Factors associated with access to basic households’ water, sanitation and hygiene in Ngorongoro cholera epidemic villages-Arusha, 2019
Ngorongoro District reported 1007 cases of cholera and case fatality rate of 1.1% between April and August, 2018. The outbreak investigation teams reported that persistence was fuelled by inadequate and unsafe water as well as poor sanitation and hygiene. This study aimed to determine access to basic households’ Water, Sanitation and Hygiene (WASH) status and associated factors after interventions as a response to Cholera outbreak. It also provides recommendations on appropriate public health intervention to further improve WASH in the district.
The design was analytical cross-sectional. Study population was the heads of households who provided the current information on household water, sanitation and hygiene. Two-stage cluster sampling technique was used to recruit participants. Interview schedule and observational checklist was used to collect data. A household had access to basic WASH if had all three; drinking water treated, a toilet not shared with other household(s) and had functional hand washing facility.
The mean age of participants was 36.3 (SD = 10.4) years. Majority, 307 (75%) were females. The average household size was 5.7 (SD = 2.5) and the mean number of households sharing one toilet was 4.8 (SD = 4.2). Respondents up to 403 (99.8%) had high knowledge on cholera, and 78 (19.6%) households had history of cholera cases with a total number of 145 cases and 8 deaths. Access to basic household WASH was only 33 (8%) and coverage of functional hand washing facilities was 49 (12.3%) despite of high coverage of sanitation facilities 353 (87.6%) and over 250 (60%) of drinking water treatment. However literatures indicate that before April 2018, the coverage of drinking water treatment, sanitation facilities and hand washing facilities was 7,706 (16.8%), 5,554 (20%) and 139 (0.5%) respectively. Access to basic household WASH increased with both, increased household monthly income and high level of education and vice versa.
Promotions of access to household WASH need to be integrated with strategies to overcome issues of “access” associated with income. Also interventions used to raise access to household WASH in Ngorongoro during outbreak can be adopted in other areas especially to nomadic community during cholera outbreak.