Sanitation and Health Practices Across Communities in Rural Kenya

It is always interesting for the sanitary engineers to know the sanitation and health practices in various areas. One can compare these practices with the similar practices in other areas, for a more deeper insight.

The authors of the paper: “Designing a Mixed-Methods Approach for Collaborative Local Water Security: Findings from a Kenyan Case Study;” Hilary Barber, Sarah E. Dickson-Anderson, Corinne J. Schuster-Wallace, Susan J. Elliott, Saaya Tema; DOI 10.1007/s12403-017-0251-0, describe, among other research and findings, sanitation and health practices in a rural Kenyan community (rural Maasai community - Chumvi (population 2000) and Nadungoro (population 375).

The authors say:

“Toileting practices are important sources of potential contamination and a potential pathway for faecal-oral pathogen transmission, especially in the absence of proper hand hygiene. Toileting practices varied across neighbourhoods and age cohorts. In Chumvi and Nadungoro, the majority of respondents reported practising open defecation at least some of the time, whether in open pits,
vegetation, or water (62 and 70%). This practice was far less prevalent in responses from Ethi. None of the households across neighbourhoods used ventilated improved pit latrines (the minimum standard for improved sanitation—WHO and UNICEF 2015) and defecation in water appears to be out of convenience while collecting water.”

The reason for not using VIP latrines was, as I found out later, affordability. People could not afford VIP latrines. The other point worth noting here is the defecation in water from where they collect water. This is not quite ethical – you collect water from a source in which you defecate.

The authors further say:

“Sanitation practices of young children (3 years old) were reported separately where present in the household. In Chumvi, 54% reported using diapers at least some of the time, while 92% reportedly practised open defecation at least some of the time. Diaper use was not reported in Nadungoro (the most inaccessible of the neighbourhoods studied), although some children reportedly used toilets
(9%) despite being considered dangerous for young children and beyond their abilities according to respondents in other neighbourhoods. All other respondents reported open defecation. Ethi (another community) reported the highest use of diapers (86%), with 14% defecating in the household.”

The above information is definitely of interest to sanitary engineers. On handwashing, the authors say:

“While respondents from Ethi only reported using this method, respondents in Chumvi and Nadungoro (23; 39%) reported practising less hygienic methods at least some of the time (i.e. wiping hands with a cloth or rinsing with water).”

“Self-reported overall family health status varied significantly between neighbourhoods, with respondents in Ethi reporting the least favourable health status (84% ‘fair’ or ‘poor’) as compared to Nadungoro (51%) and Chumvi (18%). Respondents from Ethi also reported the most frequent
incidence of diarrhoea (27% ‘often’ or ‘always’), compared with Nadungoro (18%) and Chumvi (11%). Diarrhoea was generally attributed to bad or dirty water and food, dirty hands, or germs and parasites, with little variation across communities, generally indicating a good understanding of both food- and water-related pathways.”

It is discernible that some knowledge on health and reduces the incidence of diarrhea. No matter how small a community is, knowledge on health and hygiene is instrumental for reduction of diarrhoeal diseases. It is also clear the sanitation and health practices differ from one community to another.

F H Mughal