Factors associated with access to basic households’ water, sanitation and hygiene in Ngorongoro cholera epidemic villages, Arusha

Abstract

ABSTRACT Background: Water, sanitation and hygiene have a great role in public health especially for prevention and control of diarrhoeal diseases. Between April and August, 2018 Ngorongoro District had 1007 reported cases of cholera and a case fatality rate of 1.1%. The outbreak investigation teams reported that persistence was fuelled by inadequate and unsafe water as well as poor sanitation and hygiene. We used analytical cross-sectional study to determine access to basic households’ Water, Sanitation and Hygiene (WASH) status and associated factors after interventions as a response to Cholera outbreak. Methodology: Heads of households provided the current information on household water, sanitation and hygiene. The two-stage cluster sampling technique was used to recruit the study participants. An interview schedule and observational checklist was used to collect data. “Access to basic household WASH” was a composite variable constructed with; a household having a toilet not shared with other household(s), having a functional hand washing facility and having drinking water treated. Variables that had p≤ 0.2 in bivariate analysis ware subjected to stepwise multiple logistic regressions. Odds ratio and 95%Cl was used to estimate factors associated with access to basic household WASH. Results: The proportion of households treating drinking water, with access to sanitation and hand fuanctional hand washing facility was 60%, 90% and 12% respectively. Over 90% of respondeants had high knowledge onabout cholera. However, only 8% of households had access to basic WASH. Access to basic household WASH was significantly associated with household monthly income (aOR (95%Cl) = 4.7(1.1, 20.1), 6.5 (1.3, 32.9) and 12.8 (2.9, 55.9) for monthly income 22-43 USD, 44-65 USD and ≥66 USD respectively) and young age (18-30yrs) of heads of households (aOR (95%Cl) = 0.2 (0.1, 0.9)). Conclusion: The risk of human contact with feaces in Ngorongoro was still high because most of sanitation facilities were traditional pit latrine (i.e. without slab). Promotions of access to household WASH need to be integrated with strategies to overcome issues of “access” associated with income.