Objective Oriented Outcome Evaluation of Community-Led Total Sanitation and Hygiene program in Manna Woreda, Jimma Zone, Oromia, South western Ethiopia, 2019.

Abstract

Introduction: - Globally, 2.3 billion people still do not have basic sanitation facilities such as latrines. Inadequate sanitation is estimated to cause 280,000 diarrheal deaths annually. Poor utilization of latrine or open defecation is also a serious health risk practice. However, availability and level of latrine utilization and associated factors were not well known in the study area. Therefore, this study was employed to find evidences to show the current situation outcome level of Community Led Total Sanitation and Hygiene program and factor affecting latrine utilization in the study area. Objectives: To assess the extent to which Community Led Total Sanitation and Hygiene program achieved its objectives in Manna Woreda, Oromia, Ethiopia, by 2019. Methods: The Evaluation was conducted in Manna Woreda which contains 34292 Households. Community based cross- sectional study design used to evaluate the program. Both quantitative and qualitative data collection methods was deployed for this study by structured questionnaire, observational checklist tools and document review from March 15 /2019 to March 25/2019. For quantitative data multi stage sampling was used to get the required sample size (n=482) from 12 randomly selected kebeles by lottery method, and for qualitative KII (n=15) purposely selected from (Woreda health office, 4Health Centers, and 9 from selected kebele representative) and document reviewed at 20 health facilities. All evaluation processes were undertaken after ethical clearance was obtained from Jimma University and Oromia Regional Health Bureau. Collected data was entered in to epidata version 3.1 and exported to SPSS V.21. Both binary logistic analysis and multiple logistic analyses were used for analysis data. Result: Four hundred eighty two households were included in the study making a response rate of 100%. Most of the study participants were female (328(68%) and participants mean age was 41.5 years (SD= 10.9). Out of total observed households (400 (83%)) of them had standardized latrine. Majority of these households’ latrine (342(71%)) were traditional pit latrine with slab made of wood and earth. There was fresh foot path leading to latrine (382(79.3%)) among households’ latrine observed during data collection. Presence of local community laws (AOR= 4.5) 95% CI (2.74, 7.41), P<0.0001) was significantly associated with utilization of latrines among family members. Among total observed soaps/substituent near hand washing facilities, 274(56.8%) were freshly used during data collection. Also about (207(50%)) of villages were certified for their success of ODF status. Average indicators for availability, utilization and compliance dimensions were 73%, 71% and 68.5% which was good, fair and very good according to criteria set by stake holders respectively. From in depth interview 4/7’th of these key informants revealed that households without hand washing facilities due to scarcity of water, households who did not graduated as model households, Households that were not participated during triggering were not always utilized latrines Conclusion; From objective oriented outcome evaluation of CLTSH program over all judgment dimensions indicators value scores 71% that was good according to criteria set by stakeholders. But, it needs more improvement per national CLTSH objectives sated.