Developing a Contextualised Framework for Addressing Harmful Environmental Health Practices in Kano State Using a Classical Delphi Approach: Material and Methods

Abstract

Nearly 1 billion people still practise open defecation globally, and a further 1.4 billion use unimproved toilet facilities (United Nation Children Fund/Water  Sanitation and Hygiene. The problem is principally severe in India, where 44% of the population still practise open defecation and only 40% use improved  sanitation. In sub-Saharan Africa, estimated 215 million people practice open defecation. Up to 105 million Nigerians still do not have access to safe and improve toilets facilities; and out of this figure, nearly 40 million practices open defecation in Nigeria. The overall aim of the study was to develop a  contextualized framework for addressing Open Defecation (OD) in Kano State, Nigeria. The study was conducted using a mixed design by combining both  quantitative and qualitative techniques. A total of 423 head of households participated in the quantitative study within six (6) LGAs in Kano State.  Twelve (12) communities, twelve (12) Adult Almajirai and forty-two (42) Stakeholders participated in the qualitative technique through observation, FGD  and Delphi methods respectively. All statistical data were entered in the Statistical Package for Social Sciences (SPSS) version 23.0 and analysed using  descriptive and inferential statistics. Qualitative data were transcribed, translated and emerging themes were presented thematically. Agreed upon  elements were used to designed the framework using the Delphi technique. The study concluded that there was high level of open defecation in the  State. Factors such as distance, time of the day and weather were identified to influenced the practice. It was therefore, recommended that public health  nurses, government community leaders and community members have an important role to play in eradication of open defecation.