Asfaw Berhanu, Azage Muluken, Gebregergs Gebremedhin Berhe
Organization for Rehabilitation and Development in Amhara (ORDA), MDG - Urban Sanitation Project, P.O.Box 132, Bahir Dar, Ethiopia.
School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.O.Box 79, Bahir Dar, Ethiopia.
Arch Public Health. 2016 Mar 1;74:9. doi: 10.1186/s13690-016-0120-5. eCollection 2016.
Latrine access is one of the challenges faced by people with physical disabilities that limit their mobility (PPDs) in their home and working environments. Latrines should be designed, built and located such that they are easily accessible and utilizable by PPDs. Therefore, the aim of this study was to determine latrine access and utilization, and explore the challenges in latrine use among PPDs in Bahir Dar city, northwest Ethiopia.
A cross-sectional study design was conducted from July 15 to August 15, 2014. Data were collected using a structured and pre-tested questionnaire, and focus group discussions. Four hundred nineteen participants were included using a systematic random sampling technique. SPSS version 20 was used for data entry and analysis. Binary logistic regression was used to identify factors associated with latrine utilization. Qualitative data were analyzed using themes.
Of 419 participants, 142 (33.9 %) had access to latrines and 173 (41.3 %) had satisfactory latrine utilization. Family support while using latrine (AOR = 4.7, 95 % CI (2.7, 8.3), latrine accessibility (AOR = 2.1, 95 % CI (1.2, 3.7) and past latrine modification (AOR = 3.1, 95 % CI (1.8, 5.4) were factors associated with latrine utilization. Presence of steps at the latrine entrance, privacy while using latrine, absence of handrails, unavailability of family support, narrower latrine door, distant latrine, unclean floor of the latrine and elevated foot rests were challenges mentioned by PPDs.
Latrine access and utilization were low among PPDs. Family members should encourage and support PPDs when they need to use latrine, designing accessible latrines, modifying existing latrines to accommodate PPDs are the areas of interventions to increase latrine accessibility and utilization among PPDs.
厕所使用问题是行动不便的残疾人（PPD）在家庭和工作环境中面临的挑战之一。厕所的设计、建造和选址应便于PPD使用。因此，本研究旨在确定巴希尔达尔市（埃塞俄比亚西北部）PPD使用厕所的情况及利用率，并探究他们在使用厕所时面临的挑战。
于2014年7月15日至8月15日进行横断面研究设计。使用结构化且经过预测试的问卷以及焦点小组讨论收集数据。采用系统随机抽样技术纳入419名参与者。使用SPSS 20版进行数据录入和分析。采用二元逻辑回归确定与厕所利用率相关的因素。定性数据采用主题分析法进行分析。
在419名参与者中，142人（33.9%）可以使用厕所，173人（41.3%）对厕所的使用情况感到满意。使用厕所时得到家人支持（比值比[AOR]=4.7，95%置信区间[CI](2.7, 8.3)）、厕所可达性（AOR=2.1，95%CI(1.2, 3.7)）以及过去对厕所的改造（AOR=3.1，95%CI(1.8, 5.4)）是与厕所利用率相关的因素。PPD提到的挑战包括：厕所入口处有台阶、使用厕所时缺乏隐私、没有扶手、得不到家人支持、厕所门较窄、厕所距离远、厕所地面不清洁以及脚凳过高。
PPD使用厕所的情况及利用率较低。家庭成员应在PPD需要使用厕所时给予鼓励和支持，设计无障碍厕所、改造现有厕所以方便PPD使用，是提高PPD使用厕所的可达性和利用率的干预方向。
