Adoption of Community Hygiene Strategies for Safe Water and Sanitation among Mothers of Underfives in Kitui County, Kenya

Abstract

Inadequate access to safe drinking water, sanitation and hygiene constitutes a serious global threat to health accounting for approximately 4 billion cases of illness annually. Children under five years in the developing world are most affected, where nearly 1.6 million deaths are recorded annually due to diarrhea alone. This accounts for 15% of all deaths among under fives. Poor sanitation and hygiene practices are among the main factors associated with sanitary diseases. The purpose of this study was to analyze the adoption of community hygiene strategies to safe water and sanitation among mothers of under five year olds in Migwani Division, Kitui County, Kenya. Objectives guiding the study were: to determine adoption of community hygiene facilities for safe water and sanitation among mothers of under five year olds, to examine the prevalence of common sanitary diseases among children under five years old and to assess the influence of community hygiene practices on safe water and sanitation among mothers of under five year olds within Migwani Division, Kitui County. The study adopted a descriptive survey research design. A sample of 94 mothers of children under 5years old, 3 public health officers and 57 community health workers was used for the study. The total number of respondents was 154 and the response rate obtained was 89%. Data was collected using interview schedules, questionnaires and observation checklists. Quantitative data was coded to develop code sheet quantitative data. Qualitative data was thematically categorized and analyzed using Statistical Package for Social Science Version 20. Statistical analysis involved determination of percentages, means, standard deviation and logistic regression. The results of the study show that only 50.6% of the mothers had access to treated piped water with the rest using pond water, stream water or harvested rain water. More than 40% of the mothers used untreated water sourced from open wells, which increased water borne diseases among children. Toilets were observed in 89.9% of the homesteads with 10.1% practicing open defecation. Common sanitation and water borne diseases reported were worms, amoeba, diarrhea, and dysentery. Mothers who used both open well water and stream water were more likely to have children suffer from diarrhea compared to those who used piped water (9. 37 for stream water, 9.42 open wells and 5.42 for piped water-p<0.05). Amoeba prevalence was 82.6% among children whose mothers were using untreated water. Majority of mothers (76.4%) lived more than 10km from water sources therefore forced to use unsafe water. Hand washing at critical times was at 94.4% meaning hygiene awareness was high, evidenced by 61.8% of homesteads with hand washing facilities outside toilets. High level of adoption of safe water and sanitation practices were: Availability and use of toilets, hand washing facilities, hand washing and treating drinking water. Medium level was access to safe water and participation in health programmes. Low adoption was evidenced by prevalence of sanitary diseases and long distances to water sources. Therefore, Community hygiene strategies and practices have great influence on levels of adoption of safe water and sanitation practices among mothers of children under five years old. Recommendations of the study are: community involvement in assessing their health, training of community health workers on concepts of health care and development, change in human behavior in community response towards disease outbreaks and emergencies and poverty alleviation in order to improve adoption of community hygiene strategies for safe water and sanitation.