Barriers and motivators to achieving open defecation free communities using community led total sanitation approach in Kisekka sub county, Lwengo District

Abstract

Background: Inadequate hygiene and sanitation remain the leading contributors to morbidity and mortality in children and adults. One strategy for improving sanitation access is Community-Led Total Sanitation (CLTS), in which participants are guided into selfrealization of the importance of sanitation through activities called “triggering”. CLTS is an integrated approach done to achieve and sustain open defecation free status and is focused on igniting a change in sanitation behaviour rather than constructing latrines in communities. Although CLTS was implemented in Kisekka Sub County- Lwengo district, morbidity and mortality among children under five years is still attributed to poor hygiene and sanitation. Objective: To assess the barriers and motivators to achieving open defecation free communities using Community-Led Total Sanitation approach in Kisekka Sub CountyLwengo district so as to generate information that can be used for planning to improve sanitation and hygiene in the community. Methods: Across-sectional study was conducted to collect both qualitative and quantitative data in Kisekka Sub County. Multi stage sampling was used to select 174 households and 7 Key Informants (KI) were selected purposively from CLTS triggered villages. Quantitative data was analysed using STATA version 13. And qualitative data was analysed manually using thematic content analysis. Results are presented using frequency tables and figures. Results: About 52.3% (91/174) of the respondents were females, 36.8% (64/174) were aged30to 40 years, 37.4% (65/174) had attained primary level of education and 50.6% (88/174) were peasants. More than half 55% (55/100) of the respondents mentioned poor ground conditions, 43.2% (19/44) reported unhygienic conditions while 40% (40/100) reported poverty as the barriers to latrine construction and use. Majority 79.9% (139/174) of the households owned latrines and 85.6% (119/139) of them reported prevention of diseases as main motivator to begin using latrines while 29.5% (41/139) reported avoiding shame as the motivator to owning and using latrines. Only 36.2% (63/174) of the households had hand washing facility near latrines. But only 76.2% (48/63) washed hands with water and soap or ash and 90.5% (57/63) of them washed hands after using the latrine. Conclusion: CLTS has increased latrine ownership in communities and reduced the practice of open defecation. However, poverty, poor hygienic conditions hinder latrine construction and use. Therefore, health extension workers and local authorities should put emphasis to achieving sustainable behavioral change on improved sanitation and good hygiene practices.