A study to assess the awareness and practice regarding utilization of sanitary toilet in the rural villages of Kalaburagi district

INTRODUCTION

There are about 8 lakh people in poor and developing countries die every year due to inadequate water, sanitation and hand hygiene, roughly constituting two-third of total diarrheal deaths and poor sanitation is believed to be the main cause in 38 percent of these deaths.¹ India alone accounts for approximately 60 percent of global population defecating in the open, with the majority residing in rural India.²

Open air defecation perpetuates a vicious cycle of disease and poverty and the countries with high levels of open defection have the highest number of under 5 deaths as well as the highest levels of malnutrition and poverty.³

Open defecation is an issue that can affect everyone but women are often at more risk of experiencing violence and multiple health vulnerabilities and women with poor sanitation facilities are more susceptible to hookworm infestation resulting in maternal anemia, which in turn is directly associated to adverse pregnancy outcomes.⁴

Further evidence by media analysis and reporting show that adolescent girls and young women going for open air defecation have to bear extreme hardships and vulnerabilities. They are subjected to eve teasing and other forms of sexual exploitation besides having to cope with the vagaries of weather and other hazards on a daily basis. Difficulties are also faced by elderly and disabled and shrinking open spaces further adds to their woes.⁵

For decades, scientists, world over, have focused on the impact of poor sanitation practices on health and well-being. Studies show that open air defecation contributes in the spread of bacterial, viral, and parasitic infections, including diarrhea, polio, cholera, and hookworm and could lead to child stunting.^6,7

The study was conducted to assess the knowledge and practice regarding utilization of sanitary toilet in the rural villages of Kalaburagi District.

Objectives

Objectives of the study were to assess the knowledge and practice regarding utilization of sanitary toilet in the rural villages of Kalaburagi District and to associate socioeconomic factors influencing the utilization of sanitary toilet in the rural villages of Kalaburagi District.

METHODS

Study settings

The present study was carried out in villages of Kalaburagi District, Karnataka, India.

Study period

The study was conducted for a period of 3 months.

Inclusion criteria

Age 12 years and above of either sex were included in the study.

Exclusion criteria

Below 12 years of either sex were excluded.

Data analysis

The data was analyzed using Microsoft Excel (SPSS Version 16.0 Software) and the results are explained in frequency percentage and ANOVA Test was applied for statistical significance.

A cross-sectional study was conducted in a selected rural area called Hiroli and Bhimpurwhich has a population of 6000 residents with around 900 houses. Both come under HiroliPrimary Health Centre, Kalaburagi District, North Karnataka. All the participants were personally contacted and interviewed using predesigned and pretested questionnaire. The study was conducted from June 2019 to October 2019. The sample size of 500 was calculated using the formula (n = pq/d²). The prevalence (p) of knowledge about sanitary toilet use was found to be 60% (Sidhraj J study), q = 100-p and d for error as 5% at 95% confidence interval.⁷ They were selected randomly to ascertain the validity of the questionnaire and feasibility of the study. All the persons above 12 years from each household, who were permanent residents of the village, were selected by simple random sampling technique using computer generated random table method. Informed consent was taken from the participants before the study.

A pre-designed and pretested questionnaire was used to collect the data which included various questions regarding the knowledge, attitudes and practices related to their toilet use. Data was entered in Excel sheet and analyzed using SPSS 20 version software. Analysis was done using frequency and percentages. Chi-square test was used to find the association between important socio-demographic variables and knowledge, attitude and practicesand ANOVA Test was applied for statistical significance.

Socio-economic status was calculated using Modified B. G. Prasad Classification using the average consumer price index for the year 2019. Ethical clearance was obtained from Institutional Ethical Committee of M.R. Medical College, Kalaburagi.

RESULTS

Most of the participants in this study were aged between 31 - 40 years, 262 (52.4%) participants were females. About 340(68%) were illiterates, and 160 (32%) literates. Majority of the participants were farmers 220 (44%) and 150 (30%) were housewives. About 230 (47.2%) participants belonged to class IV 205 (42.9%) class V and 65 (13.2) class III and most of them 340 (68%) were married.

The overall knowledge among study participants 95 (19%) was poor, 391 (78.2%) average and 14 (2.8) good were as attitude among 263 (52%) acceptable 132 (26.4%) and negative 105 (21%). In the study it was found that the participants who belonged to low socio economic status and illiterates had poor knowledge about sanitary latrines and it was found that, participants in higher age group used toilets than those in lesser age group and attitude was better in higher socioeconomic participants.

DISCUSSION

The study was conducted to know the knowledge, attitude and awareness level regarding sanitary latrines in the villages bordering Maharashtra in Northern part of Kalaburagi District. Most of the study participants were married 420 (84%) and aged between 31 - 40 years. In the study sample female participants were more than male 262 (52.4%) and majority of them belong to lower socioeconomic status were most of them were illiterate 340 (68%).

A study from Pune, Maharashtra recorded majority (67.8%) of participants were in the age group of more than 50 years.⁸ In a study from Mtawara, Tanzania, more than half (54.8%) were aged in between 40 - 49.⁹ In present study, majority of the participants (53%) were females which was different from another study where majority of participants were males (79.1%).¹⁰ Majority 350 (87.5%) of the participants were illiterates. A study from rural Bangladesh reported 55.3% had attended school at some point of time.¹¹ Almost all the study participants belonged to low socioeconomic status which was similar to other study conducted in Ethiopia.¹¹

In the present study majority of them were practicing open air defecation 487 (97.4%) although about 200 (40%) of the participants were having sanitary toilets constructed in their house. Regarding washing of hands after defecation and wearing of chapels most of the participants 470 (92%) wash their hands and all the participants wear chapels while going for defecation.

Many studies conducted in India and African countries have similar finding which will guide the international agencies to focus their efforts in these areas.^12-14 Maharashtra, India showed that hand washing with soap and water after defecation was practiced by 38%.¹³ Most of them (70.1%) were using footwear while going for defecation which was similar to another study in Bangladesh.¹⁵

In the study it was found that the participants who belonged to low socio economic status and illiterates had poor knowledge about sanitary latrines and it was found that, participants in higher age group used toilets than those in lesser age group and attitude was better in higher socioeconomic status participants. Similar studies conducted in South-East Asian countries also have shown that higher education and socio-economic status will affect the sanitary toilet use in a positive way.^16-17

Limitations

The study should be conducted in the other rural areas and also a comparison can be done with the urban area.

CONCLUSION

The present study showed that the knowledge, attitude and practices regarding importance of sanitary toilet are very low in a study population. Majority of the villagers were practicing open air defecation. Most of the households did not have a sanitary latrine and households who have constructed latrine but are not being used. There is a need to impart health education regarding importance of use of sanitary toilet and motivate the community to use.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

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