Water, Sanitation and Hygiene Indicator Levels Eight Years Post Community-Led Total Sanitation Implementation in Kajiado County, Kenya

Abstract

Background: The United Nations Sustainable Development Goal (SDG) 3 and 6 aim to improve people's health and wellbeing, as well as expand universal access to safe water and sanitation by 2030. The government of Kenya adopted Community-Led Total Sanitation (CLTS) as an approach to meet these goals. We assessed Water Sanitation and Hygiene (WASH) levels eight years post-CLTS implementation in Kajiado County, inhabited by pastoralists with higher WASH needs in Kenya where two sub-locations were selected.

Materials and  Methods: Through systematic random sampling, we selected 259 household heads from which we collected quantitative data. We collected qualitative data from 16 focus group discussions (FGDs) with the communities. While we analyzed quantitative data using STATA version 15.1 using logistic regression analyses, QSR NVivo version12 analyzed qualitative data. Household latrine ownership was low at 30%.

Results: Only 9% of these latrines contained a handwashing station, of which 86% were functional with water. Over half (50.8%) of the households practised open defecation. A majority (61.4%) of the households fetched water for household use from improved sources. While only 17.4% of households treated their water before drinking mainly through boiling, our water bacteriological analysis detected widespread contamination. We reported a 45.1% prevalence of diarrhoea cases among under-five-year-old children at the time of the study, predominantly from Namelok sub-location. Independent significant factors increasing the risk of diarrhoea included the use of unimproved water sources (p=0.032) and taking between half to one hour to access a water source (p=0.008). However, significant protective factors included households in Rombo sub-location (p=0.001), household water treatment (p=0.006), and covering water containers (p=0.013).

Conclusion: CLTS approach has not helped households achieve high WASH levels in the study area with the potential for sustaining high diarrhoea prevalence. This highlights the need to focus on increased WASH education and promotion through positive cultural contribution while enhancing access to safe and improved water sources.