Predictors of the resurgence and sustainability of open defecation-free status among adult residents in Kibwezi East Sub County, Makueni County, Kenya

Joshua M. Mutuku; Joseph Juma; Bibianne W. Aidi

doi:10.18203/2394-6040.ijcmph20240250

Authors

Joshua M. Mutuku Department of Epidemiology and Biostatistics, Mount Kenya University, Kenya
Joseph Juma Department of Epidemiology and Biostatistics, Mount Kenya University, Kenya
Bibianne W. Aidi Department of Epidemiology and Biostatistics, Mount Kenya University, Kenya

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20240250

Keywords:

Resurgence, Sustainability, Open defecation, Open defecation free, Adult residents

Abstract

Background: Worldwide, 2.4 billion persons lack improved sanitation and practice open defecation. In Kenya, about 14% of its population defecates in the open and the country loses over $324 million a year due to poor sanitation. The study focused on establishing infrastructural factors influencing the resurgence and sustainability of open-defecation-free status among adult residents in Kibwezi East Sub-County of Makueni County, Kenya.

Methods: The study employed purposeful, cluster, proportionate, simple random sampling and descriptive cross-sectional design. Participants included residents aged 18 or older, who lived in the area at least two years. Chi-square tests at p≤0.05 examined relationships between independent and dependent variables.

Results: Majority of respondents were Christian (98.8%), with 52.9% completing primary education. Most were female (68.6%), married (89.1%), and averaged 48.40 years. Education at or below primary level increased the likelihood of not sustaining ODF practices (uOR=1.567, 95% CI: 1.061-2.315, p=0.024). Sanitary facilities were often within 10-50 m (59.5%), with a median walk time of 3.0 min. ODF sustainability was less likely without user-friendly facilities (uOR=2.47, p<0.001) and with roofless toilets (uOR=0.355, p<0.001). Longer walking times (>3 min) reduced ODF sustainability (uOR=0.341, p<0.001). Absence of designated open defecation sites increased ODF odds by 1.669 times (UOR=1.669, p<0.001), and odor-free toilets enhanced sustainability (UOR=1.287, p=0.030).

Conclusions: The results highlight the significance of socio-demographic factors, including education levels, and infrastructural in maintaining ODF status.

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