BEHAVIOUR CHANGE AND HOUSEHOLD ENVIRONMENTAL HEALTH IN THE WA MUNICIPAL AREA, GHANA

Abstract

The rapid urbanisation experienced by developing countries over the past decades have set into motion environmental health challenges that go beyond the capacity of city authorities to manage. Policy interventions over the years have targeted the provision of water and sanitation services with less priority to creating behaviour change in environmental health management. This research examines the effectiveness of creating behaviour change in environmental health management at the household level and the prevalence of diarrhoea and malaria in children under six. A stratified sample of residential areas of the city was employed. Different methods and approaches were used for the study: questionnaires, focus group discussions, interviews and personal observation. The chi-square and the Analysis of Variance (ANOVA) were used to test for relationships in the hypotheses. Four hygiene behaviours were selected for examination before and after exposure to environmental health intervention: hand washing with soap after visiting the toilet, hand washing with soap prior to cooking, hand washing with soap after cleaning a child and closure of water storage container. There was improvement in household hygiene behaviour after the intervention. However, this improvement did not translate into a significant reduction in childhood diarrhoea as a result of the intervention. On the other hand, a significant relationship was found between the intervention and childhood fever. The results show that receiving and being exposed to hygiene intervention messages was not necessarily sufficient to ensure behaviour change. Other factors inhibiting behaviour change are access to environmental services, illiteracy, poverty and the inefficiencies of the Municipal Environmental Health and Sanitation Department to effectively design programmes to target household sanitation and hygiene behaviours that affect health negatively and their incapability of prosecuting sanitary offenders. In the light of these problems enumerated above, recommendations are made to enhance the inefficiencies in the provision of water and sanitation services. Beyond this, the need for depoliticising and massive investment in the Municipal Environmental Health and Sanitation Department and the design of programmes that can effectively change household behaviour are advocated.