CONTRIBUTION OF COMMUNITY – LED TOTAL SANITATION (CLTS) IN REDUCING SANITATION RELATED DISEASES IN THE KUMBUNGU DISTRICT

Abstract

Introduction: Open defecation is a major problem to health status of people. Cholera is particularly a potential epidemic disease known to be associated with eating another person‘s fecal matter containing vibrio cholerae. This disease in addition to diarrhea, dysentery, worm infestations, typhoid fever and malaria among others are sanitationrelated and they pose severe threat to child and adult survival in Sub-Saharan Africa as a whole and Ghana in particular. Objective: This study determined the effectiveness of community-led total sanitation in reducing the prevalence of sanitation-related diseases like the aforementioned. Methods: a cross-sectional study design was adopted with both quantitative and qualitative approaches to triangulate responses. Five communities in the Kumbungu District were studied. 150 randomly selected household heads were surveyed on CLTS programme and its impacts on their households using a structured questionnaire. Focus group discussions and key informant interviews were added to add substance to numerical descriptive statistics. Findings were presented as descriptive statistics in the form of counts and proportions, frequency tables, cross- tables for odd ratios. Results: the proportion of sanitation-related diseases were high, 91.1% of people had malaria, 71.9% had diarrhea and 15.8% had typhoid. Through CLTS, the latrine coverage was 68% but handwashing facilities were woefully inadequate both before (4.2%) and after (7%) CLTS. The odds of occurrence of sanitation-related diseases was found to be associated with unavailability of household latrines (OR=1.25, 95% CI: 0.8-1.9, p<0.05), poor hand washing facilities (2.5, 95% CI: 1.5-3.2, p < 0.05) and inadequate provision of clean and safe water-sources (OR=1.2, 95% CI: 0.6-1.8, P < 0.05). It is believed that this accounted for the continued prevalence of open defecation post-CLTS relative to pre- CLTS (OR=2.12, 95% CI: 1.8-2.7, P<0.05). Community attitude towards CLTS was nonchalant since there was no statistical difference in attitude scores before and after CLTS (t-value is 0.12319, 95% confidence, p= .904401). Recommendation: Communities need to adopt positive attitudes towards CLTS and build proper latrines to prevent deterioration over time. The government should combine CLTS with health education to build up not only knowledge but positive attitudes towards the CLTS process.