Implementation of community-led total sanitation and hygiene Approach on the prevention of diarrheal diseases in kersa district, Jimma zone

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.