Factors associated with the practice of open defecation in Lodwar, Kenya: a mixed method research

Abstract

Approximately 2.5 billion people lack access to improved sanitation globally. The situation is even worse in the Sub-Saharan African (SSA) countries. The practice of open defecation peaks beyond 72% of the population in Turkana. This has resulted into frequent outbreaks of water- related diseases such as cholera outbreak in the year 2013 and 2018. The main aim of this study was to assess socioeconomic factors associated with the persistent practice of open defecation in Lodwar. This is a report on both qualitative and quantitative aspects of a cross-sectional study. Stratified random sampling technique was chosen to select 403 participants for this study with the sample drawn from four administrative units (strata) of Lodwar. A structured questionnaire and observation checklist were used to collect quantitative data. A GPS gadget was also used to map major OD hotspots and latrine coverage. In addition, Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs) were conducted to collect qualitative data. Major OD hotspots included river banks, roads, the arboretum and the stadium. Only 19% of the study population had a latrine facility in their homesteads with 73% of the latrines constructed using poor materials. The quantitative findings revealed that culture was the leading factor why people practiced OD with the frequency of 44% followed by poverty levels that limited latrine ownership among the households (27%). Pearson's chi-square tests revealed that there was a significant association between socioeconomic factors and OD: At χ2=107.317, there was a significant association between latrine presence and the education level of the household, latrine sharing χ2 = 403, and the occupation of the household head χ2 = 74.51 (p<0.05). The quantitative findings from the thematic analysis showed that culture was by far the most common factor that contributed to the practice of OD with a theme intensity of 31.1%. Further analyses identified five major cultural aspects that were associated with the practice of OD. Open defecation as a common habit among the respondents was the most cited factor that contributed to its rampant practice (Theme intensity 31.3%). Poverty and cultural aspects influence latrine adoption. Establishment of child clubs and community members that offer education on sanitation interventions may help foster a culture that can be transferred from generation to generation.