Practice Open Defecation Research Articles

OLDER ADULTS EXPERIENCING UNSHELTERED HOMELESSNESS IN LARGE URBAN CITY LACK BASIC RESOURCES

Abstract Older adults constitute the fastest-growing segment of the homeless population in the US. Previous research has found older homeless adults to have more chronic conditions, premature mortality, greater odds of physical disability, and experience accelerated aging compared to housed populations. To inform programs to better serve this population, improved understanding of how they meet their basic needs is warranted. The purpose of this study was to explore the experience of unsheltered homeless older adults with meeting their basic needs for food, drinking water, toilet, hygiene, and healthcare in Los Angeles County. From 2021-2023 (24-months), we conducted a cross-sectional survey using the HOUSED BEDS assessment with people experiencing unsheltered homelessness and initiating care with Street Medicine (N=637). Quantitative data were analyzed to compare adults (18-49 yrs) and older adults (50+ years). Findings show that 40.3% of those sampled were older adults. Most older adults experiencing unsheltered homelessness identified as male (70%), Hispanic/Latino (46.6%), or Black/African American (25.6%). The majority of older adults had health insurance (79%) yet few (22%) had a primary care provider. Older adults lacked 24-hr bathroom access (22.3%), were forced to practice open defecation (82%), and relied on purchased food (50%) and drinking water (40.6%). Maslow’s hierarchy of needs explains that time and energy spent meeting basic needs of survival (including food, hydration, and sanitation) means time and energy not spent elsewhere, such as seeking healthcare. Results of this study suggest a need for scaling Street Medicine which provides basic needs and comprehensive, accessible primary care.

Demystifying open defecation in the capital city of Delhi, India

ABSTRACT In India, open defecation is often seen as an individual’s behavioural problem rather than the institutional inability and the failure of the policies and programmes of the government on sanitation drive. In this regard, this study tries to critically look into how infrastructural incapacity and institutional inability are responsible for the ongoing open defecation in Delhi. This study was conducted in three slum settlements across three Municipal Corporations of Delhi. It adopted a mixed methods approach. In-depth interviews, focus group discussions, observations, and various quantitative techniques have been used for showing open defecation practices in the capital city of Delhi. The study reveals that around 80% of the surveyed households purely or occasionally are still associated with open defecation. Infrastructural incapacity related to the inadequacy of public latrine and household latrine, poor availability of water, fear of foul smell due to improper drainage condition is responsible for open defecation rather than the people’s old habit. Despite this, lacuna in the public policy, e.g. underutilisation of funds and poor coordination among different governmental bodies also lead to the open defecation. The study concludes that infrastructural incapacity and institutional inability are responsible for the ongoing open defecation in Delhi. Despite this, there is lacuna in the public policy in eradicating open defecation.

Assessment of open defecation practice among Gugugu Residents in Abuja, Nigeria

Assessment of open defecation practice among Gugugu Residents in Abuja, Nigeria

The dynamics of household sanitation services and faeco-oral diseases externalities in Osun State, southwest Nigeria.

Maintaining human dignity through sanitation is a perennial challenge and highlights the externalities of sanitation and hygiene services (SHS). In Nigeria, 23.2% practise open defecation, and 45.5% use basic sanitation services, although conventional sewerage systems are rare. This study determines SHS and their predictors in the context of local governance in southwest Nigeria. The cross-sectional study applied a five-stage sampling technique and elicited information from 542 respondents using a validated semistructured questionnaire. The study results are presented by descriptive and inferential statistics. The mean age of respondents was 48.2±0.8 y. Of these, 64.2% were homeowners, and 40.0% were in the lower wealth quartiles. While 76.9% of respondents had access to toilets, only 16.6% and 18.1% benefitted from safely managed and basic sanitation services, respectively, with 21.2% practising open defecation. Open defecation (42.6%) was prevalent primarily in the Ayedaade local government area (LGA), while safely managed sanitation services (27.6%) and limited sanitation services (54.1%) were predominant in the Olorunda and Ilesa-West LGAs. The predictors influencing household sanitation services included residence, ethnicity and wealth. There were significant inequalities in sanitation access and critical infrastructure, and sanitation quality gaps exist among respondents. The prevalence of open defecation was high, and there was variation in access to sanitation services across different LGAs.

Prevalence of Open Defecation Practice and Associated Factors Poverty and Geography in Palembang Indonesia

Palembang is one of the large cities in Indonesia which has a specific geography. A study was conducted to estimate the prevalence and determine poverty factors associated with open defecation practices.An analytical cross-sectional study was conducted for one year among 397 respondents as a sampling. Prevalence was calculated with 95% confidence intervals and binary logistic regression analysis was performed to determine factors associated with open defecation.32.5 percent of people still practice open defecation which is influenced by poverty and geographical factors. Influence of income ) AOR of 13,891 (Cl 8,345 – 23,123), education AOR of 20,328 (Cl 11,881 – 34,780), clean AOR 6,192 (Cl 3,747 – 10,234), water source AOR of 28,882 (16,403 - 50,854), characteristics of the house AOR of 3,977 (2,555 – 6,191), facilities or the availability of toilets at home AOR of 7,066 (4,167 – 11,983), geographical location of the house towards the river or water AOR of 478.995 (173.112 – 1325.1399), knowledge of open defecation behavior AOR of 3.607 , attitudes AOR of 3.277. Respondents who practice open defecation have low income and education, no water source available from the government, geographical location of the house near a river or swamp, no defecation facilities, lack of knowledge and bad behavior.

EXPLORING THE ASSOCIATION BETWEEN HOUSEHOLD SANITATION AND WOMEN’S MENSTRUAL HYGIENE MANAGEMENT IN RURAL ODISHA, INDIA

IntroductionAccess to water, sanitation, and hygiene (WASH) facilities has been globally recognized as a critical need, especially for women and girls to ensure their menstrual hygiene. This study aimed to investigate the association between household sanitation and women’s menstrual management experience in Odisha, India. MethodsA cross-sectional study was conducted in Balasore district of Odisha state in India among 694 rural women and girls aged 15-45 years selected using a multi-stage sampling method. The Performance Monitoring and Accountability (PMA) 2020 questionnaire was used for data collection. Multivariate logistic regression analysis was carried out using SPSS version 25. ResultsMore than two-third (68.4%) of rural families used improved sanitary facilities. Around 30% of households have been using an unimproved sanitary facility, which means the practice of open defecation is still prevalent in rural areas. About 40.6% of women and girls reported using clothes as their primary menstrual hygiene material. Further, women and girls with improved sanitation facilities (aOR = 1.56, 95% CI: 1.09 - 2.59) were more likely to change menstrual materials at the main household sanitation facility than those with an unimproved sanitation facility. In contrast, households using improved sanitation facility were less likely to use bedroom/sleeping areas to change the menstrual materials (aOR=0.65, 95% CI: 0.42-0.99) than those with an unimproved facility. ConclusionAvailability of improved household sanitation is critical to good menstruation management practices. State-specific policy for menstrual health and hygiene could provide the much-needed impetus to strengthen WASH infrastructure in rural and tribal regions of Odisha.

Diagnosis of open defecation in Yamoussoukro District (Central Côte d’Ivoire)

The pathological landscape of Yamoussoukro district is dominated by environmental diseases (malaria, typhoid fever, respiratory infections). These diseases are linked to lack of sanitation and hygiene and open defecation. The objective of this study is to draw up an inventory of fixtures of sanitation in Yamoussoukro district and determine the reasons for the practice of open defecation and thus propose effective strategies to combat this practice. Methodology used consists of direct observation in the field and a household survey. The sampling technique adopted is that of Shawartz, with a sample size of 373 households. Initially, an inventory of the sanitation situation in the study localities was drawn up, revealing a sanitation problem with 62,34 % of households lacking latrines in Kpangbassou, 82,22% in Aboukro, and 82,14% in Duokro. Analysis of the reasons prompting communities to opt for open defecation (OD) highlights determining factors such as the absence of a law prohibiting it, cultural reasons, perceptions of populations, the low level of income and education of household heads. Although socio-economic factors play a predominant role in the adoption of this practice, it is essential to pay particular attention to the economic aspects. Following these results, solutions were proposed to OD. Suggested strategies include the CLTS / EcoSan approach, enhanced CLTS / EcoSan monitoring and community awareness raising.

Optimizing Public Health through Community Service: Addressing Stunting and Open Defecation in Sidoarjo Regency

Community service in health institutions needs to be guided by six pillars of health transformation, namely to overcome five priority diseases: tuberculosis, stunting, MCH, infectious diseases and non-communicable diseases. One of their focuses is Sidoarjo Regency, where they work closely with the Regional Government to improve public health. Some of the main problems in Sidoarjo Regency include the high rate of stunting and the practice of open defecation (ODF). There is a relationship between stunting and environmental sanitation, especially open defecation. Solutions to overcome this problem include the provision of healthy latrines to the community, increasing the capacity of Posyandu cadres, nutrition management, and promoting clean and healthy living behaviors. This community service activity is based on previous research relevant to stunting and ODF problems. The goal is to reduce stunting rates in five stunting locus villages, increase knowledge about clean and healthy living behaviors, and build 100 healthy family latrines. The method used is Theory, Practice, Follow-up (TPT) which involves training, field practice and advanced mentoring. Conclusion: with the construction of healthy latrines, there has been a decrease in the incidence of diarhe in children. Diarrhea in children is one of the latent causes of stunting rates. By implementing this strategy, it is hoped that a significant increase will be achieved in preventing and reducing stunting rates in Sidoarjo Regency

Impact of Community-Based Health Workers on Community-Led Total Sanitation Implementation on Latrine Ownership and Practice of Open Defecation among Household Members in Turkana County, Kenya

Impact of Community-Based Health Workers on Community-Led Total Sanitation Implementation on Latrine Ownership and Practice of Open Defecation among Household Members in Turkana County, Kenya

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

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.

Evaluation of Sanitation Technologies Across Sanitation Service Chain in Kericho Town, Kenya

In 2020, over half of the world's population resided in cities, with projections indicating that by 2050, this figure will rise to 70%. Providing adequate sanitation services in urban and peri-urban areas presents significant challenges due to the dense concentration of people, particularly in low- and middle-income countries. Poor sanitation practices in these areas can lead to the spread of diseases with high morbidity and mortality rates. The focus of the study was on Kericho town, Kenya, facing a notable sanitation challenge due to dilapidated sewer system and inadequate sanitation facilities . The aim of this study was to evaluate the safety of sanitation technologies used in Kericho Town. Descriptive study design was adopted. Data collection methods included surveys, interviews, and observations, with a sample size of 409 households. The findings revealed that 66.5% of the population relies on pit latrines with slabs, 13.69% use pour/manual flush systems, 11.49% have ventilated improved pit latrines, 8.07% employ automatic cistern flush, and a minimal 0.24% practice open defecation. 25% of population discharged waste directly into the sewerage system whereby 5% were considered safely managed. Additionally, 4% of waste from user interfaces was discharged directly into open ground or open drains. 2% of population used septic tanks connected to soak pits, whereas 6% of population used septic tanks connected to open ground. Sludge from septic tanks, comprising 20%, was delivered to the WWTP by exhausters for further treatment, of which only 20% underwent treatment, with the remainder released untreated into the environment. 49% of the population used lined pits, while 14% used unlined pits. Approximately 20% of faecal sludge from the pits was exhausted, with only 20% of it considered safely treated, and the remainder released into the environment. Notably, open defecation accounted for less than 1% based on the survey findings. Consequently, the current trend in faecal sludge management in Kericho Town posed potential health hazards to the community unless measures such as rehabilitating the existing wastewater treatment plant are implemented.

Household Latrine Utilization Behavioral Model as an Effort to Improve Open Defecation-Free Program

Background: Healthy latrine-using behavior indicates healthy behavior. However, many people still practice open defecation, which can cause illness and increase death risk. Self-efficacy is a dominant predictor of health behavior change. Aims: The study aims to develop a household latrine utilization behavior model based on self-efficacy to improve an open defecation-free (ODF) program. Method: The study was a descriptive-analytic with a cross-sectional design. The sample size was 138 respondents with cluster random sampling. The study variables were endogenous (household latrine utilization), exogenous (predisposing, enabling, and reinforcing factors), and intervening variables (self-efficacy). Data were collected by questionnaire and analyzed using SEM-PLS. Result: The household latrine utilization behavior-based self-efficacy model is fit (SRMR=0.098; NFI= 0.910; Q2=0.334). Valid and reliable indicators were education (predisposing), clean water availability and latrine maintenance (enabling), and health worker and family support (reinforcing). Path analysis showed exogenous factors, directly and indirectly, influence latrine utilization behavior through self-efficacy. Predisposing and reinforcing factors had a direct and significant effect (p = 0.025; p = 0.001) while enabling factors were insignificant (p = 0.438). Enabling and reinforcing factors indirectly and significantly affected latrine utilization behavior through self-efficacy (p = 0.033; p = 0.004), while predisposing factors were insignificant (p = 0.141). Self-efficacy significantly influenced latrine-using behavior (p = 0.023). Conclusion: The household latrine utilization behavior-based self-efficacy model is a fit model with good predictive relevance in predicting household latrine use behavior. Health workers can use the model to enhance household latrine utilization behavior and improve the ODF program and public health status.

Socioeconomic Risk Factors in Neurocysticercosis.

NCC is responsible for around 30% of active epilepsy in endemic countries such as India. Knowing socioeconomic factors associated with NCC can help in decreasing the incidence of this disease. We intend to study socioeconomic risk factors in NCC patients and how these factors are different from patients without NCC. Consecutive 100 adult patients of NCC presenting to neurology services with probable NCC (symptomatic or asymptomatic) along with age- and sex-matched controls were interviewed with preset proforma and then data was compiled and analyzed statistically. The NCC group had significantly more people with lesser education level (53%) as compared to control group (42%) (P = 0.002), lower socioeconomic status, poor hand hygiene practices, and use of contaminated vegetables (40% NCC group, 1% control group, P < 0.0001). Open defecation practice was also more among NCC cases. Lower education and socioeconomic status, poor hand hygiene, and eating undercooked contaminated vegetables are modifiable factors that are more prevalent in patients of NCC compared to controls. Social interventions aiming at these will help to reduce NCC patients in our country.

Upaya Peningkatan Perilaku Hidup Sehat melalui Program Community-Led Total Sanitation kepada Masyarakat Desa Tumpang, Malang

The practice of open defecation remains prevalent in Ledoksari Hamlet, Tumpang Village, Malang Regency. This behavior persists because open defecation has become a normalized culture or habit among the local community. Therefore, a change effort is needed through the implementation of the Community-Led Total Sanitation Approach by the Community Service Team of Universitas Negeri Malang. This program aims to educate the community about the impacts of open defecation. The method used in this program employs a triggering approach that directly involves the community, with stages including pre-triggering, triggering, and post-triggering activities. The outcomes of this initiative reveal an increase in participants knowledge regarding environmental health. Interactive discussions were also conducted by the service team to allow participants to voice their aspirations, which were then communicated to stakeholders. The service team further recommended the implementation of the "Arisan Jamban" program. This program encourages community members to organize activities that promote clean and healthy living behaviors within their environment. Aligned with the first pillar of the Community-Based Total Sanitation (STBM) initiative, which is to stop open defecation, the "Arisan Jamban" program can be utilized as a viable solution to reduce water source contamination.

Status of vector protection measures and awareness regarding vector borne diseases in families residing in a "Nirmal Gram Puraskar" village in India.

Mosquito-bome diseases are increasing problems in various parts of the world, causing high mortality and morbidity for humans. This study was done to assess the vector protection measures taken by rural below poverty line (BPL) families, and to assess the awareness about vector-borne diseases along with Total Sanitation Campaign (TSC) in rural BPL families. A cross-sectional study was conducted in a rural area which won "Nirmal Gram Puraskar" Award i.e., "clean village" among 96 below BPL families for a period of three months. These families (every 5 th ) were selected by systematic random sampling until we reached a sample size. Basic socio-demographic details, status of vector protection measures, solid waste management, vector-borne diseases and total sanitation campaign details were collected from the study participants. Pretested, semi-structured questionnaire was applied to the head of the families which included sanitation status at home by house-to-house visit. Data collected was analysed using SPSS version 20 and presented as frequency, percentages, mean and standard deviation. Among 96 families studied (454 adults and children), 84 (87.5%) were males and 12 (12.5%) were females. Among these, 291 (64.1%) were using one or the other mosquito protection measures, 52 (54.2%) were using bednets and 23 (23.9%) used coils. 12 families (12.5%) were not using any mosquito protection measures. In our study, 66 (68.8%) families had individual household latrine (IHHL) and 50 (52.1%) had open drainage. Even though 314 participants had an access to individual household latrine, 20 (6.36%) had practice of open air defecation compared to 127 (90.7%) who practiced open air defecation without an access to individual household latrine. When asked about the awareness regarding vector-borne diseases, 56 (58.3%) were aware about chikungunya, 47 (48.9%) about dengue, 46 (47.9%) about malaria, 14 (14.6%) and only 5 (5.2%) families were aware about Japanese encephalitis. In this study, 37 (38.5%) were aware about the total sanitation campaign and 40 (41.6%) about the government support for sanitation. While there is a general awareness of vector-borne diseases, the implementation of vector protection measures is not uniform across the village. There is a need for targeted interventions to improve the effectiveness of vector protection measures and increase awareness among the community.

Demographic factors and open defecation practices: A cross-sectional study in Gunungtua Jae Village, Padang Lawas Utara

Open defecation (OD) remains a significant public health concern, particularly in rural areas of developing countries. This study aimed to investigate the association between demographic factors and OD practices in Gunungtua Jae Village, Padang Lawas Utara, Indonesia. A cross-sectional study was conducted involving 82 households. Data were collected using structured questionnaires and analyzed using Chi-square test and logistic regression. The findings revealed a significant association between several demographic factors and OD practices. These factors included household head knowledge (p = 0.000), occupation (p = 0.002), attitude (p = 0.000), education level (p = 0.000), and income level (p = 0.000). The study highlights the importance of considering demographic factors when addressing OD practices in public health interventions. Comprehensive efforts are needed to enhance community knowledge, particularly among household heads, regarding the significance of adequate sanitation and the detrimental impacts of OD practices. Collaboration between community health centers (puskesmas) and various stakeholders is essential for the sustainable implementation of the Total Sanitation Based on Community Approach (STBM) program. This program can effectively raise awareness and promote positive behavioral changes towards environmental hygiene and personal health, with a primary focus on encouraging proper sanitation practices and preventing environmental pollution.

Women's sanitation matters: Unpacking the conundrums associated with open defecation among women in Harper City, Liberia

Ending open defecation (OD) is a major global policy goal—anchored by the Sustainable Development Goal 6. While women are vulnerable to the risks associated with poor sanitation and are disproportionately impacted by OD, little is known in the scientific literature about the intricacies, drivers, implications and the challenges women face in OD practices in low and middle income countries’ cities. Using the FOAM analytical framework and the coastal city of Harper, Liberia, as a case study, the paper aims to unravel the day-to-day hustles and hostilities women face in defecating in the open. Data were sourced through desk review, face-to-face interviews with 30 women, 7 key informants and observation. Our findings demonstrate that the beach serves as the major destination for OD in the city. Institutional failure—a low commitment of the Liberia government towards the construction of public sanitation facilities and socioeconomic factors—a general high incidence of poverty among the populace influence women's OD practices in the city. Women are exposed to insecurity, psychological trauma, loss of privacy and dignity under OD practices. The findings underscore the need for policymakers and stakeholders to prioritize women's sanitation in emerging cities. The paper recommends that the government of Liberia should prioritize providing women access to improved sanitation by scaling up the construction of public sanitation facilities, subsidising the cost of building and sanitary materials, and promoting behavioural change through public health and sanitation education as measures to curtail OD in the country.

β-Lactamase and Macrolide Resistance Gene Carriage in Escherichia coli Isolates Among Children Discharged From Inpatient Care in Western Kenya: A Cross-sectional Study.

Antimicrobial resistance (AMR) is a global threat to infectious disease control, particularly among recently hospitalized children. We sought to determine the prevalence and mitigating factors of resistance in enteric Escherichia coli among children discharged from health facilities in western Kenya. Between June 2016 and November 2019, children aged 1 to 59 months were enrolled at the point of discharge from the hospital. E coli was isolated by microbiological culture from rectal swabs at baseline. β-Lactamases and macrolide resistance-conferring genes were detected by polymerase chain reaction. A modified Poisson regression model was used to assess the predictors mph(A) and CTX-M-type extended-spectrum β-lactamase (ESBL). Of the 238 children whose E coli isolates were tested, 91 (38.2%) and 109 (45.8%) had detectable CTX-M-type ESBL and mph(A) genes, respectively. Antibiotic treatment during hospitalization (adjusted prevalence ratio [aPR], 2.47; 95% CI, 1.12-5.43; P = .025), length of hospitalization (aPR, 1.42; 95% CI, 1.00-2.01; P = .052), and the practice of open defecation (aPR, 2.47; 95% CI, 1.40-4.36; P = .002) were independent predictors for CTX-M-type ESBL and mph(A) genes. Pneumococcal vaccination was associated with a 43% lower likelihood of CTX-M-type ESBL (aPR, 0.57; 95% CI, .38-.85; P = .005), while measles vaccination was associated with a 32% lower likelihood of mph(A) genes (aPR, 0.68; 95% CI, .49-.93; P = .017) in E coli isolates. Among children discharged from the hospital, history of vaccination, shorter hospital stay, lack of in-hospital antibiotic exposure, and improved sanitation were associated with a lower likelihood of AMR genes. To mitigate the continued spread of AMR, AMR control programs should consider strategies beyond antimicrobial stewardship, including improvements in sanitation, increased vaccine coverage, and the development of novel vaccines.

Implementation of ODF (Open Defecation Free) Program in Warudoyong Sub-district, Sukabumi City

This study aims to examine how the implementation of the open defecation free (ODF) program in Warudoyong Sub-district, Sukabumi City. The Open Defection Free (ODF) program is a government program that aims to change hygienic and sanitary behavior through community empowerment so that the community independently improves good health status. The urgency of this research is due to the lack of public awareness of the importance of hygiene and health. In Warudoyong Sub-district, Sukabumi City, there are still people in two villages who practice open defecation. Based on data from the Sukabumi City Health Office, from 2019 to 2022 there was no decrease in open defecation rates in Nyomplong Village and Warudoyong Village. The research method used a descriptive qualitative method with a snowball sampling technique and the number of respondents was six informants. The result of this research is that the ODF program in Warudoyong Sub-district, Sukabumi City has not been running optimally, due to the lack of public awareness about the importance of the ODF program and limited land for the construction of communal septic tanks. Therefore, the recommendation for this research is the need for community roles and cooperation to improve facilities for the construction of communal septic tanks so that people can improve the quality of clean and healthy living, and increase socialization media by utilizing social media to provide information about the benefits of the ODF program to increase knowledge for the community.

Socio-Economy Study on Simple Healthy Septic Tank Provision in Simokerto and Kenjeran Districts, Surabaya City

Surabaya City Mayor Regulation Number 115 of 2022 has regulated the Implementation of Latrine Development in the City of Surabaya as an effort to realize the City of Surabaya Open Defecation Free City in 2023. The development of healthy latrines is prioritized for low-income people who do not have latrines. The purpose of this research is to find out responses from the community regarding the development of healthy latrines based on characteristics and financial conditions. In terms of internal community factors, the willingness of the community to participate in counseling shows the community's interest in learning about environmental sanitation issues. However, there is a problem with limited funding sources for routine desludging activities. From the results of the questionnaire to 54 recipients of healthy latrines, the following conclusions are 5.56% of people who still practice open defecation in the study area even though healthy latrines are available and 11.2% of the people in the study area demonstrated the ability to have individual healthy latrines and manage and maintain septic tanks.