ABSTRACT
Though 89% of the world‘s population had access to drinking water facilities, about 768 million people relied on unimproved drinking water-sources; 83% of them resided in rural areas by the end of 2013 (World Health Organization/ United Nations, 2013). Water hygiene practice is use of water free from water borne diseases. The study assessed the level of knowledge, attitude and practices of students of St Luke’s College Of Nursing Science Wusasa on water born disease prevention practice. A sample size of 257 respondents with a response rate of 250(97%) respondents answered the research questions through interviews. These were selected by simple random sampling through a descriptive research design.
Respondents had low knowledge water hygiene practices; because 210(84%) could not correctly define it. It could be due to the fact that 145(58%) had never had any formal education water born disease prevention practices, did not know; 158(63%) safe water sources, 140(56%) the ideal distance between a latrine and a natural water source (between 10 and 20 meters, 90(53%) the major effect of using unsafe water, 185(74%) the water borne diseases, 130(52%) the importance of fetching water in covered containers and 203(81%) that all clear water was unsafe for consumption.
Respondents had negative attitude where, they believed that; 205(82%) that all clear water was safe for consumption, 210(84%) could consume unprocessed water, 233(93%) chemicals were not safe to treat water, 173(69%) filtered water was safe for drinking, 162(65%) could share water sources with animals. However, they recommended 240(96%) boiling as the best way to process water, 200(80%) it was good to cover water for consumption and 183(73%) acknowledge the importance of having an educational program on water use. It was observed that, most of the water containers were unclean, close to latrines, never protected water sources, did not usually cover drinking water, but never shared water sources with animals. About purification, majority of the respondents never left water to settle to use it, never used chemicals, but boiled, filtered and refrigerated water for consumption. All in all, there was poor knowledge, negative attitude and poor practices of community members towards water hygiene practice. The researcher therefore recommends that; government and local administrators should promote education and sensitization programs on water born disease prevention practice , avail safe water sources such as taps at friendly costs, community members should; fetch water from safe sources, protect water sources, maintain good hygiene of water containers and purify all water before use.
CHAPTER ONE
INTRODUCTION
This chapter includes the background of the study, problem statement, and purpose of the study, specific objectives, research questions, and significance of the study.
1.1 Background to the study
Providing water hygiene practice is a major contributor to improved health. This knowledge, attitudes and practice study/survey aims at enlisting what is known, believed and done in relation to water hygiene practice in St Luke’s College Of Nursing Science Wusasa, Zaria LGA Kaduna state. Though 89% of the world‘s population has access to drinking water facilities, about 768 million people rely on unimproved drinking water-sources; 83% of them residing in rural areas (World Health Organization/ United Nations, 2013).
This study is important because in a global study conducted by the United Nations, unsafe water is responsible for around 80% of diseases and 30% of deaths in developing countries throughout the world. In Africa, which accounts for 90% of global cases of malaria, water stress plays an indirect role in curing malaria because it impedes the human recovery process.
When slum dwelling populations such as Namuwongo have limited access to water hygiene practice and present repeated incidences of waterborne diseases. This is a great public health threat which strains health budgets, calls for immediate deployment of health cadres to curb such waterborne diseases (WHO/UNICEF, 2013), and puts stress on the fewer available health facilities through congestion. Providing for water hygiene practice would act as preventive strategy that will lessen public health expenditure (MOH, 2012).
The World Health Organization and other major global public health organizations define safe water access as reasonable access through an improved or an unimproved source (WHO, 2015). An improved source of safe water consists of one of the following: a piped household connection, public standpipe, borehole, protected dug well or spring, and/or rainwater collection. An unimproved source is considered any of the following: vendors, tanker trucks, surface water, bottled water (due to the inability to confirm source and quality), and unprotected dug wells and/or springs. Reasonable access to an improved source is defined as the availability of at least 20 liters a person a day from a source within one kilometer (6 miles) of the dwelling (Global Water, Sanitation and Hygiene, 2012).
Globally, an estimated 1.7 million people die annually of waterborne diseases. Water misuse is responsible for 90% of diarrhea-related mortality more than combined mortality from malaria and HIV/AIDS (UN Water. 2015). Although piped water facility in the rural regions almost doubled in past two decades, 171 million people in rural regions use surface water as the primary source of water (WHO, UNICEF, 2013).Over 783 million people do not have access to clean and safe water worldwide, 37% of those people live in Sub-Saharan Africa, 443 million school days are lost each year due to water-related diseases and 84% of the people who don't have access to improved water, live in rural areas, where they live principally through subsistence agriculture (WHO, 2015).
Coverage of safe water in Eastern Asia increased by 27% points and exceeded the MDG target, with over half a billion people gaining access in China alone. Access in Southern Asia and South-eastern Asia rose by 20% and 19% respectively, and these regions met the target. In Africa about 85% of the water is used in agriculture. Only 10% is used in households and only 5% in the industry. Because of the growing population there will be absolutely used more and more water in agriculture.
In sub-Saharan Africa, 427 million people gained access during the MDG period – an average of 47000 people per day for 25 years, In 2015 only 3 countries – Angola, Equatorial Guinea and Papua New Guinea – have coverage of less than 50%, compared to 23 countries in 1990.SubSaharan Africa did not meet the MDG target but still achieved a 20% point increase in the use of improved sources of drinking water. There are rural and urban disparities, 96% of the global urban population uses improved drinking water sources, compared with 84% of the rural population, 80% still do not have improved drinking water sources live in rural areas.
The populations without access are mainly in sub-Saharan Africa and Asia; Sub Saharan Africa – 319 million, Southern Asia – 134 million, Eastern Asia – 65 million, South Eastern Asia – 61 million and All other regions – 84 million. 842000 deaths from diarrhoeal diseases each year could be prevented by improved water, sanitation and hygiene Globally, an estimate of more than 340,000 children under five die annually from diarrheal diseases due to unsafe drinking water – that is almost 1000 per day.
In Africa, 42% of health facilities do not have access to an improved water source within 500 metres. The Joint Monitoring Programme‘s(2012) report, notes that, in a Nigeria a population of 46.7 million, 17.3 million lack access to safe water. Access to safe water supplies throughout Nigeria is 59%, in Tanzania 23 million people did not have choice but used unsafe water WHO, (2015).
Kaduna state with about 2 million people has only 8% of Kaduna state‘s 2 million people have access to the sewer pipes operated by NWSC (Kamara, 2012).The increase in Kaduna state City‘s urban population has an stimulated exponential growth of informal settlements. Increase in slum population with less access to safe drinking water and improved sanitation is a public health threat (Kamara, 2012).
Kaduna state‘s formal water supply (production capacity currently 100,000 m3 per day) is drawn from Lake Victoria‘s Inner Murchison Bay (Water-technology.net 2010). UNDP data: in-plot piped supply 36% of households, piped supply from community standpipe 5% of households, non-piped supply or water vendors 59% of households. Promotion and provision of low-cost technologies that enable improved water, sanitation, and hygiene (WASH) practices are seen as viable solutions for reducing high rates of morbidity and mortality due to enteric illnesses in lowincome countries (Classen, et al, 2007).
This study assesses the knowledge level of community members of Iboko Kaduna state on water born disease prevention practice, assess their attitudes and establish community practices that could improve or hinder access to water hygiene practice.
1.2 Problem statement
Limited access to water hygiene practice can result in water borne diseases which can cause morbidity and loss of a productive population in terms of labour as well as mortalities, a case in point the recent (2015) typhoid outbreak in Kaduna state. St Luke’s College Of Nursing Science Wusasa is one of the major slums surrounding Kaduna state. For istance, a total of 560 people were diagnosed with typhoid, just in three days in February 2015 (Nantambi and Waiswa, 2015). Two of 506 died. All the five hundred and sixty patients were admitted at Kisenyi Health Centre IV, Kaduna state. Such an acute outbreak of typhoid and consequently admissions puts a burden on the KCAA health budget.
Communities drain water from unsafe water points especially to low income earners. An estimated 884 million people lack access to safe drinking water and contaminated water is responsible for 1.6 million deaths per year, primarily in children under age 5 (Global Water, Sanitation, 2012). Communities in slums environments are limited in terms of access to safe water provisioning points.
The NWSC has tried to supply piped water across the city, with reports putting access to safe water at 77% (Kagolo, 2012). For one to be considered having access to clean/safe water means that the water source is 250 metres from his home. However, those with the highest access are in upscale city suburbs. According to a report by the Africa Development Bank (AFDB), only about 17% of the population in informal settlements (slums) had safe water access by 2006. Inaccessibility, coupled with poverty and the high tariffs of piped water, have compelled most slums dwellers to rely on spring wells for water. This study intends to assess the knowledge, attitudes and water hygiene practice among community members of St Luke’s College Of Nursing Science Wusasa, Kaduna state.
1.3 Objectives
1.3.1 Main objective
The main objective of the study was to determine the importance of water hygiene practice among community members of St Luke’s College Of Nursing Science Wusasa Kaduna state in order to minimize the prevalence of waterborne diseases.
1.3.2 Specific Objectives
The study based on the following specific objectives
• To assess the knowledge on water born disease prevention practice among the community members of St Luke’s College Of Nursing Science Wusasa Kaduna state.
• To assess the attitudes on water born disease prevention practice among the community members of St Luke’s College Of Nursing Science Wusasa Kaduna state.
• To establish the practices among the community members of St Luke’s College Of Nursing Science Wusasa Kaduna state on water born disease prevention practice.
1.4 Research Questions
• What is the knowledge level of community members of St Luke’s College Of Nursing Science Wusasa Kaduna state on water born disease prevention practice?
• What are the attitudes of the community members of St Luke’s College Of Nursing Science Wusasa Kaduna state on water born disease prevention practice?
• What are the water hygiene practices of members of St Luke’s College Of Nursing Science Wusasa Kaduna state that are directed towards preventing water borne diseases?
1.5 Justification/significance
Water hygiene practice is a pre-requisite to preventing waterborne related diseases such as typhoid which is caused by salmonella typhi, cholera, shigellosis, amebiasis, among others. Thus this is timely to guide city authorities on promotion of use of safe water among communities of Iboko, since outbreak of water borne diseases strains health the public health budget, this research is vital in identifying community practices that hinder access to water hygiene practice, measure their attitudes towards water hygiene practice and suggest measures to Uyo Capital City Authority to deal with the challenges of water borne diseases that are of public health interest.
This study was significant to the researcher since it is leading to the award of Bachelor of Science Nursing of International Health Sciences University, Nigeria.
The study has generated data for policy makers such as Uyo Capital City Authority for proper decision making on safe water provisioning to slum dwellers. It is also an addition to the knowledge base on water born disease prevention practice especially in slum environment.
The study has further generated ideas to local council authorities on involvement of community leaders in promoting safe water access as a pre-requisite for waterborne disease prevention. This KAP could be essential to help plan, implement and evaluate water hygiene practice in St Luke’s College Of Nursing Science Wusasa, Kaduna state by Uyo Capital City Authority.
1.7 Scope of the study
1.7.1 Time scope
The study was conducted in July 2023.
1.7.2 Geographical scope
St Luke’s College Of Nursing Science Wusasa is located in Zaria LGA, Kaduna state city.
1.7.3 Subject scope
The study assessed the knowledge of community members on water born disease prevention practice, enlisted their attitudes on safe water access and established community‘s practices that hindered accessibility to safe and clean water in St Luke’s College Of Nursing Science Wusasa Kaduna state.
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