Open defecation practice in twenty remote villages located in South India: A population-based cross-sectional study

Abstract

Introduction: Open defecation practice is a major public health problem in India. We intended to study the practice of open defecation and its related risk factors in a rural area of South India. Methodology: This study was conducted in twenty villages surrounding a rural health training center, located in Tamil Nadu. Data collection was done by medical interns and medical social workers using a structured questionnaire. Results: The total population surveyed was 14,925, of which 14,061 individuals were in the age group of 5 years and above. Among them, 9069 (64% [63–65]) individuals were practicing open defecation. When compared to backward caste, individuals belonging to the most backward caste were 10% more likely (adjusted prevalence ratio [aPR]: 1.1 [1.0–1.2]) and individuals belonging to scheduled caste were 40% more likely (aPR: 1.4 [1.3–1.5]) to be practicing open defecation. With increase in age, there was a decrease in the prevalence of open defecation practice by 1% (aPR: 0.99 [0.99–0.99]) and with increase in family members, there was a decrease in the prevalence of open defecation practice by 2% (aPR: 0.98 [0.96–0.99]). Illiterate people had 14% higher chance of preferring open defecation (aPR: 1.14 [1.07–1.2]). Tobacco users were 10% more likely (aPR: 1.1 [1.0–1.3]) to be associated with the open defecation practice and nonvegetarians were 20% more likely to be associated with the open defecation practice (aPR: 1.2 [1.1–1.3]). When compared to kutcha house individuals, pucca house individuals were 10% less likely (aPR: 0.9 [0.8–1.0]) and semi-puccca house individuals were 10% more likely (aPR: 1.1 [1.0–1.2]) to adopt open defecation method. Gender, marital status, and hypertension were not associated with the open defecation practice. Conclusion: Open defecation practice is still continuing as an important public health problem in remote rural areas of South India.