Knowledge, attitudes and practices of community members on the safe water chain maintenance in Kityerera sub-county, Mayuge district

Abstract

Water contamination remains a leading cause of waterborne diseases, often occurring at different points along the water chain from source to storage. In Mayuge District, the prevalence of diarrheal diseases is on the rise despite ongoing Water, Sanitation, and Hygiene (WASH) interventions. These diarrheal diseases are largely attributed to the use of open and contaminated water sources, poor hygiene, and inadequate sanitation. Access to safe water remains low in Kityerera Sub- County, where communities often rely on contaminated lakes and shallow wells. This study aimed to assess knowledge, attitudes, and practices regarding safe water chain maintenance among households in Kityerera Sub- County, Mayuge District. This was a cross-sectional study utilizing both quantitative and qualitative methods. Data were collected from 424 household heads using a structured questionnaire, and from 5 key informants through interviews. The questionnaire was translated into Lusoga, pretested, and administered by trained research assistants after obtaining ethical approval from Makerere University School of Public Health. Data were analyzed using SPSS Version 26. Knowledge, attitudes, and practices (KAPs) were scored, with average scores used as cut-offs. Respondents scoring above average were categorized as knowledgeable, having positive attitudes, or good practices. Binary logistic regression was used to identify factors associated with safe water chain practices, with variables considered significant at p<0.05. Of the 424 respondents, 66.5% (n=283) were female, while 33.5% (n=142) were male. The majority had attained primary education 76.7% (n=325), followed by secondary 19.1% (n=81) and tertiary 4.2% (n=18). The level of knowledge on safe water chain maintenance was found to be fair, with 60.6% (257) of the participants being knowledgeable. Attitude was high, with 90.3% (n=383) of respondents showing a positive attitude and 66.7% (n=283) demonstrated good safe water chain practices. These practices were significantly associated with education level particularly secondary (AOR=4.7; 95% CI: 1.03–21.44; p=0.045), proximity to the water source especially those residing within 21-100 meters (AOR=4.1; 95% CI: 2.19–7.66; p<0.01), and awareness about the safe water chain (AOR=2.0; 95% CI: 1.11–3.75; p=0.021). Community attitudes were positive, although knowledge and safe water chain practices were fair. The study recommends increased health education, improved access to safe water sources, and stronger community engagement to promote consistent and proper safe water chain practices.