Tessema Roba Argaw
Department of Environmental Health Sciences, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia.
PLoS One. 2017 Apr 13;12(4):e0175233. doi: 10.1371/journal.pone.0175233. eCollection 2017.
Based on the sustainable development goals, the United Nations plans to achieve equitable sanitation and hygiene for all and to end open defecation by 2030. In Ethiopia, 60% to 80% of health problems are due to communicable diseases attributable to unsafe water supply, unhygienic and unsanitary waste management, which are directly linked to the practice of open defecation. This study has aimed at assessing the implementation of community-led total sanitation and hygiene (CLTSH) and associated factors. A community-based cross-sectional study design involving 420 of the 7,225 households found in Diretiyara district was conducted in June 2014. Both quantitative and qualitative data were collected. Using Logistic Regressions, bivariate and multivariate analyses were computed. This study showed that 66% of the respondents have knowledge of CLTSH. Eighty-nine percent of the respondents have latrine, of which 78% were constructed after the introduction of CLTSH. Eleven percent of the respondents reported to have defected in the open field and 15% of them reported that they had been recently exposed to diarrhea diseases. The occurrence of diarrheal disease was significantly associated with the extent of latrine ownership [AOR = 2.48; 95% CI 1.00, 6.12]. Attitude and perception parameters were significantly associated with consistent latrine utilization. Respondents who agreed that "Open defecation is preferred due to the unpleasant smell and heat from the Latrine'' [COR = 0.58; 95% CI 0.34, 0.99] were 58% less likely to use the latrine consistently. In conclusion, CLTSH has increased the extent of latrine ownership and decreased practice of open defecation, and yet, intermittent latrine use and poor hygienic practice were reported. Although some fundamental misconceptions were reported, the majority of the respondents have accepted CLTSH approach as a means to ending open defecation in their village. Health extension workers and local authorities should give emphasis to achieving sustainable behavioral change on improved sanitation and good hygiene practices.
基于可持续发展目标，联合国计划到2030年实现全民享有公平的环境卫生和个人卫生，并杜绝露天排便现象。在埃塞俄比亚，60%至80%的健康问题归因于传染病，这些传染病是由不安全的供水、不卫生和不清洁的废物管理导致的，而这些又与露天排便的行为直接相关。本研究旨在评估社区主导的全面环境卫生和个人卫生（CLTSH）的实施情况及相关因素。2014年6月，在迪雷蒂亚拉区7225户家庭中选取420户家庭进行了一项基于社区的横断面研究设计。同时收集了定量和定性数据。使用逻辑回归进行了双变量和多变量分析。本研究表明，66%的受访者了解CLTSH。89%的受访者有厕所，其中78%是在引入CLTSH后建造的。11%的受访者报告在露天场地排便，其中15%的人报告最近曾感染腹泻疾病。腹泻疾病的发生与厕所拥有程度显著相关[AOR = 2.48；95%置信区间1.00，6.12]。态度和认知参数与持续使用厕所显著相关。那些认同“由于厕所气味难闻且闷热，更喜欢露天排便”的受访者[校正比值比 = 0.58；95%置信区间0.34，0.99]持续使用厕所的可能性要低58%。总之，CLTSH增加了厕所拥有程度，减少了露天排便行为，但仍有间歇性使用厕所和卫生习惯不良的情况报告。尽管报告了一些基本的误解，但大多数受访者已接受CLTSH方法作为在其村庄杜绝露天排便的手段。卫生推广工作者和地方当局应着重实现关于改善环境卫生和良好卫生习惯的可持续行为改变。
