Abstract
This study aimed at determining improved latrine coverage and associated factors among rural community in Gicumbi district. A cross-sectional study was employed using mixed methods with quantitative and qualitative data collection approaches. The quantitative approach of data collection method was conducted and then qualitative approach followed. A structured questionnaire was used to collect quantitative data and Focus Group Discussions (FGDs) was conducted to collect the qualitative data. The study population consists of household heads or their representatives and key informants from the study area of Gicumbi district. For quantitative the total sample size was 236 households while for qualitative data, a total of three FGDs with eight (8) participants was conducted among twenty four (24) rural community members of Gicumbi district. Raw data from the questionnaire were entered into EPI data and transported into SPSS version 22 for analysis. Descriptive statistics was used to tabulate and describe the data. The strengths of the associations were determined with multiple logistic regressions. The results shows that 69.1% of respondents were male, 30.1% were farmers, 16.9% had formal employment while 57.2% completed secondary education. The prevalence of improved latrine in Gicumbi District was 65.3%. Tertiary education was also 4.3 times more likely to have improved compared to those who did not have formal education (AOR=4.3CI: 95%: 1.027-7.032. P=0.005). Respondents with average monthly income Between 50,000 and 100,000 Rwfs are 2.7 times more likely to have improved latrine (AOR=2.7 CI at 95%:1.009-4.120, P=0.022).
Author Contributions
Copyright© 2022
Umubyeyi Muhimpundu Alice, et al.
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Introduction
Despite encouraging progress on sanitation, most of Sub-Saharan Africa did not meet the MDG sanitation target. In 2015 it was estimated that 2.4 billion people globally still use unimproved sanitation facilities. Of these, an estimated 1 in 8 (946 million) people still practice open defecation worldwide Globally, 15% of the world’s population do not use improved latrine facilities forcing over 1 billion people to resort to open defecation. Overall, the global latrine coverage as at 2011, was estimated to be 64% implying that the world was set to miss the 75% sanitation MDG target by more than half a billion people if the current trends continued Sub-Saharan Africa remained the farthest behind in its progress towards accelerating access to improved latrine facilities (UN, 2013). Regional estimates indicated that only 30% of the population in Sub Saharan Africa used improved latrine facilities and an estimated 26% practiced open defecation due to lack of latrines In developing countries, 47 % of the population was living in unhygienic environment, while in developed countries the proportion is only 1%. The sanitation coverage of rural and urban was 39% and 71% respectively in developing countries Sub-Saharan countries including Rwanda still have the significant numbers of people living in unimproved hygiene and need rapid improvement of sanitation which calls for details research Whereas most studies conducted have focused on establishing the latrine coverage levels, there is a clear gap in the investigation of the underlying factors leading to the low latrine coverage levels especially in marginalized areas like Gicumbi district. Therefore this study sought to determine the improved latrine coverage and associated factors among rural community members of Gicumbi district, Rwanda. The lack of improved latrine coverage in Rwanda continues to be a widespread health and environmental hazard. The total latrine coverage in Rwanda is 92.2% indicates 73.1% in rural while 82.6 % in urban. Latrine coverage is generally low with 2.12% of the population who defecate in the open The promotion of improved latrine use coupled with the requisite knowledge, attitudes and practices has not received significant attention from researchers, the National and program designers, law enforcers and policy-makers. There is limited information on latrine coverage and associated factors that are attributed to the low improved latrine coverage levels among communities like Gicumbi district. This study therefore assessed latrine coverage and associated factors in Gicumbi district, one of the rural districts with low level of improved latrine coverage in Rwanda
Results
All 236 households selected as a sample participated in the study, this explains why the response rate was 100%. This section examines the demographic information of respondents that include Gender of household head, occupation, level of education,Age, Average monthly income and number of household members. Descriptve statistics of each demographic variable is describes in the following Source: Primary Data The table above ( The research further more sought to find out the occupation status of respondents and categorized into Formal employment (16.9%) , Informal employment (19.5%) , Business/Trading 20.8% , Livestock keeping (11.9%) ,Agriculture (30.1%) ,and others (0.8%) who cited the hand to month work for surviving. To get the information on school-learnt skills, education of respondent was asked and 0.4% of repondents did not have chance to go to chool whereas 7.6% completed Primary education and , 57.2% completed Secondary education and 34.7% completed tertiary education. The Age of respondents was reviewed and the results showed that only 7.6% were below 30 years old, most of the respondents equivalent to 42.8% were between 30-40 years and 36% were aged between 40-50 years whereas 13.5% are above 50 years old. To understant the earnings of respondents, the average monthly income of respondents were asked and most of respondents (45.3%) said that their monthly income ranges between 100,001 and 200,000 Rwfs, only 5.9% of respondents earn less than 50,000Rwfs, 14.8% earn between 50,000 and 100,000 Rwfs and only 33.9% of respondents had income which is above 200,000 Rwfs monthly. And lastly, the research wanted to know the size of household in terms of number of people living in, asked the respondents about the number of household members and 42.4% respondents that there were four or five household members, 13.6% said that there six or more members in their household, 12.3% repondended that there were two household members whereas only 1.7% who was alone in the household. The study further established the prevalence of latrine use in rural community of Gicumbi district, having improved latrine was to facilitate for the safe disposal of human faeces and urine without slab and to also know the proportion of households having ownership of an improved latrine facility among community under the study. As shown by the To sort out the factors associated with improved latrine coverage among the respondents in Gicumbi district, Bivariate analysis was conducted through a chi-square test in SPSS to find out the interdependence among independent variables and the outcome variable of interest which is the possession of improved latrine. Chi-square test statistic was observed and P-Value was viewed to compare it to significance level (0.05) so as to take the decision against the null hypothesis (there is no association between any independent variable and the possession of improved latrine). Source: Primary Data The table above ( Gender of the household head was not significantly associated with improved latrine coverage (p=0.06), although households with males as the household heads 100(42.4%) tend to have improved latrine. There is no significant association between occupation of respondents and improved latrine coverage, although more respondents with farming activities 70(29.7%) have improved. A significant association was also found between education level of the respondents and improved latrine coverage (P-Value = 0.017). The Age of respondent was found significantly associated with improved latrine coverage in Gicumbi district (P-Value = 0.019), respondents aged between 30 and 50, 76(32.2%) tend to have improved latrine comparing to older and younger respondents. There is a significant relationship between average monthly income and improved latrine coverage (p=0.002), respondents who earn more than 100,000Rwf per month 174(73.7%) have improved latrine. No significant relationship between number of household members and latrine coverage (P=0.138), having necessary skills for constructing latrine does not influence the ownership of improved latrine (p= 0.088) which shows that the relationship is insignificant, the research also found no significant relationship between whoever is responsible for latrine construction and improved latrine with (p=0.073). Results from bivariate analysis showed that only Age and occupation of respondents were found statistically, significantly associated with improved latrine with the P-Values 0.041, 0.008 respectively. Multivariate analysis estimates the logistic model with independent variables significantly associated (Age and Occupation) with outcome variable and the outcome variable (Improved, Unimproved latrine), the results from Binary logistic regression are shown in the Source: Primary Data Results from multivariate analysis Respondents with average monthly income Between 50,000 and 100,000 Rwfs are 2.7 times more likely to have improved latrine compared to those who earn on average less than 50,000 Rwf (AOR=2.7 CI at 95%:1.009-4.120, P=0.022).Earning on average between 100,001 and 200,000 Rwfs per month increase by 6.5 times the likelihood of having improved latrine (AOR=6.5, CI at 95%: 1.092-12.294, P<0.001) and respondents who on average earn above 200,000 Rwfs per month are 4.7 times more likely to have improved latrine compared with those who earn less than 50,000Rwf per month (AOR=4.7, CI at 95%:1.012-6.720, P=0.005). Respondents who did not have skills for constructing latrine were 0.3 times less likely to have improved latrine as compared to those who had skills for constructing the latrine (AOR=0.3, CI at 95%: 0.09-0.71, P=0.006).
Characteristics
Frequency (N=236)
Gender of household head
Male
163
69.1
Female
73
30.9
Occupation
Formal employment (Salaried)
40
16.9
Informal employment (Casual)
46
19.5
Business/Trading
49
20.8
Livestock keeping
28
11.9
Agriculture
71
30.1
Others (Specify)
2
0.8
Level of Education
No formal education
1
0.4
Primary
18
7.6
Secondary
135
57.2
Tertiary
82
34.7
Age
Below 30yrs
18
7.6
30-40
101
42.8
40-50
85
36
Above 50
32
13.5
Average Monthly Income
Less than 50,000 Rwfs
14
5.9
Between 50,000 and 100,000 Rwfs
35
14.8
Between 100,001 and 200,000 Rwfs
107
45.3
Above 200,000 Rwfs
80
33.9
Number of Household members
Six or more
32
13.6
Four or five
100
42.4
Three
71
30.1
Two
29
12.3
One
4
1.7
Variables
Have Improved Latrine
P-Value
Yes n(%)
No n(%)
Gender of household head
0.06
Male
100(42.4)
63(26.7)
Female
54(22.9)
19(8.1)
Occupation
0.262
Formal employment (Salaried)
31(13.1)
9(3.8)
Informal employment (Casual)
32(13.6)
14(5.9)
Business/Trading
21(8.9)
28(11.9)
Farming
70(29.7)
31(13.1)
Level of Education
0.017
No formal education
0(0.0)
1(0.4)
Primary
9(3.8)
9(3.8)
Secondary
113(47.8)
22(9.3)
Tertiary
74(31.4)
8(3.4)
Age
0.041
Below 30yrs
13(5.5)
5(2.1)
30-40
76(32.2)
25(10.6)
40-50
46(19.5)
39(16.5)
Above 50
19(8.1)
13(5.5)
Average Monthly Income
0.002
Less than 50,000 Rwfs
9(3.8)
5(2.1)
Between 50,000 and 100,000 Rwfs
25(10.6)
10(4.2)
Between 100,001 and 200,000 Rwfs
98(41.5)
9(3.8)
Above 200,000 Rwfs
76(32.2)
4(1.7)
Number of Household members
0.138
Six or more
22(9.3)
10(4.2)
Four or five
57(24.2)
43(18.2)
Three
50(21.2)
21(8.9)
Two
23(9.7)
6(2.5)
One
2(0.8)
2(0.8)
Having necessary skills for constructing latrine
0.038
Yes
153(64.8)
79(33.5)
No
1(0.4)
3(1.3)
Who is responsible for constructing latrine
0.073
Men
103(43.6)
64(27.1)
Women
51(21.6)
18(7.6)
Variables
Description
AOR
(CI at 95%)
P-Value
No formal education
Ref
Primary
0.6
(0.168 - 2.442)
0.069
Secondary
2.5
(1.002 - 4.362)
0.018
Tertiary
4.3
(1.027 - 7.032)
0.005
Age
Below 30yrs
Ref
30-40
1.6
(1.001 - 3.061)
0.019
40-50
2.5
(1.211 - 4.238)
0.012
Above 50
0.4
(0.525 - 1.061)
0.075
Average Monthly Income
Less than 50,000 Rwfs
Ref
Between 50,000 and 100,000 Rwfs
2.7
(1.009 - 4.120)
0.022
Between 100,001 and 200,000 Rwfs
6.5
(1.092 - 12.294)
<0.001
Above 200,000 Rwfs
4.7
(1.012 - 6.720)
0.005
Having necessary skills for constructing latrine
Yes
Ref
No
0.3
(0.09 - 0.71)
0.006
Discussion
The study showed that 154 (65.3%) had improved latrine in rural community of Gicumbi district, this proportion is lower that the national coverage (81.3%) in rural areas according to integrated household and living condition survey (EICV, 2016-2017). 100% of the households participated in this study share their own improved latrine in Gicumbi district, according to EICV5 only 66.9% do not share their own improved latrine, In this study, findings from bivariate analysis showed that Education level, Age and skills for constructing improved latrine and average monthly income of household per month are significantly related to improved latrine coverage. The increase in average income earned by household increase the likelihood of the household to own improved latrine, this was also found in the study conducted by Households with educated household member tend to have improved latrine, this was also highlighted by Having skills for constructing improved latrine was found associated with improved latrine coverage since it increase the positive attitude towards latrine use, this is in line with what In multivariate analysis, respondents with both secondary and tertiary education were more likely to have improved latrine compared to those with primary and no formal education, this is because they are skilled of the benefits of having improved latrine as a sanitation tool. Respondents with more than 50,000Rfw income per month tend to have improved latrine when compared to who earn less, this is because their can afford to pay the related cost of establishing the sanitation tools like improved latrine.
Conclusion
The improved latrine coverage among rural areas in Gicumbi district is low compared to the national level. Households with a member with secondary or teritiary education are respectively 2.5 or 4.3 times more likely to have improved latrine compared to those with no formal education. Respondent aged 40-50 was 2.5 times more likely to own improved latrine compared to other aged below 30years. Households with average monthly income of between 100,000Frw and 200,000Frw are 6.5 times more likely to have improved latrine compared to those earning less than 50,000Frw per month and having no skills for constructing latrine is 0.3 times less likely to influence the availability of improved latrine. Since the improved latrine coverage in rural areas was found to be less than the national level’s prevalence of improved latrine, there is a need of mobilization among communities of Gicumbi district to improve awareness, knowledge and benefits of availability of improved latrines in the households.