Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P.O.Box 7072, Kampala, Uganda.
Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
BMC Public Health. 2022 Mar 1;22(1):414. doi: 10.1186/s12889-022-12759-z.
Achieving the Open defecation free (ODF) status remains a major challenge in Uganda, yet it contributes significantly to child health improvement. Literature on social, cultural and behavioral aspects that influence the ODF status in rural Uganda is limited. The study therefore, explored perceived factors influencing the ODF status in rural South Western Uganda.
An exploratory study employing qualitative techniques and based on deductive analysis between month December 2020 and January 2021 was conducted. Seven Focus Group Discussions (FGDs and three Key Informant Interviews (KIs) were conducted in Kabale District, southwestern Uganda. Focus Group Discussion participants were mothers and fathers having children of 2 years and below while KIIs included local community leaders and health extension workers. Data was analyzed using a categorization matrix derived from the Risks, Attitudes, Norms, Abilities, and Self-regulation (RANAS) model which is comprised of contextual and psychological factors. Text was further categorized into high and low statements for attainment of ODF status.
The contextual factors influencing the Open Defecation Free status behavior included; farming activities far from home, financial constraints, rainy seasons, collapsible soft soils, and alcohol use. Psychological factors influencing ODF status included; perceived health risk for typhoid disease, low perceived severity for lack of ODF components, negative attitude of less value attached to ODF components, and a feeling of time wastage practicing ODF status behavior. The perception that the community has the ability to attain the ODF status was high. Although, the capability to maintain ODF was low when it comes to replacement of ODF component if stolen or destroyed.
Open Defecation Free status is influenced by contextual and psychological factors. Therefore, it's crucial for sanitation promotors to always identify such context specific factors in order to design sanitation and hygiene promotion interventions to address the ODF free status related challenges.
在乌干达，实现无露天排便（ODF）状态仍然是一个主要挑战，但它对儿童健康改善有重大贡献。关于影响农村乌干达 ODF 状态的社会、文化和行为方面的文献有限。因此，本研究探讨了影响农村乌干达西南部 ODF 状态的感知因素。
这是一项探索性研究，采用定性技术，并基于 2020 年 12 月至 2021 年 1 月的演绎分析。在乌干达西南部卡巴莱区进行了 7 次焦点小组讨论（FGD）和 3 次关键知情者访谈（KIs）。焦点小组讨论参与者是有 2 岁及以下儿童的母亲和父亲，而 KII 包括当地社区领导和卫生推广工作者。使用源自风险、态度、规范、能力和自我调节（RANAS）模型的分类矩阵分析数据，该模型由与 ODF 状态相关的情境和心理因素组成。文本进一步分为高和低声明，以实现 ODF 状态。
影响露天排便自由状态行为的情境因素包括：远离家园的农业活动、经济拮据、雨季、易塌陷的软土和饮酒。影响 ODF 状态的心理因素包括：对伤寒病的健康风险感知、对缺乏 ODF 组件的严重程度感知较低、对 ODF 组件价值的负面态度以及对实践 ODF 状态行为的时间浪费感。社区有能力达到 ODF 状态的看法很高。尽管如此，当 ODF 组件被盗或损坏时，维持 ODF 的能力很低。
ODF 状态受到情境和心理因素的影响。因此，卫生促进者始终确定这些特定情境因素非常重要，以便设计卫生和个人卫生促进干预措施，以解决与 ODF 自由状态相关的挑战。
