A community based cross sectional study on use of sanitary latrines in a rural setup in Maharashtra.

Abstract

Background Even after more than 60 years of independence, open air defecation is widely prevalent in rural India. Objectives: To find out the reasons for under utilization of community latrines in a rural set up of district Pune, Maharashtra, India and to recommend measures which would lead to increase in the utilization of the sanitary latrines. Methods: The present community based crosssectional study was carried out in a village of district Pune (Maharashtra) during MayJune 2011 among 282 subjects. A modified WHO questionnaire adapted to local conditions was used for data collection. Interpretation of data was done using percentages and proportions. Results: In spite of presence of community latrines, 67% of the population resorted to open air defecation. Inadequate water was the major reason for under utilization (48.6%) of community latrines followed by lack of awareness about the availability of these (19.5%). Only 14.5% were not aware of any harmful effect of open air defecation. 66.7% of them had the knowledge of night soil disposal. 77.6% were aware of the importance of hand washing with regards to prevention of disease. Women found open air defecation even more embarrassing and dangerous. Conclusion: The attitude to use these latrines is present in the surveyed population but people are not willing to take the responsibility of maintaining their cleanliness. Inadequate water supply stands out to be the most important reason for under utilization of these latrines. Reinforcement and guidance is required to solve the problem of under utilization of these latrines. Key-words: rural sanitation, sanitary latrine, underuse. Introduction: “Sanitation is a way of life”, it should be people’s programme. In many areas of the world, including India, access to basic sanitation especially excreta disposal is a problem of grave importance. 1,2 Access to safe water and sanitation facilities remains a formidable challenge in developing countries. 3,4 In 2008, only 21% of rural and 54% of urban India has access to improved sanitation, the national average was measly 31%. 5 Despite comprehensive programmes like total sanitation campaign, open defecation still remains the predominant norm and poses one of the biggest threats to the health of the people. Even after more than 60 years of independence, open air defecation is widely prevalent in rural India. Nearly 60 per cent of the people in the world who defecate in the open belong to India. 6 Efforts made by various organizations to persuade people to do away with this practice have failed miserably in the past. Situation in the village under study is also grim with only 15% of the population having attached sanitary latrines. The present study was therefore conducted to ascertain the healthline pISSN 2239-337X/eISSN 2320-1525 Volume 4 Issue 1 January-June 2013 P a g e 9 0 reasons of under utilization of community latrines in a rural village of Maharashtra (India) and to recommend measures which would lead to increase in the utilization of sanitary latrines. Materials and methods: The present cross sectional community based survey was carried out in a selected village of district Pune (Maharashtra) during May-June 2011 using a modified WHO questionnaire (WHO Library Cataloguing-in-Publication Data, Core questions on drinking-water and sanitation for household surveys). Visit to the gram panchayat office was made followed by an interactive session with the village development officer (VDO). Related schemes operational in this aspect as told by the Gram Sewak are: Nirmal Gram Yojna, Agandhari Mukt Yojna, Gadke Baba Scheme and Goodmorning Pathak. The study village was randomly selected from the list of villages falling under rural field practice area of Department of Community Medicine, Armed Forces Medical College (AFMC), Pune. (It’s around 40 km from Pune on the Sholapur Highway. It has been adopted by the medical college for training of under graduate and post graduate students in community medicine and for provision of health services to the villagers.) Total households in the selected village were 357. It was planned to interview one member per household so total number of households required to be surveyed were 357. The author of the study visited each household and conducted face-to-face interview with the head of the family using a structured questionnaire to conduct the survey. One person (preferably the head of the family) was interviewed from each household. The purpose of the study was explained before the interview started. Informed consent was obtained. Ethical committee approved the study. Some interviews were rescheduled as the interviewees were busy with other jobs at the stipulated time. In spite of all the efforts, only 282 out of the 357 persons per household selected could be interviewed giving overall response rate of 78.99%. The interviews lasted for 30 to 45 minutes. Volunteers from Deep Griha (an NGO for orphan children in the village) came along with the interviewer to overcome the difficulty expected to occur in comprehending the local language (Marathi). All the questionnaires were manually checked and edited for completeness and consistency and were then coded for computer entry. Finally they were compiled and summarized. The collected data was entered in Microsoft Excel. Coding of the variables was done. SPSS version 11.5 was used for analysis. Interpretation of the collected data was done by using appropriate statistical methods like percentage and proportions. Results Out of total 282 persons interviewed, majority of respondents (48.6%) were illiterate, followed by those educated till High school (21.6%). Most (67.8%) of the study participants were in the age group of more than 50 yrs. Gender wise males outnumbered females. Table 1: Profile of study subjects Variable Total Sample