Factors associated with uptake of community-led total sanitation practices and behavior among triggered and followed-up households and communities in Agorigiroi Sub County, Rural Ngora District

Abstract

Background: Community Led Total Sanitation (CLTS) practices and behaviors have been emphasized and promoted during community wide mobilizations to improve sanitation, enforced through non-coercive efforts for households to achieve and sustain lasting open defecation free (ODF) practices and behavior in the triggered villages in rural Ngora district. Although approaches have been implemented to improve uptake of CLTS practices, certain indicators such as provision of; improved latrines, hand washing facilities and squat hole covering have remained low. This is as a result of people’s lack of access to affordable durable latrine construction materials and labour force, worst in rural settings and environments to enhance prolonged behavior and mind set change to sustain Open Defecation Free (ODF) practices. Methods: A cross-sectional study involving 385 households from 8 of 16 villages in 8 parishes was employed. Simple random sampling using a household list was used in the selection of respondents. Quantitative data was collected using a pre-tested and standardized questionnaire; while qualitative data was collected using key informant interview (KII) guides. Quantitative data was coded and summarized in Excel then imported into the STATA version 14.0 software for analysis. Logistic regression was used to obtain Odds ratios as a measure of association where statistical significance of p<0.05 was used for statistical inference. Qualitative data were collected using 21 key informant interviews which were analyzed through thematic analysis using Nvivo software. Was arranged as per summary notes on the subject matter, using operational saturation. Results: Only 9.1% (35/385) of the participants practiced complete CLTS. Factors associated with the uptake of community led total sanitation practices included; having over 50 years [AOR=4.03, CI-2.82-7.81, P=0.007], having attained tertiary education [AOR=10.54, CI=5.43-13.54, P<0.001], having permanent housing [AOR=5.64, CI=1.80-8.76, P=0.02], having over 5 children in the household [AOR=0.05, CI-0.004-0.80, P=0.03], and not being ashamed with open defecation [AOR=0.002, CI=0.0001-0.15, P=0.005]. Conclusion: Generally, latrine ownership among sampled households was high. However, a number of gaps remain in key CLTS practices such as squat hole covers and hand washing facilities with soap and water provision and use. Therefore, interventions to increase the uptake and sustainability of CLTS practices and behavior should therefore focus on these indicators.