Relevance of sustainable rural water supply and sanitation program on improving sanitation facilities at the household level in Itilima district Simiyu region

Abstract

ABSTRACT Introduction: Unimproved sanitation is a significant global concern, leading to adverse health outcomes and increased healthcare costs. Despite efforts to address this issue, many households lack access to improved sanitation facilities. In response, Tanzania has implemented several programs to improve sanitation, including the Sustainable Rural Water Supply and Sanitation Program (SRWSSP). Objective: To assess the relevance of the SRWSSP in improving sanitation facilities in Itilima District. Methods: A cross-sectional study with a quantitative approach was employed. Data were collected from household heads using questionnaires and observations. Descriptive statistics analyzed socio-demographic characteristics, latrine coverage, toilet utilization, and attitudes toward sanitation. Multivariable logistic regression identified factors associated with acceptance, with significance set at a P-value of less than 0.05. Results: In Itilima District, 23% of households had improved sanitation facilities, with 54.3% utilization. Regarding acceptance, 55.4% of respondents noted efforts to improve sanitation, while 43.8% felt comfortable with the facilities. Significant factors associated with acceptance included age (40-59 years: AoR = 0.29, P = .014; 60+ years: AoR = 0.04, P = .000), income (AoR = 0.17, P = .043), education (AoR = 3.17, P = .022), and family size (AoR = 3.93, P = .047). Conclusion: Improved sanitation facilities show partial relevance, with moderate relevance for utilization and acceptance. Despite efforts, many households continue to use unimproved facilities due to inadequate infrastructure and socio-economic disparities. Recommendations include promoting durable, culturally appropriate sanitation facilities, implementing health education programs to highlight the benefits of improved sanitation, and providing targeted subsidies to enhance improved sanitation among households.