TORORO DISTRICT SANITATION SURVEY

FINAL DRAFT (25/3/93)

DR.C.KARAMAGI AND DR.A.ABODA

With the assistance of;

ABSTRACT:

The Tororo District Sanitation Survey was carried out as part of the Tororo District operational research (OR) course, which was itself a follow-up of the 1990 CHDC/Tororo District CSD linkage workshop recommendations. The main objective of the OR course was to train a core team of health-related personnel based in Tororo District as principal investigators. Experiential training was carried out while conducting a sanitation survey of Tororo District. The focus on sanitation was selected after brain-storming sessions with the Tororo District Health Team, and a review of the available documents. In the UDHS (Kaijuka et al, 1989), the prevalence of diarrhoea was found to be higher among children in the Eastern region. Furthermore, a study that included the eastern area had reported a latrine coverage of 51% to 89%, while less than 5% of the households had improved rubbish disposal methods (UNICEF, 1989).

The Tororo Sanitation Survey was carried out to gather baseline data on factors affecting Tororo District household sanitation patterns and childhood diarrhoeal disease. Specifically, the survey was carried out to;

1. Determine the prevalence and sanitary status of excreta disposal facilities among households in Tororo District;

2. Assess the KAP of Tororo District households regarding food hygiene and refuse disposal;

3. Determine the prevalence of diarrhoeal diseases in young children.

The survey was carried out in Tororo District in July 1991. The study was a cross-sectional survey with a target population of all households in Tororo District. The WHO 30-cluster sampling technique was used to identify 30 clusters corresponding to three fifths of the sub-counties in Tororo District. Twenty-nine clusters were rural, and one was in Tororo Municipality. The survey consisted of a household sanitation survey and a survey of community leaders for constraints to sanitation administration. In the household survey, seven households were randomly selected from each cluster, yielding a total of 210 households. In the survey on constraints to sanitation administration, three to five local officials and opinion leaders were selected from each cluster. Pretested, interviewer-administered questionnaires were used in both surveys.

Only 48% of the sampled households had functionally appropriate latrines. Most of the latrines were made of semi-permanent materials, and timber was a limiting resource. Basic knowledge of the value of latrines ranged between 48% and 73%, whereas negative traditional beliefs and attitudes have a minor role (2%-8%). Water was a felt need of the district, and was perceived as a greater priority than sanitation. Handwashing was infrequently done, even after stooling. Storage facilities for food and utensils were generally lacking. The two wek recall of diarrhoea in children under age five was 19%, lower than that reported in the 1988/89 UDHS.

Illness was said by the community leaders to be the major problem in the district. Lack of water, tsetse flies, mosquitoes, and lack of latrines were perceived as the main contributory factors to ill health. Lack of effort was the main obstacle to sanitation activities. Other obstacles included lack of tools and materials, lack of specific knowledge, lack of funds, and insufficient transport. Suggested solutions included community mobilization, formation of sanitation maintenance crews, health education, provision of tools and materials, and enforcement of public health by-laws.