[Studying Determinants of Latrine Uptake in Garissa, Northeastern Province and Tana River, Coastal Province, Kenya Using Household Surveys and Qualitative Interviews] Public
Du, Eric (2012)
Published
Abstract
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]
[2012]
Abstract
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
Kenya.
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
TABLE OF CONTENTS
Background & Literature Review
------------------------------------------- pg. 4-6
Introduction
---------------------------------------------------------------------pg.
7-9
Methods
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10-17
Results
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18-25
Discussion
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pg. 26-31
Tables
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pg. 32-37
Reference------------------------------------------------------------------------
pg. 37- 44
Public Health Implications
--------------------------------------------------- pg. 45-
47
Acknowledgements
----------------------------------------------------------- pg.
48
3
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