Abstract:
Background: Diarrheal diseases are considered as major causes of morbidity and mortality in
Ethiopia. Lack of access to safe water and inadequate sanitation, unsafe hygiene practices and
poor hand washing with soap, can cause diarrheal diseases. It is believed that implementation of
Community-led Total Sanitation and Hygiene (CLTSH) has significantly reduced the risk of
diarrheal diseases and currently it is a nationwide strategy to promote sanitation and hygiene.
Objective: To assess the CLTSH implementation approach on the prevention of diarrheal disease
in Kersa District of Jimma Zone, Southwest Ethiopia.
Methods: A cross-sectional study was conducted in Kersa District of Jimma Zone, Southwest
Ethiopia from December 2012 to January 2013. The study subjects were randomly selected 423
households from CLTSH implemented and 423 households where CLTSH none implemented
kebeles. Two health centers and one District Health Office were included to compile secondary
data on the prevalence of diarrheal diseases. Primary data were collected through interview and
observation and secondary was collected from log books and reports. Then the data were
analyzed using SPSS version 16.0 software package.
Result and discussion: From the total 72.81% households in CLTSH implemented and 54.10%
in the CLTSH non-implemented kebeles used protected water as the main source of supply. The
study revealed that the average water consumption of the CLTSH approach implemented kebeles
(8.05 L/C/ day) was greater than the non-implemented (7.27 L/C/ day). This study showed that
the extent of latrine coverage in CLTSH implemented (91.49%) was greater than that of CLTSH
non-implemented kebeles (87.90%) and about 98.71% households in CLTSH implemented&
85.75% in non-implemented kebeles use latrine always. But the occurrence of diarrhea was
statistically associated with the extent of latrine utilization in the bivariate analysis in the
CLTSH non-implemented kebeles [OR: 9.64, 95%CI: (5.11-18.19)]. The study showed that handwashing
facility near the latrine in CLTSH implemented (73.06%) was greater than that of
CLTSH non-implemented kebeles (72.58%). The study also indicated that from those households
with latrine the habit of hand-washing after defecation in CLTSH implemented and none
implemented kebeles were 99.48% and 95.97% respectively. In the study, the prevalence of
diarrhea in the CLTSH non-implemented kebeles (22.22%) is high when compared with the
figure in the CLTSH implemented (18.91%). This might be due to mass sensitization and
awareness creation during trigger.
Conclusion: The implementation of CLTSH approach improves the sanitation and hygiene of the
community with a reduction of diarrheal disease prevalence by 0.84 odd ratios as well as with
high influence to its nearby neighbors.
