Latrine Utilization and Associated Factors Among Community-Led Total Sanitation and Hygiene (CLTSH) Implemented Kebeles in Gurage Zone, Southern Ethiopia: A Cross-Sectional Study.

In developing countries, open defecation is still a major health issue. While there has been a great deal of empirical research on latrine coverage. But little is known about household latrine utilization behavior. The objective of this study was to assess latrine utilization and associated factors among Community-Led Total Sanitation and Hygiene (CLTSH) implemented kebeles in Gurage Zone, Southern Ethiopia. A community-based cross-sectional study was conducted on 585 randomly selected households in Gurage Zone's rural Community-Led Total Sanitation and Hygiene (CLTSH) implemented kebeles. The data were entered into Epi-data version 3.1 and analyzed in SPSS version 20. A binary logistic regression analysis was used to identify factors associated with latrine utilization, and a P-value < .05 was used to declare significance. In this study, 65.8% of households used latrines [95% CI: 61.8%-69.8%]. The odds of using a latrine were higher in households with less than 5 family members [AOR = 2.53, 95% CI: 1.33-4.84], in households with no vegetation around their latrines [AOR = 4.56, 95% CI: 2.27-9.18], households with clean latrines [AOR = 2.19, 95% CI: 1.17-4.12], households with latrines located <6 m from the dwellers [AOR = 5.94, 95% CI: 3.13-1.27], households with latrines located 6 to 10 m from the dwellers [AOR = 3.94, 95% CI: 1.93-8.03], households head not attending formal education [AOR = 0.24, 95% CI: 0.13-0.44], households without school children [AOR = 0.15, 95% CI: 0.08-0.28], households owned latrine for less than 1 year's [AOR = 0.24, 95% CI: 0.12-0.49], Households owned latrine for 1 to 3 year's [AOR = 0.39, 95% CI: 0.25-0.64], and latrine that does not require maintenance 1.94 [AOR = 1.92, 95% CI: 1.04-3.61], were significantly associated with latrine utilization. The findings of this study revealed that open field defecation is still practiced by households in CLTSH implemented kebeles. Therefore, to improve latrine utilization, community awareness must be raised through regular training on proper latrine construction, latrine usage, and sanitation and hygiene practices.

Woyessa ET ，Ashenafi T ，Ashuro Z ，Ejeso A ... -  《-》

Assessment of community led total sanitation and hygiene approach on improvement of latrine utilization in Laelay Maichew District, North Ethiopia. A comparative cross-sectional study.

Gebremariam B ，Hagos G ，Abay M 《PLoS One》

Latrine Utilization and Its Associated Factors Among Community Led Total Sanitation Implemented and Non-Implemented Kebeles of Tullo District, West Hararge, Eastern Ethiopia.

Improper human waste management is a major health problem in most developing countries, including Ethiopia. In Ethiopia, the majority of the population used unimproved sanitation facilities and practiced open defecation. This problem is significantly higher in the rural parts of the country. The aim of this study was to assess latrine utilization and associated factors among Community Led Total Sanitation (CLTS) implemented and non-implemented kebeles in Tullo District, West Hararghe, and Eastern Ethiopia. A community-based comparative cross-sectional study design was conducted in 740 households in 3 kebeles Community Led Total Sanitation implemented and 3 kebeles non-Community Lead Total Sanitation implemented for comparison. Study units were selected using a multi-stage sampling technique. The data was cleaned and coded before being entered into Epi-data version 3.1 and analyzed with the Statistical Package for the Social Sciences version 20. Logistic regression analysis was used to assess the association between dependent and independent variables. In this study, the overall prevalence of latrine utilization in the study area was 415 (56.1%) (95% CI = 52.6%, 59.9%). Of them, 243 (65.7%) (95% CI = 60.4%, 70.3%) and 172 (46.5%) (95% CI = 41.3%, 51.7%) of participants in the CLTS and non CLTS kebeles were utilized latrine, respectively. In CLTS implemented kebeles, literate (AOR = 3.66; 95% CI: 1.53, 8.73), households being visited by health extension worker (AOR = 11.72; 95% CI: 4.01, 34.31), households being graduated as model family(AOR = 7.56, 95% CI: 2.79, 20.44), ⩾2 years by years of latrine owning (AOR = 12.10, 95% CI: 3.21, 45.64), >6 meters distance of toilet to home (AOR = 27.43, 95%CI: 8.43, 89.29),Latrine with hand washing (AOR = 2.93, 95%CI: 1.19, 7.17), latrine with superstructure (AOR = 6.54, 95% CI: 2.04, 20.98) were significantly associated with latrine utilization, while in non CLTS implemented kebeles, literate (AOR = 25.78, 95% CI: 13.35, 49.78), medium wealth status(AOR = 4.87, 95% CI: 2.10, 11.29), poor wealth status(AOR = 2.51, 95% CI: 1.26, 5.01) were significantly associated with latrine utilization. The findings of this study revealed that more of the rural households had utilized latrines in CLTS implemented kebeles than non-CLTS implemented' kebeles. So, it is recommended that the district health office increase the latrine utilization rate through the effective and sustainable implementation of the CLTS approach.

Murad M ，Ayele DM ，Gobena T ，Weldegebreal F ... -  《-》

Having a latrine facility is not a guarantee for eliminating open defecation owing to socio-demographic and environmental factors: The case of Machakel district in Ethiopia.

Temesgen A ，Molla Adane M ，Birara A ，Shibabaw T ... -  《PLoS One》

Prevalence of and factors associated with acute diarrhea among children under five in rural areas in Ethiopia with and without implementation of community-led total sanitation and hygiene.

Since Ethiopia has been implemented the Community-Led Total Sanitation and Hygiene (CLTSH) approach to control incidence of diarrhea, few studies have compared the prevalence of diarrhea and associated factors in rural areas that have implemented this approach with those that have not implemented it, and none have examined it in the district of Menz Gera Midir in the Amhara Region of Ethiopia. This study addressed this gap. A community-based comparative cross-sectional study was conducted among 224 children under five in three randomly selected rural kebeles (the smallest administrative units in Ethiopia) where CLTSH had been implemented and 448 similar children in three other randomly selected rural kebeles where CLTSH had not been implemented during February and March, 2020. Data were collected using a structured questionnaire and an on-the-spot observational checklist. Data were analyzed using three different binary logistic regression models with 95% confidence interval (CI): the first model (Model I) was used for CLTSH-implementing kebeles, the second model (Model II) for non-CLTSH-implementing kebeles, and the third model (Model III) for pooled analysis of CLTSH-implementing and non-implementing kebeles. To control confounders, each multivariable logistic regression model was built by retained variables with p < 0.25 from the bi-variable logistic regression analysis. From the adjusted multivariable analysis of each model, variables with p-values < 0.05 were declared factors significantly associated with acute diarrhea. The prevalence of acute diarrhea among children under five from households in kebeles that had implemented CLTSH was 10.6% (95% CI:6.6-14.7%) and among those that had not implemented CLTSH 18.3% (95%CI:14.8-22.2%). In CLTSH-implementing areas, use of only water to wash hands (AOR: 3.28; 95% CI:1.13-9.58) and having a mother/caregiver who did not wash their hands at critical times (AOR: 3.02; 95% CI:1.12-8.12) were factors significantly associated with acute diarrhea. In non-CLTSH-implementing areas, unimproved water source (adjusted odds ratio [AOR]: 2.81; 95% CI:1.65-4.78), unsafe disposal of child feces (AOR: 2.10; 95% CI:1.13-3.89), improper solid waste disposal (AOR: 1.95; 95% CI:1.12-3.38), and untreated drinking water (AOR: 2.33; 95% CI:1.21-4.49) were factors significantly associated with acute diarrhea. From the pooled analysis, not washing hands at critical times (AOR: 2.54; 95% CI:1.59-4.06), unsafe disposal of child feces (AOR: 2.20; 95% CI:1.34-3.60) and unimproved water source (AOR: 2.56; 95% CI:1.62-4.05) were factors significantly associated with the occurrence of acute diarrhea while implementation of CLTSH was a preventive factor (AOR: 0.24; 95%: 0.20-0.60) for the occurrence of acute diarrhea. The prevalence of acute diarrhea among under-five children in Menz Gera Midir District was lower in kebeles where CLTSH had been implemented than in kebeles where CLTSH had not been implemented. Therefore, we recommend that governmental and non-governmental sectors increase implementation of CLTSH programs, including improving handwashing at critical times, promoting safe disposal of child feces and enhancing the availability of improved water sources.

Mernie G ，Kloos H ，Adane M 《BMC Pediatrics》