ASSESSMENT OF COMMUNITY LED TOTAL SANITATION ACHIEVEMENT AND ASSOCIATED FACTORS IN RURAL COMMUNITIES OF SOUTH ACHEFER, WEST GOJJAM, NORTHWESTERN ETHIOPIA, 2018.

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