Bokea, John Ombongi2021-01-292021-01-292020-11http://ir-library.ku.ac.ke/handle/123456789/21245A Thesis Submited in Partial Fulfilment of the Requirements for the Award of A Degree of Master of Science (Environmental Health) in the School of Public Health and Applied Human Sciences of Kenyatta University, November, 2020Open defecation refers to defecating in bushes, fields, water bodies and other places that are open. Across the world, approximately 1 billion people are practicing open defecation. This is worse in sub-Saharan Africa where about 215 million people defecate in the open. In Kenya, an estimated 5.6 million people practice defecation in the open. The introduction of Community Led Total Sanitation strategy by the Ministry of Health has not achieved its goal of improved sanitation and hygiene due to poor implementation. The study sought to assess implementation of Community Led Total Sanitation in Kajiado County, Kenya. The specific objectives of this study included determining socio-cultural factors, functional pit-latrine to household ratio, knowledge level and attitude towards community led total sanitation in Kajiado County. The study used a descriptive cross-sectional study design adopting both quantitative and qualitative data collection methods. Quantitative data was collected using semi-structured questionnaires from selected household heads while qualitative data was collected using key informant interview schedules with 8 selected Key Informants. Additional qualitative data was obtained through Focused Group Discussion sessions with selected primary respondents. The study interviewed 303 household heads selected using systematic random sampling with a predetermined interval of 3. Descriptive statistics were calculated using Statistical Package for Social Sciences version 20.0 with the aid of Microsoft Excel program to generate frequency tables, graphs and pie-charts. Qualitative data was analyzed using thematic analysis and results triangulated with quantitative data as direct quotes or narrations. To test the relationship between study variables, Chi-Square tests done at 95% confidence interval (p<0.05) were used. The study results revealed that 27% of respondents had fully implemented community led total sanitation. Socio-cultural factors such as embracing use of latrines (p=0.001), involving community in planning health programs (p=0.023), disposal of child excreta (p=0.001), responsibility for pit-latrine construction and herdsmen using pit-latrines (p=0.032) were significantly associated with implementation of Community Led Total Sanitation. The study results further revealed that 68.3% of respondents had low knowledge levels with 61.0% having negative attitude towards community led total sanitation implementation. Knowledge level (p=0.001) and attitude level (p=0.019) were significantly associated with implementation of community led total sanitation among respondents. The study concludes that the implementation level of community led total sanitation status in Kajiado County was low. This may be due to low knowledge levels and negative attitude towards its implementation. The study generated data on the implementation status of Community Led Total Sanitation in Magadi Ward, Kajiado County. These results would also be of use to the Ministry of Health for purposes of health education and policy formulation towards improved implementation rates of community led total sanitation to increase latrine coverage thus reduced negative health implications as a result of open defecation.enImplementationCommunitySanitationKajiado CountyKenyaThesis