Centre of Development Studies, University of Cambridge, Cambridge, CB3 9DP, UK.
Centre of Development Studies, University of Cambridge, Cambridge, CB3 9DP, UK.
Int J Hyg Environ Health. 2020 Jul;228:113554. doi: 10.1016/j.ijheh.2020.113554. Epub 2020 Jun 5.
Rural Vietnam has been subject to continuous hygienic latrine interventions since the mid-1990s. However, most have concentrated on improving coverage rather than use. It is thus important to examine rural hygienic latrine use rates and the predictors impacting them. Accordingly, this can inform subsequent sanitation policy and enrich pertinent, rural health scholarship.
For this study, 792 adult household heads were surveyed in Giong Trom district, Ben Tre, Mekong Delta region, Vietnam. A logistic regression analysis was performed on household heads owning a hygienic and unhygienic latrine simultaneously (N = 140). Included use predictors were individual-contextual and RANAS. This permit assessments of behavioural or normative predictors that, in many instances, are absent from comparable studies. Predictors' statistical significance was set at p < 0.03.
Unsatisfactory hygienic latrine use in Ben Tre, among hygienic latrine owners, exceeds 20%. Many owners (26.8%) choose to retain their unhygienic latrine when acquiring a hygienic one, resulting in a 46.4% unhygienic latrine use rate within this sub-group. Meanwhile, the only hygienic latrine use predictors with statistical significance are neighbours' behaviour, user preference and health-benefit beliefs.
The Ben Tre case underscores that hygienic latrine ownership or access does not ensure comprehensive use. This even applies to latrines that are clean, working and adequate privacy-providing. Sanitation interventions thus ought to consider a targeted, community-coverage approach with expansive health messaging and emphasis on behavioural change. Demographic or socioeconomic-particular targeting, however, is not always necessary: no individual-contextual predictors proved statistically significant.
自 20 世纪 90 年代中期以来,越南农村地区一直在持续进行卫生厕所干预。然而,大多数干预措施都集中在提高覆盖率上,而不是提高使用率。因此,重要的是要检查农村卫生厕所使用率及其影响因素。这可以为后续的卫生政策提供信息,并丰富相关的农村健康研究。
本研究在越南湄公河三角洲地区的槟椥省 Giong Trom 区对 792 名成年户主进行了调查。对同时拥有卫生厕所和不卫生厕所的 140 户家庭户主进行了逻辑回归分析。纳入的使用预测因子包括个体-背景和 RANAS。这允许评估在许多情况下,在类似的研究中不存在的行为或规范预测因子。预测因子的统计学显著性设置为 p < 0.03。
在槟椥,拥有卫生厕所的人中,卫生厕所的使用情况并不理想,超过 20%。许多(26.8%)所有者在获得卫生厕所时选择保留不卫生的厕所,导致该亚组的不卫生厕所使用率为 46.4%。与此同时,具有统计学意义的唯一卫生厕所使用预测因子是邻居的行为、用户偏好和健康效益信念。
槟椥的案例表明,拥有卫生厕所或获得卫生厕所并不一定能确保全面使用。即使是干净、正常工作且提供足够隐私的厕所也是如此。因此,卫生干预措施应该考虑采用有针对性的、覆盖整个社区的方法,广泛宣传卫生知识,并强调行为改变。然而,人口统计或社会经济特定目标并不总是必要的:没有个体-背景预测因子具有统计学意义。