Factors associated with adherence to safe water chain practices among refugees in Pagirinya refugee settlement, Uganda
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Poor adherence to safe water chain practices is a major obstacle to consumption of safe drinking water by people around the world. It is also one of the leading con-tributors to various incidences of water-borne diseases. This study aimed at assessing the level of adherence to safe water chain practices and to investigate the factors affecting/ responsible for this adherence among refugees in Pagirinya refugee settlement in Adjumani district, North West-ern Uganda. Methodology: A cross sectional design employing qualitative and quantitative methods of data collection was used. The quantitative research data was collected through conducting a survey among 400 households selected through multi stage sampling procedure. The qualitative compo-nent included observations during visits to 30 water sources, eleven key informant interviews and nine focus group discussions held with purposively selected community health workers, hy-giene promoters and block leaders. Result: Majority of the respondents, 71.5% were female. Almost three quarters of the respond-ents, 73.3% were married and about half, 43.3% of the respondents had attained primary educa-tion level. Almost half, 47.7% (191/400) of the respondents had a medium level of adherence to safe water chain practices. Multivariate logistic regression after dichotomizing the dependent variable into medium + high and low adherence showed that being married (AOR= 1.79; 95% CI 1.03-3.14), education; at primary level (AOR= 2.72; 95% CI 1.36-5.43), secondary level (AOR= 3.87; 95% CI 1.82-8.25) and at tertiary level (AOR=3.26; 95% CI 1.21-8.75), individual‟s level of knowledge about the safe water chain; at moderate level (AOR=2.93; 95% CI 1.40-6.12) and high level (AOR= 5.59; 95% CI 2.50-12.51) and weekly maintenance of water sources (AOR= 0.47; 95% CI 0.26-0.83) had statistically significant association with medium + high levels of adherence. Conclusions and Recommendations: The study found a medium level of adherence to safe wa-ter chain practices among the respondents. There is need for knowledge and awareness cam-paigns among refugees without any formal education about household water treatment and safe storage. Homes of married individuals and those with formal education should be singled out as model homes for reference in terms of safe water chain management practices. Scheduled sani-tary surveys of water sources should be done by WASH implementing actors in the settlement in order to identify potential hazards. This will contribute to a comprehensive risk management ap-proach in terms of water safety from source to point of consumption.