Abstract
BackgroundSafe management of faeces (SMoF) and environmental contamination by faecal pathogens have been extensively researched although the SMoF in under-five children has been perennially neglected perhaps due to the misconception that it is harmless. This research, therefore, studied the situation, to determine the magnitude and dimensions of the problem aimed at making policy level stakeholders aware of child faeces management systems and so, inform evidence-based implementation of child and health-related programmes in Nigeria.MethodsThe study utilized an exploratory cross-sectional design and a multi-stage sampling technique to identify 300 respondents from 12 randomly selected streets from 4 wards in Ife central local government area. The study collected data with a pretested questionnaire which included direct observations of child defecation practices and existing toilet facilities. Cleaned data were analyzed by IBM-SPSS version 20 with child faeces management outcomes as the dependent variable.ResultsThe mean age of respondents’ and monthly income (mode) were 30.8 ± 7.5 years and ₦10,000.00 ($28.60). Most respondents were mothers to the under five children (84.7%), had a secondary education (72.0%) and were semi-skilled (57.0%). The caregivers had access to improved water sources (93.7%), improved toilets (64.3%), with 64% and 53.7% having above average scores in knowledge and attitudes, respectively. In the study, 19.7% and 69.0% of caregivers practiced safe disposal of faeces passed by the under five child during the day and at night respectively, though most caregivers (94.3%) omitted steps in the safe management of child faeces chain. The under five diarrhoea prevalence rate was 13.7% and unsanitary passage of child faeces is associated with four folds likelihood of having diarrhoea (p = 0.001). The caregivers whose under five children practiced safe sanitation were rich (p = 0.009) and knowledge was significantly associated with ownership of household toilet (P = 0.037), night faeces management chain practice (P < 0.001) and disposal of anal cleaning materials (P = 0.002). Handwashing was significantly associated with household toilet (P < 0.001), wealth (P < 0.001), under five child defecation preferences during the day (P < 0.001) and at night (P = 0.008).ConclusionThe high knowledge and positive attitudes exhibited by the caregivers were at variance with practice. Where under five children defecate during the day were influenced by the disposal of their anal cleaning materials, distance to the toilet and caregivers’ education. The findings highlight the dangers of unsanitary disposal of child faeces and the need to strengthen the related policies that can increase caregivers awareness and practice at all levels and in all livelihood domains.
Highlights
Safe management of faeces (SMoF) and environmental contamination by faecal pathogens have been extensively researched the SMoF in under-five children has been perennially neglected perhaps due to the misconception that it is harmless
As at 2015, the proportions of people that used improved (29%), shared (24%), other unimproved (22%) toilet facilities were below those required to meet the sanitation target of the Millenium Development Goal (MDG) seven, that sought to halve the proportion of people without sustainable access to basic sanitation in Nigeria [5]
Knowledge of caregivers on child defecation and hygiene indicators As shown in Table 3, 82% (247) of respondents knew about the sanitary handling of faeces of under five children while only 32.3% (97) had knowledge that faeces of under five children can not be used on farms as manure without adequate treatment
Summary
Safe management of faeces (SMoF) and environmental contamination by faecal pathogens have been extensively researched the SMoF in under-five children has been perennially neglected perhaps due to the misconception that it is harmless. This research, studied the situation, to determine the magnitude and dimensions of the problem aimed at making policy level stakeholders aware of child faeces management systems and so, inform evidence-based implementation of child and health-related programmes in Nigeria. 30.1% households had improved, non-shared toilet facilities being used by 34.0% of the population with coverage skewed towards urban residence [4]. In Osun State, where this study occurred, only 16.1% of households had access to improved sanitation facilities, mostly in urban residential areas being used by 19.2% of the population [4]. As at 2015, the proportions of people that used improved (29%), shared (24%), other unimproved (22%) toilet facilities were below those required to meet the sanitation target of the Millenium Development Goal (MDG) seven, that sought to halve the proportion of people without sustainable access to basic sanitation in Nigeria [5]. The above statistics predisposes young children, who tend to defecate in areas where other susceptible children are exposed while learning to walk or playing in their premises, with frequent hands to mouth contacts, increasing the prevalence of faeces related diseases in such places and the risk of environmental enteropathy [7,8,9]
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