[Studying Determinants of Latrine Uptake in Garissa, Northeastern Province and Tana River, Coastal Province, Kenya Using Household Surveys and Qualitative Interviews] Open Access

Du, Eric (2012)

Permanent URL: https://etd.library.emory.edu/concern/etds/gb19f652r?locale=en


An abstract of
A thesis submitted to the Faculty of the
Rollins School of Public Health of Emory University
in partial fulfillment of the requirements for the degree of
[Master of Public Health]
in [Global Epidemiology]


Introduction: Diarrheal-related causes of deaths are prevalent in developing countries. Improved
sanitation has been shown to reduce incidence of diarrhea. To date, however, around the globe, about
2.6 billion people have no safe means to excreta disposal, and only 31% of the households in
sub-Saharan Africa have access to basic sanitation facilities. Millennium Water Program (MWP)
is a consortium of NGOs in Kenya aimed to increase sanitation coverage in rural communities.
Previous studies indicated that demand for sanitation arises from social-cultural factors, in
addition to desire for better health. We used quantitative survey and qualitative interviews to
investigate which factors determine sanitation adoption in the water-deprived Northeastern
Method: 2,146 household surveys clustered in 222 villages were collected in all MWP regions except
Tana River district in 2010. Logistic regression was used to model latrine ownership with 9 selected
indicators from the survey using SAS. In 2012, 18 in-depth interviews were conducted, and equally
distributed between Tana River and Garissa districts, Northeastern Province. Interviewees were
categorized as self-financed adopters, supported adopters and non-adopters. MAXQDA was used for
coding and analyzing of the interview results. Two key informant interviews were conducted on staff
members of CARE and CRS.
Result: Regression shows that age, education, household size, gender and presence of community
latrines are positively associated with household latrine ownership (OR =1.06; 1.17; 1.16; 1.78;
2.16). Radio and land ownerships are inversely associated with the outcome (OR = 0.20; 0.67).
Qualitative interviews show that the most prominent facilitators in Garissa and Tana River are:
privacy, distance to defecation site, security and health concerns; the most prominent barriers
are: finance, cultural values, stigma, perceived danger, and smell.
Conclusion: Organizations must seek to generate demand for sanitation uptake by addressing issues of
privacy, security, cultural values, stigma and finance, in addition to health messages. Manner in which
interventions is executed should be adjusted to avoid dependency.

Table of Contents


Background & Literature Review ------------------------------------------- pg. 4-6
Introduction ---------------------------------------------------------------------pg. 7-9
Methods -------------------------------------------------------------------------pg. 10-17
Results ---------------------------------------------------------------------------pg. 18-25
Discussion ---------------------------------------------------------------------- pg. 26-31
Tables ----------------------------------------------------------------------- pg. 32-37
Reference------------------------------------------------------------------------ pg. 37- 44
Public Health Implications --------------------------------------------------- pg. 45- 47
Acknowledgements ----------------------------------------------------------- pg. 48


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