Influence of Perceived Health Risk Factors on Adoption of Community-Led Total Sanitation: A Case of Turkana Central Sub-County, Turkana County, Kenya

Abstract

The primary objective of Sustainable Development Goal 6 target 2 is to achieve widespread accessibility to sufficient sanitation and hygiene facilities, therefore eliminating the practice of open defecation by the year 2030. One strategy for achieving this objective involves the implementation of Community-Led Total Sanitation (CLTS), a participatory method that allows communities to take on accountability for their sanitation behaviors. However, sustaining favorable changes after the implementation of the intervention continues to be a significant obstacle. The objective of this study was to investigate the influence of perceived health risk factors on adoption of Community-Led Total Sanitation. The study was carried out on the household members of Lodwar township and Kalokol ward, targeting a sample size of 382 respondents The research utilized a convergent design methodology, which combined quantitative and qualitative data collection methods, enabling the simultaneous gathering of both types of data. Quantitative data were collected using structured questionnaires and observation checklist, while qualitative data were collected from Focus Group Discussions. A stratified sampling technique was applied to group the village units into strata and simple random sampling used in selection of household heads. Qualitative results were structured into themes and direct quotes. The study determined that an increase in perceived knowledge regarding health risks was associated with a higher likelihood of latrine presence (p-value< 0.05). Findings from multiple regression analysis also showed that education level was a significant predictor for awareness, understanding, and knowledge (p=0.000<0.05), while gender demonstrated a significant negative relationship with awareness and understanding p= -0.2573, suggested males score lower in these areas compared to females. Age correlated positively with awareness and was marginally significant for understanding (p=0.043), indicating that older individuals had higher scores. The study concluded that increased knowledge regarding health risk in terms of vulnerability and susceptibility influenced latrine presence at the households and thus the adoption of community-led total sanitation programs in Turkana Central Sub-County. The study highlighted the critical role of knowledge in achieving open defecation-free status in the area. The study recommended that CLTS interventions by the Ministry of Health and sanitation implementers place a particular focus on knowledge enhancement, to ensure that communities are better informed, which could lead to a higher likelihood of adopting improved sanitation practices, thereby reducing the prevalence of open defecation and related health issues.