Abstract:
Abstract
Background: - Globally there are still 46 countries where less than half the population
has access to an improved sanitation facility. Among the world’s regions, Southern Asia
and sub-Saharan Africa continue to have the lowest levels of sanitation coverage. So to
combat the problems of hygiene and sanitation in Africa Community led total sanitation
is the best choice. However, data on the level of implementation of community led total
sanitation and associated factors are scanty and there is a lack of rigorous and objective
data, particularly in the study area and Ethiopia at large.
Objective: To assess community led total sanitation achievement and associated
factors and challenges among rural communities of the South Achefer District,
Northwest Ethiopia.
Methods: community based cross-sectional triangulated with a qualitative study was
conducted among 595 participants from March – April 30/2018. Data were collected
using a pretested structured questionnaire, observation checklist and focus group
discussion and interview guide. Multistage sampling technique was applied. Data were
entered using Epi info version 7 and analyzed using SPSS version 23 statistical
software. Bi-variable and multivariable binary logistic regression model were done to
identify associated factors of community led total sanitation achievement. For qualitative
study, the audio data from focus group discussions and key informant interviews were
transcribed and translated to English. Responses arranged in general categories using
discussion and interview guide and were analyzed manually using a content thematic
approach identified in the discussion guide.
Results: The proportion of community led total sanitation achievement was (12.01%
95% CI: 9.4%, 14.4%) among rural communities. household head of educational status
who learned to five and above (AOR= 2.73, 95% CI (1.16, 6.39), household head of
monthly income who had greater than 3800 birr per month (AOR=2.55, 95% CI (1.09,
5.98), household trained triggering steps of glass of water exercise (AOR= 2.98, 95% CI
(1.26, 7.03) and respondent visited by health extension workers at least in two months
(AOR= 3.14, (95% CI (1.59, 6.20) were statistically significant with community led total
sanitation achievement. Lack of frequent supervision and follow-up, lack of forma
