Assessment of community led total sanitation and hygiene approach on improvement of latrine utilization in Laelay Maichew District, North Ethiopia. A comparative cross-sectional study.

Abstract

BackgroundLack of latrines remain a widespread health and environmental hazard in many developing countries. Low latrine utilization mostly affects the poor, rural and marginalized communities as the majority of those who do not use improved latrines live in rural areas where 90% of all open defecation takes place. The counterpart to this problem, Community-Led Total Sanitation, and hygiene (CLTSH) is an approach that involves facilitating a process to inspire and empower communities to stop open defecation and to build and use latrines in a participatory manner.ObjectiveThis study was aimed at assessing the Community Led Total Sanitation and Hygiene approach on improvement of latrine utilization in Laelay Maichew District of Central Zone, Northern Ethiopia.MethodsA comparative cross-sectional study was conducted in Laelay Maichew District of Central Zone, Northern Ethiopia from November 2016 to January 2017. The study subjects were randomly selected 388 households from CLTSH implemented kebeles and 388 households from CLTSH non-implemented kebeles. Systematic random sampling technique was used to select households among proportionally allocated sample frame of households. Then, Interview of household heads using semi-structured questionnaire was conducted to collect data. Finally, data were entered and analyzed using SPSS version 20.0. Bivariate Logistic regressions model was used to identify candidates of multiple logistic regressions. Those P-values < 0.25 were considered as candidates to multiple logistic regressions to determine independent factors of latrine utilization. Variables with Odds Ratio at 95% CI and P-value < 0.05 was considered statistically significant. The study obtained approval from Aksum University Institutional Review Board before its commencement.ResultThis study indicated that the level of latrine utilization and latrine availability in CLTSH implemented kebeles were greater than that of CLTSH Non-implemented kebeles. The finding of this study revealed that the rate of latrine utilization in the rural community of Laelay-matches district was about 47.4%, 95% CI (42.9%-51.8%). The majority (71.1%) of household in CLTSH implemented kebeles and (93.5%) of households in CLTSH non-implemented kebeles did not have hand washing facility near the latrine. Households which had no fresh excreta in around latrine were significantly 11.5 times higher than [AOR: 11.5, 95% CI (0.18, 50.2)] utilizing their latrine in CLTSH implemented kebeles.ConclusionThe study showed that the level of latrine utilization in CLTSH implemented and that of CLTSH non-implemented kebeles was low. Therefore, concerted efforts should be made by local and national governmental and non-governmental organization to should be used to promote behavioral change in the communities to implement community-led total sanitation and hygiene for improving latrine utilization.