The role of psychological factors in predicting latrine ownership and consistent latrine use in rural Ethiopia: a cross-sectional study

Fikralem Alemu,Janvier Gasana,Girmay Medhin,Abera Kumie

doi:10.1186/s12889-018-5143-0

Fikralem Alemu, Janvier Gasana + Show 2 more

Open Access

https://doi.org/10.1186/s12889-018-5143-0

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Abstract

BackgroundInadequate sanitation is one of the leading causes of disease in poor and middle-income countries.ObjectiveThe objective of the study was to identify the psychological factors that predict latrine ownership and consistent latrine use in the rural Becho district of central Ethiopia.MethodA quantitative, cross-sectional, community based study was conducted. A total of 1047 heads of household were interviewed using a structured questionnaire. Ownership of latrine and consistent latrine use constituted the outcome variable of the study. Data were entered using Epi Info version 3.5.4 and were analyzed using SPSS version 20.ResultsOf the 1047 households, 73% owned a traditional pit latrine. Among the psychological factors, attitude (AOR 1.70; 95% CI 1.21–2.37) and injunctive norm (AOR 6.18; 95% CI 4.46–10.44) were positively and significantly associated with latrine ownership. Among the demographic factors, having a family size of more than six (AOR = 1.43; 95% CI 1.01–1.97, having a child attending school (AOR = 1.88; 95% CI 1.17–3.02), and having a high school education (AOR = 1.98; 95% CI 1.34–2.87) were significantly associated with latrine ownership. With respect to exposure to communication about sanitation (the cues to action), households that had a family member who took part in Community Led Total Sanitation and Hygiene (CLTSH) triggering were three times more likely to be latrine owners than those who did not participate in CLTSH triggering (95% CI 1.92–4.78.) Results from adjusted logistic regression analysis of potential predictors of consistent latrine use showed that having a positive attitude (AOR 7.00; 95% CI 4.55–10.55), owning of a latrine that had superstructure (AOR 2.3 95% CI 1.47–3.48), having a clean latrine (AOR 1.69 95% CI 1.00–3.00), and having a latrine with a protected door (AOR 1.94; 95% CI 1.10–3.48) were significantly associated with consistent latrine use.ConclusionThe study findings showed that attitude and injunctive norm are the psychological predictors of latrine ownership, and consistent latrine use was associated with attitude, cleanliness of the latrine, and its privacy. Hence, sanitation intervention needs to focus on changing societal norms, attitudes, and the promotion of latrine quality.

Highlights

Inadequate sanitation is one of the leading causes of disease in poor and middle-income countries
Attitude (AOR 1.70; 95% confidence interval (CI) 1.21–2.37) and injunctive norm (AOR 6.18; 95% CI 4.46–10.44) were positively and significantly associated with latrine ownership
With respect to exposure to communication about sanitation, households that had a family member who took part in Community Led Total Sanitation and Hygiene (CLTSH) triggering were three times more likely to be latrine owners than those who did not participate in Community Lead Total Sanitation and Hygiene (CLTSH) triggering Results from adjusted logistic regression analysis of potential predictors of consistent latrine use showed that having a positive attitude (AOR 7.00; 95% CI 4.55–10.55), owning of a latrine that had superstructure (AOR 2.3 95% CI 1.47–3.48), having a clean latrine (AOR 1.69 95% CI 1.00–3.00), and having a latrine with a protected door (AOR 1.94; 95% CI 1.10–3.48) were significantly associated with consistent latrine use

Summary

Introduction

Inadequate sanitation is one of the leading causes of disease in poor and middle-income countries. Evidence suggests that improved sanitation reduces diarrheal disease by up to 36% and intestinal parasitic infection by up to 50% [1,2,3,4,5]. An estimated 64,540 child deaths occur in Ethiopia due to inadequate water, sanitation, and hygiene [14]. In 2011, Ethiopia adopted the Community Lead Total Sanitation and Hygiene (CLTSH) programs as a national sanitation strategy [17]. These programs have been successful in decreasing open defecation [18], there was no progress in access to improved sanitation in Ethiopia, increasing from a baseline of 3% in 1990 to 28% in 2017 [6]

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