Open Defecation Practices in Lodwar, Kenya: A Mixed-Methods Research

Area of Science:

• Public Health
• Environmental Health
• Sociology

Background:

• Globally, 2.5 billion people lacked improved sanitation in 2014, with Sub-Saharan Africa, including Kenya, disproportionately affected.
• Open defecation (OD) remains a critical issue in Turkana County, Kenya, with over 72% of the population practicing it despite ongoing interventions.

Purpose of the Study:

• To investigate the socioeconomic factors associated with the practice of open defecation (OD) in human settlements within Lodwar, Turkana County.
• To understand the underlying reasons for the high prevalence of OD in the region.

Main Methods:

• A cross-sectional study employing a partially mixed sequential dominant (quantitative) design.
• Data collected through standardized questionnaires, focus group discussions, and key informant interviews with participants selected via simple random sampling.

Main Results:

• Culture emerged as the leading factor for OD practice (44%), with poverty significantly influencing latrine ownership (27%).
• Significant associations were found between latrine presence and education level, latrine sharing, and occupation of the household head.
• Key cultural factors contributing to OD included habit, nomadic pastoralism, and specific beliefs, with OD being a common habit (31.3%) and nomadic lifestyle limiting construction (28.1%).

Conclusions:

• High poverty levels and cultural aspects are significant determinants of latrine adoption and continued OD practices.
• Future sanitation interventions must integrate an understanding of cultural contexts to develop effective OD eradication strategies.
• Poverty eradication and existing sanitation campaigns have faced challenges, highlighting the need for culturally sensitive approaches.