Research, Department of Health Systems and Policy Research, Dar es Salaam, Tanzania
| |
Collapse
|