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Exploring Barriers Related to the Use of Latrine and Health Impacts In Research Article iMedPub Journals Health Science Journal 2017 http://www.imedpub.com/ Vol.11 No.2:492 ISSN 1791-809X DOI: 10.21767/1791-809X.1000492 Exploring Barriers Related to the Use of Latrine and Health Impacts in Rural Kebeles of Dirashe District Southern Ethiopia: Implications for Community Lead Total Sanitations Wanzahun Godana1 and Bezatu Mengistie2 1Department of Public Health, Arba Minch University, Arba Minch, Ethiopia 2School of Public Health, Haramaya University, Harar, Ethiopia Corresponding author: Wanzahun Godana, Department of Public Health, Arba Minch University, Arba Minch, Ethiopia, Tel: 251913689198; E- mail: [email protected] Received date: 17 February 2017; Accepted date: 15 March 2017; Published date: 23 March 2017 Copyright: © 2017 Godana W, et al. This is an open-access article distributed under the terms of the creative Commons attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. Citation: Godana W, Mengistie B. Exploring Barriers Related to the Use of Latrine and Health Impacts in Rural Kebeles of Dirashe District Southern Ethiopia: Implications for Community Lead Total Sanitations. Health Sci J 2017, 11: 2. than its merely physical presence, the health status of the Abstract people improves [1,4]. Unsanitary disposal of human excreta, together with unsafe Unsanitary disposal of human excreta, together with drinking water and poor hygiene conditions contribute for 88% unsafe drinking water and poor hygiene conditions of diarrheal diseases; the burden of this disease is a leading contribute for 88% of diarrheal diseases; the burden of cause of morbidity and mortality particularly in young children this disease is a leading cause of morbidity and mortality and lack of access to sanitation has significant non-health particularly in young children and lack of access to consequences, especially for women and girls, including lack of sanitation has significant non-health consequences, security and privacy, decreased school attendance and basic especially for women and girls, including lack of security human dignity. In addition, inadequate sanitation is implicated and privacy, decreased school attendance and basic in helminth infections, enteric fevers and trachoma [5-7]. human dignity. In addition, inadequate sanitation is In contrast, the use of improved sanitation has been found implicated in Helminth infections, enteric fevers and trachoma. There are many factors that limit the utilization to reduce transmission of enteric pathogens and intestinal of latrines in rural setting. Qualitative study was parasites, reducing morbidity and mortality especially in conducted to explore the barriers related to the use of children. Thus, facilitating access and use of improved latrine and health impacts in rural kebeles of Dirashe sanitation can prevent the transmission of diarrheal diseases district Southern Ethiopia. Data was collected through [4,8]. In total the prevention of sanitation and water-related focus group discussions, in-depth interview and diseases could save some $7 billion per year in health system observations. The study revealed that the utilization of costs; the value of deaths averted based on discounted future latrine was low with high open field defecations and the earnings, and adds another $3.6 billion per year [9]. community had poor attitude towards the sanitation However, in 2012, an estimated 2.5 billion people in the practice. world have no access to improved sanitation facilities. Of Keywords: Latrine utilization; Barriers; Dirashe; Sanitation these, 761 million use public or shared sanitation facilities and another 693 million use facilities that do not meet minimum standards of hygiene. The remaining 1 billion (15% of the world population) still practice open defecation. The majority Introduction (71%) of those without sanitation live in rural areas, where 90% of all open defecation (OD) takes place [10]. The order of Sanitation means the safe and sound disposal of human the magnitude of sanitation and related health context are excreta [1]. According to world health organization and United striking; every year the failure to tackle these problems claim Nations children’s Fund Joint monitoring Program (JMP) the lives of 1.5 million children and result in severe welfare sanitation defined as the ‘Lowest cost option that ensures a losses – wasted time, reduced productivity, ill health, impaired clean and healthful living environment both at home and in learning, environmental degradation and lost opportunities – the neighborhood of users [2]. At the household level, for millions more [5,11,12]. adequate sanitation facilities include an improved toilet and a disposal that separates waste from human contact [3]. On In developing regions people are most vulnerable to account of proper utilization of well-maintained latrine rather infection, where only one in every three people has access to improved sanitation; the vast majority, 82% of people © Copyright iMedPub | This article is available from: www.hsj.gr/archive 1 Health Science Journal 2017 ISSN 1791-809X Vol.11 No.2:492 practicing open defecation now live in middle-income hand washing facilities at all. The latrine utilization of populous countries [8,10]. In sub-Saharan Africa 69% of the households which have been declared fully as open defecation populations do not have access to improved sanitation free is assumed to be superior to non-open defecation free facilities and the practice of open defecation has highest households though. Thus, the latrine utilization is questioned. prevalence in Southern Asia, Oceania and sub-Saharan Africa Therefore, this study aims to explore the barriers for latrine which is associated with significant negative externalities as it utilization in rural kebeles district Southern Ethiopia. releases germs into the environment that can harm the rich and poor alike even those who use latrines, thus it needs to be Methods brought to an end [13-16]. Poor sanitation and hygiene conditions are among the major Study area and setting causes of public health problems in Ethiopia in general and in Dirashe district in particular, nearly 40% of Ethiopians lack The study was conducted in Derashe district, Segen Area access to sanitation facilities in 2009. Even where toilets do People’s Zone, SNNPR. Derashe district is one of the five exist, many are not used, meaning that open defecation is districts in Segen Area People’s Zone. It is located at 550 km common for almost all the rural population. In Ethiopia 82% of from Addis Ababa, 330 km from Hawassa, 55 km from Arba the population use unimproved sanitation facilities, 38.1 Minch and 42 km from Segen, the capital city of the zone. The million populations still practice open field defecation [3,17]. district is bordered in north by Gamo Gofa zone, south Konso Diarrhea is the leading cause of Under-5 mortality in Ethiopia district, and west Ali district and in east Amaro and Konso causing 23% of all under-5 deaths. Around 44% of under-5 districts. According the report from the district, it has an children in Ethiopia are stunted, which can be strongly linked estimated 1,16,000 population with 1:1 sex ratio. The main to the childhood incidence of diarrhea and other mechanisms livelihood of the population is based on farming. There are two such as environmental enteropathy [15]. main rainy seasons which make the district to cultivate biannually. The main cush crops of the district include “teff”, According to the most recent EDHS, 80% of all incidences of wheat, barley, grain, coffee and others. In addition to their diarrhea are due to unsafe water supply, poor sanitation and ethnic language the people are the speakers of Affan Oromo unsafe hygiene behaviors; 17% of childhood deaths are [19,20]. This study was conducted rural kebeles of the district associated with diarrhea. There is also high prevalence of during 2014/15. worm infestations causing contributing to the high levels of malnutrition mainly among the large population of under-five year's children which sanitation can prevent [13,18]. However, Data collection methods the government of Ethiopia has been promoting universal Data was collected through Focus Group Discussion and in- sanitation coverage to ensure better health and quality of life depth interview. Both the methods were used to generate the for all Ethiopians working hard to increase access to and adequate information from the community. Qualitative data utilization of improved sanitation to its rapidly growing will be collected by using semi-structured questionnaire or population. interview guide. In Dirashe district the annual health service report 2013 shows that 80% of the households have latrines. But still it FGDs needs a clear, reliable, consistent and sustainable sanitation The qualitative data was collected by using semi-structured use by all family members beyond simply calculating the questionnaire or interview guide. The interview guide was coverage. The morbidity report of the district indicated that developed by reviewing different literatures of WASH and to the burden of diarrheal disease is still 5th of top ten disease of address the objectives of the study. The FGD questionnaires the area and other related illness lead to the economic had perception on latrine utilization and the effect of latrine impacts i.e., cost for treatment per infection, decreased work utilization on diarrheal diseases. A trained environmental
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