A thesis submitted to deprtment of epidemioloy College of public health and medical sciences jimma University in partial fulfilment of the requirements For degree of master of public health in epidemiology

Abstract

Background: Faecal-oral diseases represent the largest health burden associated with a lack of improved sanitation. Diarrhea being the most burdensome of these and accounting for over millions of deaths each year. Access to improved household sanitary facilities have great health benefits ranging from reductions in diarrhea, helmenth infections and trachoma through reduced risk of accidents and enhanced psycho-social well-being. Objective: This study was aimed at assessing the availability of improved sanitation facilities and factors affecting it among rural communities in Lemo woreda of Hadiya zone in 2014. Methods: Community based cross-sectional study was conducted from March to April, 2014 in Lemo Woreda, Hadiya Zone. To draw a total sample of size 515 a multistage sampling technique was used. Head of the households or their spouses were interviewed to collect data using structured, pretested questionnaire. Data were entered using Epi-Data version 3.1 and exported to SPSS version 16 for analysis. Binary logistic regression was used to predict variables which have independent association with outcome variables. Results: The findings of this study showed that 35.9% (95%CI: 30.9%, 40.9%) of the households included in the study had improved sanitation facilities. The likelihood of improved sanitation facility was 2.3 fold higher in households that had a higher income than those with lower income (AOR: 2.346(1.483, 3.714)). The odds of having improved sanitation facilities was 6.5 folds higher in households headed by government employers/students as compared to households headed by farmers (AOR: 6.521, 95%CI: (2.216,19.188)). Respondents who had sufficient knowledge on improved sanitation facilities were 1.6 times more likely to have improved sanitation facilities as those who had insufficient knowledge on improved sanitation facilities (AOR: 1.606, 95%CI: (1.022,2.253)). Respondents who had positive attitude towards improved sanitation facilities were 2 times more likely to had improved sanitation facilities as those who had negative attitude towards improved sanitation facilities (AOR: 1.989, 95%CI: (1.250,3.165)). Conclusion: The findings of this study showed that 35.9% (95%CI: 30.9%, 40.9%) of the households included in the study had improved sanitation facilities. Income of the household, occupation of the respondents, knowledge and attitude of the respondents towards improved sanitation were the major factors affecting availability of improved sanitation facilities. Therefore, it is recommended that continuous education on improved sanitation facilities should be provided to rural communities and special attention be given to farmers.