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A Preview of Water, Sanitation and Hygiene Practices in Kofai Community of Taraba State, Nigeria

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Water, including sources and types of treatment, sanitation and hygiene practices affect human health. The prevention, control and protection against outbreaks of water related diseases is crucial. The study assessed water, sanitation and hygiene related conditions and practices of the households in Kofai community to determine appropriate public health interventions for the community. A cross sectional descriptive study was carried out using 372 individual households selected using multistage random sampling method after due consents and ethical processes. The analysis of data was done using the SPSS software version 20.0 and Microsoft Excel 2010. The result showed that 204 (54.8%) participants were females; 267 (71.8%) were married; the mean age was 33.6±11.9 and farming formed approximately 31.2% of all occupational categories amongst the respondents. The sources of water supply was mainly through vendors 130 (34.9%), followed by borehole 92 (24.7%), well 71 (19.1%) and rain water 36 (9.7%). Type of treatment for drinking water included boiling (18.5%), filtration with cloth (16.1%), use of chlorine tablet (5.7%) and no form of treatment at all (59.7%). Only 84 (22.6%) had facility for hand washing. Domestic waste disposal practices include open dumping (73%), burning (18%), and refuse pit (9%). Sewage disposal practices were open defecation (36%), while 64% were using latrines. Of all latrines, 42.4% were pit latrines, 39.0% were pour flush, and 18.6% were cistern flush. Water, sanitation and hygiene practices and infrastructure in Kofai are in mid-stage development. More of modern water supply in form of boreholes and pipe-borne water are needed, as well as sanitary disposal of domestic waste and sewage. Provision of more latrines will drastically reduce the open defecation practice seen in more than a third of the community. Deploying appropriate triggering intervention through sustained community led total sanitation has a potential of transforming the community to an open defecation free status towards Nigeria’s target of 2025. Keywords: Water, Sanitation, Latrine, Open Defecation, Taraba, Nigeria
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Central African Journal of Public Health
2020; 6(4): 213-219
http://www.sciencepublishinggroup.com/j/cajph
doi: 10.11648/j.cajph.20200604.15
ISSN: 2575-5773 (Print); ISSN: 2575-5781 (Online)
A Preview of Water, Sanitation and Hygiene Practices in
Kofai Community of Taraba State, Nigeria
Esther Nnennaya Umahi
1, *
, Emmanuel Chukwuma Obiano
2
, Rimande Ubandoma Joel
1
1
Department of Public Health, Faculty of Health Science, Taraba State University, Jalingo, Nigeria
2
Department of Environmental Health Science, Nnamdi Azikiwe University, Awka, Nigeria
Email address:
*
Corresponding author
To cite this article:
Esther Nnennaya Umahi, Emmanuel Chukwuma Obiano, Rimande Ubandoma Joel. A Preview of Water, Sanitation and Hygiene Practices in
Kofai Community of Taraba State, Nigeria. Central African Journal of Public Health. Vol. 6, No. 4, 2020, pp. 213-219.
doi: 10.11648/j.cajph.20200604.15
Received: June 16, 2020; Accepted: June 28, 2020; Published: July 6, 2020
Abstract:
Water, including sources and types of treatment, sanitation and hygiene practices affect human health. The
prevention, control and protection against outbreaks of water related diseases is crucial. The study assessed water, sanitation and
hygiene related conditions and practices of the households in Kofai community to determine appropriate public health
interventions for the community. A cross sectional descriptive study was carried out using 372 individual households selected
using multistage random sampling method after due consents and ethical processes. The analysis of data was done using the
SPSS software version 20.0 and Microsoft Excel 2010. The result showed that 204 (54.8%) participants were females; 267
(71.8%) were married; the mean age was 33.6±11.9 and farming formed approximately 31.2% of all occupational categories
amongst the respondents. The sources of water supply was mainly through vendors 130 (34.9%), followed by borehole 92
(24.7%), well 71 (19.1%) and rain water 36 (9.7%). Type of treatment for drinking water included boiling (18.5%), filtration with
cloth (16.1%), use of chlorine tablet (5.7%) and no form of treatment at all (59.7%). Only 84 (22.6%) had facility for hand
washing. Domestic waste disposal practices include open dumping (73%), burning (18%), and refuse pit (9%). Sewage disposal
practices were open defecation (36%), while 64% were using latrines. Of all latrines, 42.4% were pit latrines, 39.0% were pour
flush, and 18.6% were cistern flush. Water, sanitation and hygiene practices and infrastructure in Kofai are in mid-stage
development. More of modern water supply in form of boreholes and pipe-borne water are needed, as well as sanitary disposal of
domestic waste and sewage. Provision of more latrines will drastically reduce the open defecation practice seen in more than a
third of the community. Deploying appropriate triggering intervention through sustained community led total sanitation has a
potential of transforming the community to an open defecation free status towards Nigeria’s target of 2025.
Keywords:
Water, Sanitation, Latrine, Open Defecation, Taraba, Nigeria
1. Introduction
A key focus of Environmental Public Health in disease
prevention and control is on water, sanitation and hygiene
practices [1]. In recent times, lack of access to potable water,
sanitation and hygiene (WASH) and their impacts on health
and well-being have become a major concern. Globally, 663
million people lack access to an improved water source [2],
and an estimated 2.4 billion people (more than 35% of world’s
population) had no access to improved sanitation facilities [3].
Comparatively, the situation is worse for sub-Saharan Africa
(sSA) which has the lowest levels of access to both potable
water and sanitation. In sSA, it is estimated that 102 million
people still use surface water, and 695 million people still use
unimproved sanitation facilities [4]. In Nigeria, an estimated
100 million people lack basic sanitation facilities, with 62
million people having no access to safe drinking water [5].
Very recently, official Country Report on Nigeria by the
Federal Ministry of Water Resources, (FMWR) revealed an
alarming high rate of open defecation across the country
(national average, 37%), with Taraba State at 52.5% [6]. This
rate, of course, is expected to be higher in specific rural
communities such as Kofai. What hazards and risks do such a
Central African Journal of Public Health 2020; 6(4): 213-219 214
situation pose?
Inadequate sanitation is estimated to cause 280,000
diarrheal deaths annually, and is a major factor in several
neglected tropical diseases [7]. Globally, diarrhoea is a leading
cause of child mortality [8], and is thought to be a determinant
cause of childhood malnutrition [9]. In Nigeria, it was
reported that about 122,000 persons including 87,000
under-five children die each year from diarrhoea with 90%
directly attributed to water, sanitation and hygiene [10]. But
the greatest risk attending such ugly situation is heightened
vulnerability to classical epidemic outbreak such as cholera.
The morbidity, mortality and other socio-economic losses
arising from lack of access to WASH have rekindled a concern
among Governments, responsible institutions, communities
and individual actors to take all necessary actions to improve
on existing WASH situations and forestall any possible
outbreak of epidemic. According to the WHO:
“The provision of safe water, sanitation, and hygienic
conditions is essential for protecting human health during
all infectious disease outbreaks, including the coronavirus
disease 2019 (COVID-19). Ensuring evidenced-based and
consistently applied WASH and waste management
practices in communities, homes, schools, marketplaces,
and health-care facilities will help prevent
human-to-human transmission of, the virus that causes
COVID-19” [11].
This study aligns with this prevailing concern, especially,
considering the proximity and intimate interaction between
Kofai community and the Taraba State University (TSU)
community. Accordingly, this study seeks to ascertain WASH
related conditions and practices in Kofai community as a
prelude to the determination of appropriate remedial
interventions. It is a pioneering research that will provide the
sub-structure for future knowledge super-structure and
evidence-led intervention.
2. Methods
2.1. Study Area
The study was carried out in Kofai, a rural community
located in Ador-Kola Local Government Area (LGA) in
Taraba State, North-East Nigeria. It is a moderate-sized
settlement with household population of 5,386 [12]. Taraba
State University (TSU), established in 2007, is located at the
outskirt of Kofai territory. The Faculty of Health Sciences of
TSU was established in 2017. Therefore, Kofai, being a host
community to a young University with a new Faculty of
Health Sciences will, inevitably, be a proximal ground for
health science research.
2.1.1. Study Design
This is a cross-sectional descriptive study conducted in
Kofai which offered precise description and information on
water, sanitation and hygiene practices.
2.1.2. Study Period
The study period spanned from 12
th
July, 2018 – 15
th
September, 2018.
2.2. Participants and Sampling
Total study population was 5,386 households.
Respondents were 18 years of age and above, able to speak
and understand English Language and/or the local dialects.
All respondents live in house units included in the study.
The sample size used was 372, which was determined using
Sloven’s formula [13] n=N/1 + Ne
2
. Where: n=sample size,
N=total population of the study (5,386), e=the error of
sampling (5% or 0.05), 1=constant. A community based
cross-sectional interview was administered to respondents in
randomly selected households in Kofai using multistage
sampling method. The community was partitioned into seven
sections to ensure equitable area distribution. In each
area-section, 53 households were selected using systematic
random sampling at a sampling interval of 14 (5386/372).
Every 14th household was entered starting from the first
household at one end of the street randomly selected, on both
sides, until the end of that street. At this point the researchers
turned and continued sampling till the selected sections were
sampled and the estimated sample size achieved. Within a
household, an eligible respondent was identified and then
interviewed.
2.3. Questionnaire and Interview Procedure
A pre-tested, structured, interviewer-administered
questionnaire was used to collect primary data from
members of households on WASH practices in Kofai
community. Village Health Workers and local council
leaders assisted to facilitate a seamless interface with
respondents. The research questions were read out and
interpreted (where applicable) to the respondents to make
sure all sections are filled. Responses were recorded and
ticked in the questionnaire. WASH practices were assessed
using basic information on provision of latrine/toilet in the
household, type of toilet facility provided, hygienic
condition of the latrine/toilet facility, presence of
handwashing facility, method of water treatment, sources of
drinking water and methods of domestic solid waste disposal.
The questions included single type responses where the
respondent selects from among two or multiple options.
2.4. Data Analysis and Presentation
The data collected were processed and analyzed using SPSS
software version 20.0 (IBM-SPSS Corporation, Chicago, III,
USA) and Microsoft Excel 2010. Results were presented in
the form of frequency table and figures.
2.5. Ethical Consideration
The Department of Public Health, Taraba State University,
Jalingo approved the study protocol. Respondents were
informed of study objectives, consent procedures and
potential benefits. They were also informed of their liberty to
accept or decline participation or withdraw at any time
without fear of any retribution. Those eligible gave informed
215 Esther Nnennaya Umahi et al.: A Preview of Water, Sanitation and Hygiene Practices in Kofai
Community of Taraba State, Nigeria
verbal consent and were enrolled in this study. The use of
study identification numbers for respondents was adopted to
ensure anonymity and confidentiality in the data collection
process.
3. Result
3.1. Respondents’ Characteristics
The demographic statistics of the respondents is
presented below. A total of 372 respondents participated in
this study which included 204 females (54.0%) and 168
males (46.0%). The mean age was 33.6±11.9, with a range
of 18 70 years. Quite a number of the respondents (300,,
80.9%) were married. Respondents with secondary
education were 38.2% and farming formed approximately
31.2% of all occupation categories amongst the respondents
(Table 1).
Table 1. Socio Demographic Characteristics of the Respondents (n=372).
Respondent characteristics Number (%)
Gender
Male 168 (45.2)
Female 204 (54.8)
Age (Years)
18 – 25 106 (28.5)
26 – 35 138 (37.1)
36 – 45 55 (14.8)
46 – 55 51 (13.7)
56 and above 22 (5.9)
Mean Age=33.6±11.9
Marital Status
Single 81 (21.7)
Married 267 (71.8)
Divorced 8 (2.2)
Widow 16 (4.2)
Highest Educational Level
None 50 (13.4)
Primary 124 (33.3)
Secondary 142 (38.2)
Tertiary 56 (15.1)
Occupation
Civil Servant 68 (18.3)
Farming 116 (31.2)
Trading 115 (30.9)
Housewife 10 (2.7)
Student 48 (12.9)
Others 15 (4.0)
Number of Children
None 68 (18.3)
1-2 94 (25.3)
3-4 112 (30.1)
5 and above 98 (26.3)
Religion
Christian 360 (87.1)
Muslim 46 (12.4)
Others 2 (0.5)
3.2. WASH Practices
3.2.1. Latrine Facilities
Most of the respondents, 236 (64%), had latrines in their
household (Figure 1). Figure 2 shows that out of the 236 (64%)
of the respondents who recorded presence of latrine/toilet
facility in the household, 100 (42.4%) had access to pit latrine
with slabs/platforms, 92 (39.0%) had access to pour flush
while 44 (18.6%) to septic tank. Figure 3 presents the
condition of the latrines in the households. Majority (150;
40.3%) of the latrine/toilet facilities were in a moderate
hygienic condition, (64; 17.2%) maintained good hygienic
condition; while (138; 33.1%) were in bad/deplorable
hygienic condition.
Figure 1. Provision of Latrines by Households.
Figure 2. Types of Latrine Facility Provided in Households (n=236).
Figure 3. Hygienic Condition of Latrine.
3.2.2. Water Conditions
Majority (288; 77.4%) of the households do not have
hand washing facility while 84 (22.6%) have (Figure 4).
Central African Journal of Public Health 2020; 6(4): 213-219 216
Figure 5 presents the source of drinking water. The major
source of household drinking water was procurement from
water vendors (130: 34.9%); boreholes (92: 24%), and
wells (52: 19.1%). In Figure 6, 222 (59.7%) of the
respondents were not using any method of water treatment;
69 (17.8%) used boiling method; while 60 (15.5%) filter
with cloth.
Figure 4. Presence of Hand Washing Facility.
Figure 5. Sources of Drinking Water.
Figure 6. Water Treatment Methods in Use.
3.2.3. Domestic Solid Waste Disposal Practices
Figure 7 shows that 271 (73%) of the respondents
discharged their solid waste in open area (open dumping),
Figure 7. Methods of Domestic Solid Waste Disposal.
4. Discussion
Referring to Figure 1, 236 respondents (64%) have latrines
within their households, while 136 respondents (36%) do not
have any latrines within their households. This implies that
36% of households engage in open defecation. It follows
therefore that Kofai community is exposed to all the risks
associated with open defecation such as diarrheal morbidity
and mortality, especially of the under-five. The average of
diarrheal incidence for North East Nigeria is 5.5% as at 2007
(6). Other ugly health outcomes include stunting, wasting
and under-weight in children; while worm infestation and
associated iron deficiency anaemia (IDA) occur among
adolescent girls and young mothers, which, in turn,
predispose to low-birth-weight as well as to heightened
vulnerability to maternal and infant mortalities.
Of course, the social and economic impacts of such open
defecation on Kofai cannot be overlooked. Many still feel
stigmatized by open defecation. For girls and young women,
open defecation is a cause of great apprehension not only for
privacy but for safety also. A study conducted in Lagos [14]
found that a quarter (25%) of women experienced harassment,
threat of violence or actual assault in a 12 month period as a
result of exposure to open defecation. In terms of economic
cost, the World Bank [10] reports that Nigeria loses N455
billion annually due to poor sanitation, of which open
defecation constitute a part. This, according to the report,
translates to a loss of US $20 per capita/year or a decline of
1.3% in Nigeria’s GDP [10].
But then, there is a somewhat positive side to the situation
in Kofai. Kofai’s household open defecation rate of 36% is
16.5% better than the Taraba State average household open
defecation rate of 52.5%. It is also 1% better better than the
national household open defecation rate of 37%. Conversely,
access to latrines in Kofai (64%) is slightly higher than the
average rate in Nigeria (63%), and far higher than the Taraba
State average access of 47.5%. This must be for a reason. A
number of neighbouring institutions and projects have
exerted many years of positive impact upon them and
uplifted the socio-economic demographics of Kofai including
217 Esther Nnennaya Umahi et al.: A Preview of Water, Sanitation and Hygiene Practices in Kofai
Community of Taraba State, Nigeria
the Advanced Teachers College (ATC) established in 1977;
the College of Agriculture, Jalingo, established in 1979; the
strategic Jalingo-Garba-Chede Road that traversed Kofai
territory; and the Taraba State University, Jalingo established
in 2007.
In figure 2, of the 238 households with latrines, 42.4%
were pit latrines with slab/platforms; 39.0% were pour flush
latrines; while 18.6% were cistern-flush septic tank system.
This implies that all the latrines (100%) met the requirements
for classification as “improved sanitation facilities”.
Accordingly, in the 4-rung “Sanitation Ladder” [6], kofai
community, speaking figuratively, has one leg on the 1
st
bottom-rung of “open defecation”, while the other leg is on
the topmost 4
th
rung of “improved sanitation facilities” in the
‘Sanitation Ladder” This scenario of Kofai having her two
legs simultaneously on the 1
st
and 4
th
rungs of the “Sanitation
Ladder” has a practical prospect. By focusing attack on open
defecation through the deployment of sustained community
led total sanitation (CLTS) strategy, it is feasible to trigger
accelerated access to improved sanitation in kofai and move
the community upwards to open defecation free (ODF) status
within the next five years.
From Figure 2 also, we can deduce another challenge.
Since 137 households, altogether, use the septic tank and
pour-flush latrines, the availability and affordability of water
to flush the latrines becomes a serious issue for consideration.
Water availability and affordability will influence the
hygienic conditions of the latrines, as well as the provision
and use of hand washing facilities. From Table 1, showing
the socio-demographic characteristics of respondents, we can
estimate the average number of persons in each household as
5. If we consider the recommendation by FMWR that one
bucket of water should be used to flush the latrine after each
use, then about 75 litres of water shall be needed daily to
flush and maintain the latrines. For other domestic needs,
another 175 litres of water may be required daily.
Figure 5 gives us all the sources of water availability to
community members in Kofai, the most popular sources
being water vendors (35%); boreholes (25%) and wells
(19%). But then, water vendors in Kofai sell a 25-litre jerry
can of water for twenty naira (N20). This means that the 35%
of households that depend on water vendors will spend
N60/day for water to flush and maintain their latrines, and
another N140/day for water to service other domestic needs.
In a month, this will amount to N1, 800 and N4, 200
respectively. Such cost outlay for water needs is clearly
cumbersome for rural community dwellers in a country still
struggling to meet a national minimum wage of N18,
000/month. Little wonder, then, that most latrines in kofai,
were in poor hygienic conditions, and hand washing facilities
were lacking as shown in Figures 3 and 4, respectively. This
situation is obtainable in many other developing countries [1,
15].
The combined effect of Figures 5 and 6 will give a rough
picture of the safety of drinking water in Kofai, but with
slight uncertainties remaining unresolved. We can
reasonably say, with a degree of certainty, that the 3% of
households with pipeline water supply in Figure 5 and the
18.6% that boil their water before use in Figure 6 have
access to safe drinking water. But mindful that we are
dealing with a rural community in a resource-constrained
setting, ‘partial safety’ consideration can be accorded to the
borehole source and to rain water collected with clean
receptacles in open spaces.
Water vendors remain the most popular source of drinking
water in Kofai. Principally, such water vendors operate with
plastic cans conveyed in pushcarts that carry 10-12 cans.
Many authorities [16-18] have highlighted the utility value
and advantages of retail water vending including penetration,
reach, acceptability, flexibility and promptness. However,
Ahmad [19] documents the many unhealthy practices of
retail water vendors including using their mouth to drink
directly from the cans; using sand to wash the cans;
puncturing the cans to ease off pressure; and sometimes
leaving the cover of the cans unfastened. Inadvertently, the
same can that is used to draw water from a well or stream to
supply to a launderer or block molder is still used to supply
to other householders for domestic use including drinking
and preparation of food.
It does appear that the use of chlorine tablet for water
treatment has gained some ground in Kofai. The use of
chlorine tablet is effective per se, however, proper dosing and
appropriate retention period still remain a challenge to the
ordinary user. It does not appear to us that the method of
filtering with cloth which 16.1% of the households embark
on can be relied upon as an effective water treatment option.
Nevertheless, it would be of interest for further research to
understand why such practice had gained ground in the
community.
Taking a more curious look at Figure 6 would inevitably
prompt a relevant question. Why would a whopping 222
households, approximately 60% of the community, not treat
their drinking water at all? Even if one discounts those that
rely on pipe borne water (3%), boreholes (25%) and rain
water (10%) as safe sources - all amounting to 38% of
households, it may not provide sufficient explanation for the
remaining gap. Neither can the gap be explained away as
attributable to ignorance considering the educational and
occupational background of the respondents. It is possible
that an underlying cultural belief may have reinforced the
attitude of many that their water is safe without further
treatment.
In any rural community where household refuse is not
separated (garbage and rubbish) at source, open dumping
is inevitable, for obvious reasons. First, the quantity of
mixed refuse generated will be overwhelmingly large.
Second, the capacity (institutional, technological,
financial, etc) to treat and dispose such refuse by
conventional methods will be over-stretched. Third,
where large expanses of land (farms, bushes, forests) are
readily available, they are used as sites for open dumping,
apparently, without any further financial cost to the rural
dwellers. This must be the case with Kofai, and explains
why 72.9% households embank on open dumping of
Central African Journal of Public Health 2020; 6(4): 213-219 218
refuse. It does appear, however, that households that
generate mostly combustible wastes resort to burning,
whereas non-combustible wastes as cans are buried in
pits in order not to affect cultivation activities in
farmlands.
5. Conclusion
Kofai is a rural agricultural community in Ardo-Kola
Local Government Area of Taraba State, North-East, Nigeria.
She is however undergoing rapid transformation owing to the
impact of modern socio-economic development within and
proximal to her vast territory. Water, sanitation and hygiene
(WASH) practices and infrastructure in Kofai are in a phase
of transition. Though open defecation is still practiced,
improved latrines are predominant. By deploying appropriate
triggering intervention through a sustained community led
total sanitation (CLTS), Kofai has potentials to attain open
defecation free (ODF) status in 5 years in line with Nigeria’s
Road Map/Policy of making Nigeria Open Defecation Free
by 2025.
6. Recommendations
1. Immediate enrolment of kofai in the CLTS program of
Taraba State should be facilitated.
2. The CLTS program in Kofai should focus, among
others, on the provision of cheap sanitary pit latrines in
the first phase, and pour flush latrines, in the second
phase of its intervention to eliminate open defecation as
soon as practicable.
3. The water table in Kofai is favourable to wells.
Accordingly, provision of affordable wells should be
encouraged to expand water supply.
4. To safeguard their drinking water, all householders
should be sensitized and mobilized to, at least, boil their
drinking water before use.
5. Plastic and polythene waste is a current challenge in all
parts of Nigeria, both for urban and rural communities.
To forestall or minimize the adverse effects of plastic
and polythene wastes on farming, it is advisable for
Kofai to designate a common location for collection of
such plastic and polythene wastes for eventual
evacuation to approved dump-site.
7. Suggestions for Further Research
To contribute further in building up the knowledge base on
Kofai, the following researches are suggested:
1. Evaluation of the health awareness level (knowledge,
attitude, and practice) of members of Kofai community,
focusing on contemporary health issues.
2. Assessment of the incidence, prevalence and impact of
common endemic diseases on Kofai.
3. Assessment of the chemical and biological qualities of
various sources of water in Kofai with special focus on
boreholes and wells.
Conflict of Interest
All the authors do not have any possible conflicts of
interest.
Role of Funding Source
Authors state that No funding was obtained from any
institution or organization in writing this paper.
Acknowledgements
Authors wish to appreciate all our participants for their
willingness to partake in this study.
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... Several researchers have reported that the SARS-CoV-2 genome is shed through the urine and excreta of infected individuals [36]. This may imply there exists a probable complex cycle involving transmission of the viral components into the communities recurrently. ...
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