Assessment of water, sanitation and hygiene practices on diarrhoea among under-five children in Temeke Municipality, Dar Es Salaam - Tanzania

Abstract

Water, sanitation and hygiene are essential determinants of both physical and mental human health and acts as the prerequisites for human development. For decades water, sanitation and hygiene have been treated as a single sector regardless of their impacts on human health. This study investigated WASH practices and associated infections among under-five children in selected wards of Temeke Municipality in Dar es Salaam region. The study was cross-sectional and involved 220 respondents randomly selected from three wards namely Azimio, Mtoni and Tandika. The study employed a mixed method approach, whereby both quantitative and qualitative data were obtained from the household survey and key informant (KI) interview. Quantitative data which were collected from household interviews with mothers and caregivers were analysed with the aid of IBM-Statistics SPSS v.20. The findings show that, 40% of all the respondents depend on public tap/ standpipe as their major sources of water. The findings revealed further that, the majority (99.6%) of the respondents were aware about the importance of washing hands; however, only 22.6% wash their hands with soap before meals and 45.2% use soap to wash hands after meals. The overall perception towards hand washing behaviour varied among the respondents; the majority (71.7%) reported to have been washing their hands. Others (17.8%) suggested that hand washing is hygienic, and 16.5% said it is a primary preventive measure against communicable diseases. Furthermore, findings in the present study on personal hygiene activities revealed that 79.1%, 43.4% and 35.6% of all the respondents cited bathing, wearing clothes (washing), and tooth brushing as leading. On the part of proper utilization of latrine, majority (60.8%) reported to have been washing their hands after visiting the toilet saying that it is a preventive measure against transmission of diseases, while 46.5% said they washed their hands just to keep them clean. Moreover, the study found that 9.1% of all the households have latrines that can be accessed within their plot. The study revealed further that, 96.5% of all the households in a range of 6-10 households share latrine facilities, which are located near their respective compounds. The most common type of latrine available in the study area was pour flush without water seal linked to pit (57.3%) in Tandika, 65.3% in Mtoni, and 36.3% in Azimio. The other type was traditional pit latrines, 47.6% of which are found in Azimio, 13.3% in Mtoni, and 1.3% in Tandika. In addition, only 26%of all the latrines available were clean and 6% had water available inside the facility. As for hand washing facilities, 97.4% of the respondents reported to use a bowl for hand washing and only 0.9% had tap connected to water distribution. About 1.7% reported to have facilities available inside the house right next to the latrine, 0.9% reported to have facilities outside the house within 10 metres and only 1.3% reported to have soap available at the facility. The respondents reported that, of all the widely known WASH related infection in the areas, diarrhoea was the leading accounting for 10% followed by cholera accounting for 7.8% of all other infections. Overall, the most vulnerable group to these infections was the under-five children accounting for 10.4% of the population. Moreover, 32.5%, 22.7%, and 17.3% of the respondents from Azimio, Mtoni and Tandika respectively suggested self- cleanliness as among the preventive measures against known water-borne diseases. Other measures were food safety from preparation to the actual eating as suggested by 32.5% from Azimio, 14.7% from Mtoni, and 6.7% from Tandika. Hand washing before meals was significantly associated with respondents’ contracting of diarrhoea (p ≤ 0.05). Generally, it can be concluded that water is still a problem in the informal settlements. Sanitary conditions and hygienic measures are even worse and these can be attributed to socio-economic factors such as income levels, education status, and place of residence. Factors such as hand washing behaviours during critical times, water treatment measures, and education levels were positively associated with diarrhoea incidences among the under-five. The study recommends that, both infrastructural improvement and education provision should be employed in these areas with the emphasis in awareness creation regarding public health and the importance of each practice. Both sanitation and hygiene should be dealt with separately as they both impact human health at large. Projects should be implemented based on the needs of the areas such as urban slums, informal settlements, and special groups such as children, elders, and women.