International Journal of Research in Pharmacy and Biosciences Volume 4, Issue 1, January 2017, PP 6-12 ISSN 2394-5885 (Print) & ISSN 2394-5893 (Online) Study on Knowledge and Practice Regarding Sanitation Application among the Residents of Rangeli Municipality of Morang District, Nepal Sah RB1, Khadgi A2, Jha N3 1Associate Professor, School of Public Health and Community Medicine, BPKIHS, Dharan, Nepal 2Junior Resident, School of Public Health and Community Medicine, BPKIHS, Dharan, Nepal 3Professor & Chief, School of Public Health and Community Medicine, BPKIHS, Dharan, Nepal ABSTRACT Inadequate sanitation has direct effect on health of individual, family, communitiesand nation as a whole. This study was conducted to identify the knowledge and practice regarding sanitation application among the residents of Rangeli Municipality of Morang District and to measure the association between sociodemographic characteristics and disease pattern with sanitation practices of the study population.A Community based cross- sectional study was conducted from 27th November – 10th December 2016 in Rangeli Municipality where 300 households were taken as subjects. Simple random sampling method was applied. Semi-structured questionnaire was used and face to face interview was conducted. Chi-square test was applied to find out the association between sociodemographic characteristics and disease pattern with sanitation practices of the study population.Only 28% of residents were treat water before drinking. Most of the study population (98.7%) had latrines less than 50 feet away from the water source.Majority of respondents dispose of stool of children in toilet (54%) followed by left in open field (27%), Put/ rinsed in drain or ditch (14.3%) and throw with waste materials (4.6%) respectively.Majority of respondents manage solid wastes by burning (68%) followedby preparecompost (27.3%) and bury (4.7%) respectively.Almost58% of the study population had good sanitary conditions. The study population who studied SLC and above(89.9%), business in occupation(74.6%), above the poverty line (78.3%) and the study population who treat diarrhea using modern medicine had significantly more sanitary practices (p<0.05). We conclude that majority of respondents had average knowledge and practice regarding sanitation. Middle age and old age group, high education level, business in occupation, higher economic condition and study population who treat diarrhea using modern medicine was found significantly more sanitation practices. Keywords: Knowledge, Practice, Sanitation, Rangeli Municipality, Morang District INTRODUCTION Inadequate sanitation has direct effect on health of individual, family, communities and nation as a whole. Simply, having sanitation facilities increases health well-being and economic productivity. Sanitation includes use of latrine, clean surrounding, water treatment, and proper disposal of solid and liquid wastages. Toilet is taken as an essential and basic indicator of health and sanitation worldwide [1]. Proper sanitation is a necessary prerequisite for improvement in general health standards, productivity of labour force and good quality of life [2]. Every 20 seconds, a child around the world dies as a result of poor sanitation [3]. About 80% of all disease of the developing world is related to unsafe water and inadequate sanitation [4].Worldwide, 5.3% of all deaths and 6.8% of all disability are caused by poor sanitation and unsafe water. Nearly two-thirds (67%) of the total population go for open-air defecation and only one-third (33%) having access to a latrine [5]. The lack of access to sanitation in Nepal is striking. A total of 75% of the population is without access to sanitation, one of the highest proportions in Asia. However, the urban sanitation coverage is75% and the rural sanitation coverage is only 20% [6]. Every day, 16 million Nepalese (around 57% of the population) practice open defecation because they have no toilets [7]. Access to sanitary system, garbage disposal and toilets are lowest among the poorest population and is better in the richer quintiles of the population. There is huge gap in access to sanitary facilities between that available to the poorest population and the national average [8]. Therefore, the present study is undertaken to International Journal of Research in Pharmacy and Biosciences V4 ● I1 ● January 2017 6 Sah RB, et al. ”Study on Knowledge and Practice Regarding Sanitation Application among the Residents of Rangeli Municipality of Morang District, Nepal” identify the knowledge and practice regarding sanitation conditions and to find out the association between sociodemographic characteristics and disease pattern with sanitation practices among residents of Rangeli Municipality. METHODS A Community based cross-sectional study was conducted from 27th November – 10th December 2016 in Rangeli Municipality of Morang District of Nepal. Rangeli is located in the eastern geographical region of Nepal. This was a two weeks study to fulfill epidemiological management carried out by students of MBBS 3rd year Batch 2014 of B. P. Koirala Institute of Health Sciences, Dharan, Nepal. This research was based on random selection of the study area Rangeli Municipality. This study considered 64% of world populations have good sanitation practices. It was calculated as 225.3 by using the formula, sample size (n) = 4 pq/L2 [(n=4 x 64 x 36 / (6.4)2 = 225.3] household as sample based on the prevalence of 64%, 95% confidence level and 10% allowable error. Adding of 15% on final sample for non-response, 226 x 15 / 100= 34, then sample size became 226 + 34 = 260 ≈300.The required sample size is 300 household of mixed ages, 18 years and above in Rangeli Municipality of Morang District (Vivas et al., 2010) [9]. The data was collected from 300 households of mixed ages, 18 years and above in Rangeli Municipality. There are 11 wards in Rangeli Municipality. Among 11 wards, 4 wards was randomly selected. The list of households of four selected wards was prepared and equal number of households (75) from each ward was selected on the basis of simple random sampling by lottery method. Each subject was selected till the sample size was fulfilled from the four wards of Rangeli Municipality. Ethical clearance was taken from Undergraduate Medical Research Protocol Review Board (UM- RPRB) of B P Koirala Institute of Health Sciences, Dharan, Nepal. Written permission was taken from each participants of the study. The participants of both sexes, aged 18 years and above, who were willing to participate in the study, those who gave written consent andthose individuals who were available after three visits were included in the study. Three visits means the selected study subject who was not present at the time of the first visit to the respective place, he or she was followed for three attempts so as to include in the study and in the case of unavailability next study subject was taken.Semi-structured questionnaire and an observational checklist were used for data collection and face to face interview was taken. The confidentiality and privacy of the study was maintained; name of the individuals or participating group was not disclose after the study. All interviewed questionnaires were indexed and kept on file. The collected data was entered in Microsoft Excel and converted into SPSS (Statistical Package for Social Science) software package 11.5 version for statistical analysis. Data was analysed to find out percentage and proportion, and Chi- square test was used to measure the association between socio demographic characteristics and disease pattern with sanitation practices of the study population. The confidence level was set at 5% in which probability of occurrence by chance is significant if P< 0.05 with 95% Confidence Interval. RESULTS Table1. Knowledge and practice regarding sanitation (N=300) Characteristics Frequency Percentage Source of drinking water River/Stream 10 3.3 Spring 4 1.3 Well 117 39.0 Tap 28 9.3 hand pump 141 47.0 Time take to reach the source of water Less than 5 min 296 98.7 More than 5 min 4 1.3 Water treat before drinking Yes 84 28.0 No 216 72.0 If water treat then method used for purification (n=84) Boil 47 56.0 Filter 36 42.9 7 International Journal of Research in Pharmacy and Biosciences V4 ● I1 ● January 2017 Sah RB, et al. ”Study on Knowledge and Practice Regarding Sanitation Application among the Residents of Rangeli Municipality of Morang District, Nepal” Disinfection 1 1.2 Store drinking water Covered 173 57.7 Uncovered 127 42.3 Have Latrines Yes 209 69.7 No 91 30.3 If no latrine then where defecate (n=91) Public toilet 5 5.5 River 11 12.1 Open fields 75 82.4 If no latrine then why didn’t construct latrine (n=91) Not necessary 1 1.2 No money 40 43.9 No place 50 54.9 *Important to have Latrines To keep village clean 284 94.7 Free from odour 60 20.0 Safe from diseases 148 49.3 How often clean Latrines? (n=209) Daily 108 51.7 Every alternate day 11 5.3 Twice in a week 22 10.5 Once a week 64 30.6 Once in 15 days 4 1.9 Distance between water source and latrine <50 feet 296 98.7 ≥ 50 feet 4 1.3 Dispose of stool of children Put/ rinsed in drain or ditch 43 14.3 Left in open field 81 27.0 Throw with waste materials 14 4.6 Used toilet 162 54.0 Drainage Adequate 185 61.7 Inadequate 102 34.0 Absent 13 4.3 Animals at home Yes 148 49.3 No 152 50.7 Distance between cattle sheds & dwelling house (n=148) < 25 feet 124 83.8 ≥ 25 feet 24 16.2 Manage liquid wastes Use in kitchen garden 130 43.3 Feed to cattle 62 20.7 Surrounding home 108 36.0 Manage solid wastes Burn 204 68.0 Bury 14 4.7 Prepare compost 82 27.3 Mosquito breeding sites around the house Yes 271 90.3 No 29 9.7 Mosquito prevention Net 284 94.7 Coils 14 4.7 Smoke around house 2 0.7 Total 300 100.0 *Multiple Responses International Journal of Research in Pharmacy and Biosciences V4 ● I1 ● January 2017 8 Sah RB, et al.