Sanitation, water, and hygiene in Ethekwini Municipality, Durban, South Africa : a baseline cross-sectional study.
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Date
2007
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Abstract
Introduction: Inadequate water supply and sanitation adversely affects the health and
socio-economic development of communities. Since 2003, more than 40 000
households in peri-urban and rural areas within eThekwini Municipality, South
Africa, have been provided with urine diversion toilets, safe water and hygiene
education. eThekwini Municipality have requested that these interventions be
evaluated to monitor their effect on health outcomes.
Aim: The aim of the study is to describe the baseline situation in respect of sanitation,
safe water and hygiene behaviour in Intervention Areas in eThekwini Municipality
and compare these to Control Areas.
Methods: An observational analytic cross sectional study design was undertaken. A
multi-stage sampling procedure was followed and six study areas were randomly
selected. Three Intervention Areas (urine diversion toilets) were matched with three
Control Areas (no urine diversion toilets). A total of 1337 households, comprising of
7219 individuals, were included in the study. A Household Questionnaire a and an
Observational Protocolb was administered by fieldworkers. Data was entered onto a
custom designed EpiData database, processed and analysed using SPSS version 13.
Results: The baseline characteristics revealed that Intervention and Control areas
were very similar other than the provision of urine diversion toilets, safe water and
hygiene education in the Intervention area. The Intervention area scored higher than
the Control area (2.31 vs. 1.64) with regard to having a cleaner toilet, with no flies, no
smells, having hand-washing facilities and soap provided close to the toilet. Some of
the collected data from questionnaire responses were not consistent with the
fieldworkers observations. It was reported that 642 households in the Control and 621
in the Intervention areas washed their hands with soap, whilst only 396 households in
the Control and 309 in the Intervention areas were observed to have washed their
hands with soap. Conclusion: Households in the Control area are at a greater risk of developing
diarrhoeal and other related diseases. The provision of safe water, urine diversion
toilets and hygiene education in the Intervention area has proved to be successful.
Recommendations: eThekwini municipality must expand the package of services c to
the Control areas. Sustainable hygiene education programmes must continue to be
implemented and be evaluated over time.
Plate 1: Inside view of the UD Toilet Plate 2: Ground tank providing 200 litres free water
Plate 3: Hygiene education material Plate 4: External rear view of the UD toilet
Description
Thesis (MMed.)-University of KwaZulu-Natal, Durban, 2007.
Keywords
Sanitation--KwaZulu-Natal--Durban., Water-supply., Environmental health., Environmental health., Theses--Public health medicine.