WASH Practices-A Determinant of Gastrointestinal Community Health: A Community Study from Rural Odisha, India

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Background: Rural Odisha, a state in Eastern India, lags far behind much of India in access to toilet facilities and safe drinking water, with 88% of the rural population lacking access to improved sanitation facilities. However recently there has been a political advocacy at the national and regional level in the wake of Swach Bharat Abhyan (Clean India Campaign) wherein a lot of changes have been witnessed in the state. Hence, the current study was contemplated to assess the Water and Sanitation Hygiene (WASH) access in the state and improvements if any. Objectives: a) To assess the wash amenities and practices of 2 sampled districts. b) To determine the association of gaps in wash and disease incidence in the sample. Methodology: Current study explores the wash practices of 2 districts which were randomly selected out of the Human Development Index (HDI) ranking of the state i.e. Khurdha and Jagatsinghpur. The households were selected randomly from 2 blocks of the district; 50 households each and the respondent were the women of the house, as they are considered to the propagators of all WASH practices in the house. Study tool was a predesigned pretested questionnaire which elicited information on sociodemographic information, housing, key questions on toilets on drainage and general sanitation and hygiene. Incidence of diarrheal disease in the household and its course was taken as a proxy of illness and health behaviour. Focus group discussion was also done in order to know the opinion of the women towards toilet in every home. Results: A total of 100 women respondents participated in the study wherein safe access to drinking water was available to 70% of sample, out of which Khurdha had better access in terms of piped water supply in the house itself (14%). Open defecation was practiced by 45%; which was more among men of the house (86.3%) and among the ladies mostly among those over 40 years of age. Hand hygiene was very good in Khurdha and incidence of diarrhoea in the last one month was reported 5.6 times in those who said that they washed their hands with ash and water. Diarrheal incidence was more than double in Jagatsinghpur (P=0.001). 92% women lauded the government’s initiative to make toilets but almost all insisted that the move would be a success only if regular water supply is ensured. Conclusion: The study brings out largely that the community mandate of a developing state with regards to urgent addressal of WASH initiatives in terms of mobilization and availability of cost effective basic amenities to improve the living conditions of the community.