Open defecation among Kenyan households: an analysis of demographic and health survey 2022 and census report of 2019.
Kenya
Open defecation
Sustainable development goals
Journal
Journal of health, population, and nutrition
ISSN: 2072-1315
Titre abrégé: J Health Popul Nutr
Pays: Bangladesh
ID NLM: 100959228
Informations de publication
Date de publication:
19 Sep 2024
19 Sep 2024
Historique:
received:
27
05
2024
accepted:
10
09
2024
medline:
20
9
2024
pubmed:
20
9
2024
entrez:
19
9
2024
Statut:
epublish
Résumé
Open defecation (OD) is the disposal of human excreta in the fields, bushes, water bodies and other open spaces. It poses a public health risk as it can lead to the spread of diarrhoea, cholera, soil-transmitted helminths and trachoma. Kenya aims to achieve 100% open defecation free status by 2030 in line with Sustainable development goal number 6. This study sought to determine factors influencing OD at the household level as well as quantify the number of households practicing OD in each of the 47 Kenyan counties. Data from the household questionnaire of the Kenya Demographic and Health Survey, 2022 was analysed. Bivariate logistic regression was done with open defecation status as the dependent variable. Independent variables were poverty status, place of residence, ownership of farm animals, gender and educational level of household head. The number of households practicing OD per county were determined using the Kenya Census report of 2019. Poverty was the strongest predictor of a household practicing OD (OR 43.8 95% CI 26.1-73.8) followed by educational status of the household head (OR 3.3 95% CI 2.3-4.6 ) and the household not owning livestock ( OR 0.7 95% CI 0.6-0.9). An estimated 7.4% of households practice OD. These are estimated to be 814,223 households. Out of these, 686,051 households (84.3%) are found in the 15 counties ranked as having a high population practicing OD. Five counties have managed to eliminate OD and another nine have OD rates of less than 0.5%. Kenya has made commendable progress in eliminating OD. Poverty is a significant predictor of OD at the household level. To eliminate OD, it is advised that more efforts be targeted towards poor households as well as the 15 counties having a high number of OD-practicing households.
Sections du résumé
BACKGROUND
BACKGROUND
Open defecation (OD) is the disposal of human excreta in the fields, bushes, water bodies and other open spaces. It poses a public health risk as it can lead to the spread of diarrhoea, cholera, soil-transmitted helminths and trachoma. Kenya aims to achieve 100% open defecation free status by 2030 in line with Sustainable development goal number 6. This study sought to determine factors influencing OD at the household level as well as quantify the number of households practicing OD in each of the 47 Kenyan counties.
METHODS
METHODS
Data from the household questionnaire of the Kenya Demographic and Health Survey, 2022 was analysed. Bivariate logistic regression was done with open defecation status as the dependent variable. Independent variables were poverty status, place of residence, ownership of farm animals, gender and educational level of household head. The number of households practicing OD per county were determined using the Kenya Census report of 2019.
RESULTS
RESULTS
Poverty was the strongest predictor of a household practicing OD (OR 43.8 95% CI 26.1-73.8) followed by educational status of the household head (OR 3.3 95% CI 2.3-4.6 ) and the household not owning livestock ( OR 0.7 95% CI 0.6-0.9). An estimated 7.4% of households practice OD. These are estimated to be 814,223 households. Out of these, 686,051 households (84.3%) are found in the 15 counties ranked as having a high population practicing OD. Five counties have managed to eliminate OD and another nine have OD rates of less than 0.5%.
CONCLUSION
CONCLUSIONS
Kenya has made commendable progress in eliminating OD. Poverty is a significant predictor of OD at the household level. To eliminate OD, it is advised that more efforts be targeted towards poor households as well as the 15 counties having a high number of OD-practicing households.
Identifiants
pubmed: 39300588
doi: 10.1186/s41043-024-00644-x
pii: 10.1186/s41043-024-00644-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
150Informations de copyright
© 2024. The Author(s).
Références
The WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP). 2023. Open Defecation Data. https://washdata.org/monitoring/sanitation/open-defecation . Accessed on 10 Jul 2024.
United Nations Children’s Fund (UNICEF) and the World Health Organization. State of the World’s sanitation: an urgent call to transform sanitation for better health, environments, economies and societies. New York: United Nations Children’s Fund (UNICEF) and the World Health Organization; 2023.
Saleem M, Burdett T, Heaslip V. Health and social impacts of open defecation on women: a systematic review. BMC Public Health. 2019;19(1):158.
doi: 10.1186/s12889-019-6423-z
pubmed: 30727975
pmcid: 6364430
Owino V, Ahmed T, Freemark M, Kelly P, Loy A, Manary M, Loechl C. Environmental enteric dysfunction and Growth Failure/Stunting in Global Child Health. Pediatrics. 2016;138(6):e20160641.
doi: 10.1542/peds.2016-0641
pubmed: 27940670
World Health Organization. Burden of disease attributable to unsafe drinking-water, sanitation and hygiene, 2019 update. Geneva: World Health Organization; 2023.
Republic of Kenya. Rural sanitation and Hygiene Protocol. Nairobi: Ministry of Health; 2023.
Kenya National Bureau of Statistics (KNBS) and ICF. Kenya Demographic and Health Survey 2022: volume 1. Nairobi, Kenya, and Rockville. Maryland, USA: KNBS and ICF; 2023.
Republic of Kenya. 2019 Kenya Population and housing census. Volume I: Population by County and sub-County. Nairobi: Kenya National Bureau of Statistics; 2019.
Belay DG, Asratie MH, Aragaw FM, Tsega NT, Endalew M, Gashaw M. Open defecation practice and its determinants among households in sub-saharan Africa: pooled prevalence and multilevel analysis of 33 sub-saharan Africa countries demographic and health survey. Trop Med Health. 2022;50(1):28.
doi: 10.1186/s41182-022-00416-5
pubmed: 35351215
pmcid: 8962481
Kenya National Bureau of Statistics. 2023. The Kenya Poverty Report. Nairobi: Kenya National Bureau of Statistics; 2023.
Banks LM, Kuper H, Polack S. Poverty and disability in low- and middle-income countries: a systematic review. PLoS ONE. 2017;12(12):e0189996.
doi: 10.1371/journal.pone.0189996
pubmed: 29267388
pmcid: 5739437
United Nations Children’s Fund (UNICEF) and World Health Organization (WHO). Progress on Sanitation and Hygiene in Africa 2000–2022. New York: UNICEF and WHO; 2023.
Girmay AM, Alemu ZA, Mengesha SD, Dinssa DA, Wagari B, Weldegebriel MG et al. Effect of demographic disparities on the use of the JMP ladders for water, sanitation, and hygiene services in Bishoftu Town, Ethiopia. 2022. Discov Water 2, 8.
Ministry of Health. 2023. Community-led Total Sanitation monitoring portal. http://wash.health.go.ke/clts/user/loadGuestDashboard . Accessed 20 Sep 2023.
IBP Kenya. 2016. Is equalization funds distributed fairly? https://internationalbudget.org/wp-content/uploads/ibpkenya-equity-week-2016-issue-3-equalization-fund-distribution.pdf . Accessed 21 Sep 2023.
The Parliament. 2023. The Equalization Fund Appropriation Bill, 2023. http://parliament.go.ke/sites/default/files/2023-02/The%20Equalization%20Fund%20Appropriation%20Bill%2C%202023.pdf . Accessed 10 Sep 2023.
Kenya Sanitation Alliance. 2023. Progress Report 2023. https://www.globalwaters.org/sites/default/files/4._ksa_ppt_rvd.pptx_.pdf . Accessed Sep 20 2023.
Hutton G. Benefits and costs of the water, sanitation and hygiene targets for the post-2015 development agenda. In: in, Edited by Bjorn Lomborg, editor. Prioritizing Development. Cambridge University Press; 2018. Chapter 23.
Boerma JT, Sommerfelt AE. Demographic and health surveys (DHS): contributions and limitations. World Health Stat Q. 1993;46(4):222–6.
pubmed: 8017081