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Status of Sanitation in the Rural Areas of a Health Unit District, Tamil Nadu, India

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Status of Sanitation in the Rural Areas of a Health Unit District, Tamil Nadu, India ORIGINAL ARTICLE pISSN 0976 3325│eISSN 2229 6816 Open Access Article www.njcmindia.org Status of Sanitation in the Rural Areas of a Health Unit District, Tamil Nadu, India Renuka Prithviraj1, P Sivaprakasam2, Mahendran C3, Prasan Norman3, KR Pandyan3, Balasubramaniam4 Financial Support: Grants from ABSTRACT MAHER university,Chennai,Tamilnadu Conflict of Interest: None declared Background: Sanitation is the key to better health. Even towards Copy Right: The Journal retains the the end of the millennium development goal era, provision of sani- copyrights of this article. However, re- tation still continues to be a challenge especially in rural areas. production of this article in the part or Objectives: The present study was undertaken to describe the total in any form is permissible with due acknowledgement of the source. availability and utility of sanitary latrines in study population and to assess knowledge / practice of households about use of latrines. How to cite this article: Materials and Methods: This cross-sectional study was carried out Prithviraj R, Sivaprakasam P, Mahen- dran C, Norman P, Pandyan KR, Bala- in Cheyyar taluk of Tamil Nadu which comprised of three blocks. subramaniam. Status of Sanitation in Stratified random sampling technique was followed to draw sam- the Rural Areas of a Health Unit Dis- ples from all villages in the three blocks. From each stratum, 20% trict, Tamil Nadu, India. Natl J Com- of the villages were selected. In each village, 10% of the house- munity Med 2017; 8(9):521-525. holds were again selected at random, with individual household being the sampling unit. Author’s Affiliation: 1Prof; 2Prof & Head; 3Postgraduates; Results: Availability of in-house toilets in the study area was only 4Statistician, Dept of Community Med- 22% with 73% utilization among them. With regard to community icine, Meenakshi MC&RI, Kanchipu- toilets, the availability and utility was grossly inadequate. Know- ram, Tamil Nadu ledge about importance of toilet use was more among households with toilets when compared to their counterparts. The knowledge Correspondence about government giving subsidy to construct toilets was also Dr. Renuka Prithviraj lacking. [email protected] Conclusion: The efforts to improve sanitation needs to be sustain- Date of Submission: 20-11-16 able with stress on IEC and community participation. Date of Acceptance: 21-09-17 Date of Publication: 30-09-17 Key words: Availability, utility, sanitary latrine, rural areas INTRODUCTION also achieved a significant increase of 24 percent- age points, but narrowly missed the target 2. Sanitation is a human right and a key component of primary prevention to ensure better health1. While India is now in the front ranks of fast- Since its inception, WHO has recognized sanitation growing emerging economies, it is also one of the as vital to global health and development. The countries wherein a lot of efforts are still required WHO/UNICEF Joint Monitoring Programme for to eliminate the practice of open defecation (De- Water Supply and Sanitation (JMP) monitors the partment of drinking water and sanitation, Gov- progress towards targets under Millennium De- ernment of India. 2010)3. In rural areas, open defe- velopment Goals which was to reduce the propor- cation though reduced in scale, continues to be a tion of the population without sustainable access to socially and culturally accepted traditional beha- basic sanitation to half by 2015. The final report in vior at large. 2015 states that despite failing to meet the target, The statistics given by the different agencies of the use of improved sanitation facilities rose from 54 government is also alarming. The ministry of per cent to 68 per cent globally. South-eastern Asia drinking water claims 53 percent has toilet facilities in rural areas, whereas the Joint Monitoring Pro- National Journal of Community Medicine│Volume 8│Issue 9│Sept 2017 Page 521 Open Access Journal │www.njcmindia.org pISSN 0976 3325│eISSN 2229 6816 gramme and census 2011 data keep the figure at method with the individual household being the 33% and 30%, respectively 4. In Tamil Nadu, the sampling unit. A total of 1515 households were ministry claims 24.47 % do not have toilet facility identified finally. Data collection was done both by while the census 2011reports 76.1%. This stresses direct observatory method, check list and also by the need for a more accurate monitoring system. using a pre tested questionnaire. In each village, a prior consent was taken from the village leaders Therefore, the need of the hour is to identify the after having a preliminary meeting with them and existing system of environmental sanitation and to explaining them the purpose of the study. prioritize the strategies according to the need of the country. These priorities are particularly im- The sanitary status was assessed using a check list portant because of issue of water constraints, envi- consisting of questions on presence/absence and ronment-related health problems, rapid population use of toilets, use of public toilets and the know- growth, inequitable distribution of water re- ledge/ practice aspects were assessed using a sources, issues related to administrative problems, structured questionnaire. Health education regard- urbanization and industrialization, migration of ing sanitation was given to the villagers at the end population, and rapid economic growth5 of the study .Data entry and analysis was done us- ing the statistical package for social sciences (SPSS) The baseline survey on water and sanitation car- version 19 software. Descriptive statistics was used ried out in the entire country by the ministry of to present data on availability of toilets anduniva- drinking water and sanitation in 20126 showed riate analysis was used to find association between paucity of information reported from Tiruvanama- toilet availability and knowledge. lai district. A small proportion of this district being the field practice area of the institution, and based on the observations made during the field visit to RESULTS the villages, the present study was carried out in the rural areas of Cheyyar health unit district to Of the 74 villages selected for the purpose of our study the current status of sanitation with the ob- study, 31 villages were from vembakkam, 22 vil- jectives to describe the availability and utility of lages were from Anakkavur and 21 villages were sanitary latrines in the study population and to as- from Cheyyar. The study unit comprised of 1515 sess knowledge and practice of the households households from 74 villages. about use of household latrines. Of the 1515 houses surveyed, 705(46.5%) of the houses were terraced, 538(35.5%) were tiled and 272(18%) were thatched. Most 1227(81%) of the MATERIALS AND METHODS houses were on the streets (within the main vil- This cross-sectional study was carried out in one of lage) and 102(6.7%) which comprised mainly of the the health unit districts (Cheyyar) of Tamil Nadu lower caste were staying in the outskirts of the vil- state, India. The study was carried out in 2013 for a lages. The average family size was 4.36.The literacy period of four months(February to May). The status (as per census 2011 definition) comprised of health unit district is divided into 3 talukas (a talu- 64.7% literates. The proportion of illiterates was ka is a subdivision of a district- a group of several higher when compared to the state Tamil Nadu villages organized for revenue purposes in India) (19.7%) as per Census 20117. namely Arani, Cheyyar and vandavasi. The study The use of cell phones was 49 % with a mean mo- was conducted in one (Cheyyar) taluk (population bile bill expenditure of Rupees 258.37 per month of 288004 distributed in 374 villages) which com- per person. This was similar to the census 2011 da- prised of three blocks-vembakkam, Anakkavur ta8 which revealed 53.2% use of mobile phones. and Cheyyar, with vembakkam having 153 Villag- es, Cheyyar having 117 villages and Anakkavur having 104 villages. Table 1: Availability of public toilets in Cheyyar taluk Stratified random sampling technique was used to Name of n Villages with Actually Not draw samples from all the villages in the three Block community toilets used used blocks. Villages were stratified on the basis of Vembakkam 31 14 (45) 3 (9.7) 6 (19.3) number of households in each village into ten stra- Anakkavur 22 8 (36.4) 2 (9) 2 (9) ta. From each stratum, 20% of villages were se- Cheyyar 21 8 (38) 1 (4.8) 5 (23.8) lected randomly by simple random sampling and a Total 74 30 (40.5) 6 (20) 13 (43.4) total of 74 villages were selected. This resulted in selection of 31 villages from vembakkam, 22 villag- Availability of public facilities: Community toi- es from Anakkavur and 21 villages from Cheyyar. lets In each village, 10% of the households were again Community toilets are being constructed in the ru- selected at random by simple random sampling ral areas for the benefit of only women and child- National Journal of Community Medicine│Volume 8│Issue 9│Sept 2017 Page 522 Open Access Journal │www.njcmindia.org pISSN 0976 3325│eISSN 2229 6816 ren at the rate of one toilet per village. Each unit when compared to 30 (11%) of thatched houses had 10 toilets seats with adequate electricity, venti- (p<0.0001). lation, privacy and water facility. Only 30 (40.5%) Only 16 (15.7%) houses in the outskirts had toilet of the 74 villages surveyed had community toilet facility in relation those situated within the village facility (Table 1). of these, 13(43.4%) were not 317(22.4%). This could probably be that people liv- used/or were locked either because of no electrici- ing in outskirts are more comfortable with outdoor ty, water or unknown reasons (funds not re- defecation but the difference was not statistically ceived).A little of only 6 (20%) toilets were put to significant (p>0.05).
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