Busienei Phylis Jepkorir, Ogendi George Morara, Mokua Millicent A
Department of Environmental Science, Egerton University, Egerton, Kenya.
Dryland Research Training and Ecotourism Centre, Chemeron, Kenya.
Environ Health Insights. 2019 Feb 19;13:1178630219828370. doi: 10.1177/1178630219828370. eCollection 2019.
As of the year 2014, about 2.5 billion people globally lacked access to improved sanitation. The situation is even worse in the sub-Saharan African countries including Kenya. The practice of open defecation (OD) peaks beyond 72% of the population in Turkana County, Kenya, despite various interventions to end it.
This article reports on both qualitative and quantitative aspects of a cross-sectional study. A partially mixed sequential dominant (quantitative) status was used to understand various socioeconomic factors associated with OD practice in Lodwar's human settlements, Turkana County. Simple random sampling technique was chosen to select participants for this study with the sample drawn from various administrative units of Lodwar. Standardized questionnaires, focus group discussions, and key informant interviews were used to collect data.
The quantitative findings revealed that culture was the leading factor as to why people practiced OD with a frequency of 44%. The findings further revealed that poverty was the major influencing factor for latrine ownership among the households (frequency 27%). Pearson χ tests revealed that there was a significant association between latrine presence and education level of the household head (χ = 107.317; < .05), latrine sharing (χ = 403; < .05), and occupation of the household head (χ = 74.51; < .05). The quantitative findings showed that culture was by far the most common factor that contributed to the OD practice with a theme intensity of 31.1%. Further analyses identified 5 major cultural aspects that were associated with OD practice. This included sexual immorality, OD as a common habit, nomadic pastoralism, bride's dignity and mixing of feces. Open defecation as a common habit among the respondents was the most cited factor that contributed to its rampant practice (theme intensity 31.3%) followed closely by nomadic pastoralism kind of life among the residents that limit latrine construction (theme intensity 28.1%).
In addition to cultural aspects, high poverty levels influence latrine adoption and consequently OD practices. Future sanitation interventions addressing OD should assess and factor in these cultural aspects in such communities to come up with appropriate eradication measures which have otherwise been difficult to solve through poverty eradication and sanitation campaigns that have been in existence.
截至2014年，全球约有25亿人无法使用改良卫生设施。在包括肯尼亚在内的撒哈拉以南非洲国家，情况更为糟糕。尽管采取了各种措施来杜绝露天排便（OD），但在肯尼亚图尔卡纳县，露天排便的现象在72%以上的人口中极为普遍。
本文报告了一项横断面研究的定性和定量方面。采用部分混合顺序主导（定量）状态来了解图尔卡纳县洛德瓦尔人类住区与露天排便行为相关的各种社会经济因素。本研究采用简单随机抽样技术从洛德瓦尔的各个行政单位中选取参与者。使用标准化问卷、焦点小组讨论和关键 informant 访谈来收集数据。
定量研究结果显示，文化是人们进行露天排便的主要因素，占比44%。研究结果还显示，贫困是家庭拥有厕所的主要影响因素（占比27%）。Pearson χ检验显示，厕所的存在与户主的教育水平（χ=107.317；<0.05）、共用厕所（χ=403；<0.05）以及户主的职业（χ=74.51；<0.05）之间存在显著关联。定量研究结果表明，文化是导致露天排便行为的最常见因素，主题强度为31.1%。进一步分析确定了与露天排便行为相关的5个主要文化方面。这包括性道德、露天排便作为一种常见习惯、游牧畜牧业、新娘的尊严以及粪便混合。露天排便作为受访者中的一种常见习惯是导致其普遍存在的最常被提及的因素（主题强度31.3%），紧随其后的是居民中的游牧畜牧业生活方式限制了厕所建设（主题强度28.1%）。
除文化方面外，高贫困水平影响厕所的采用，进而影响露天排便行为。未来针对露天排便的卫生干预措施应评估并考虑这些社区的文化方面，以制定适当的根除措施，否则通过消除贫困和现有的卫生运动很难解决这些问题。
