Author:
Galan Deise I,Kim Seung-Sup,Graham Jay P
Abstract
Abstract
Background
In sub-Saharan Africa, it is estimated that 215 million people continue to engage in open defecation. This practice facilitates the transmission of diarrheal diseases – one of the leading causes of mortality in children under 5 in sub-Saharan Africa. The main purpose of this study is to: estimate changes in open defecation prevalence between 2005 and 2010 across countries in sub-Saharan Africa; examine the association between national level indices and changes in open defecation prevalence; and assess how many countries can achieve ‘open defecation free status’ by 2015.
Methods
After applying selection criteria, this study analyzed country-level data for 34 sub-Saharan African countries. Seven country-level indices were collected: 1) presence of a national sanitation policy; 2) budget line for sanitation; 3) budget allocated to sanitation; 4) annual per capita GDP; 5) GDP growth; 6) implementation of total sanitation approaches; and 7) per capita aid disbursement for water supply and sanitation. The relationships between these country-level indices and the change in open defecation from 2005 to 2010 were investigated using Wilcoxon Signed-Rank test and Spearman's rank correlation test.
Results
Only 3 countries (i.e. Ethiopia, Angola and Sao Tome and Principe) decreased open defecation by 10% or more between 2005 and 2010. No significant associations were observed between the change in open defecation prevalence and all of national level indices except per capita aid disbursement. Per capita aid disbursement for water and sanitation was positively associated with a reduction in open defecation (p-value = 0.02) for a subset of 29 low-income countries from 2005 to 2010. Only one country in our analysis, Angola, is on track to end open defecation by 2015 based on their performance between 2000 and 2010.
Conclusions
Most of the national level indices, including a country’s economic status, were not associated with the change in the open defecation prevalence. Based on current trends, the goal of ending open defecation in the majority of sub-Saharan African countries by 2015 will not be achieved. Our findings may be limited by the exploratory nature of this analysis, and future research is required to identify and characterize national level factors specific to reducing open defecation in sub-Saharan Africa.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference27 articles.
1. WHO: The global burden of disease: 2004 update. 2008, Geneva: World Health Organization
2. Clasen TF, Bostoen K, Schmidt W-P, Boisson S, Fung IC-H, Jenkins MW, Scott B, Sugden S, Cairncross S: Interventions to improve disposal of human excreta for preventing diarrhoea. Cochrane Database Syst Rev. 2010, 6:
3. Aziz KMA, Hoque BA, Hasan KZ, Patwary MY, Huttly SRA, Rahaman MM, Feachem RG: Reduction in diarrhoeal diseases in children in rural Bangladesh by environmental and behavioural modifications. Trans R Soc Trop Med Hyg. 1990, 84: 433-438. 10.1016/0035-9203(90)90353-G.
4. Garrett V, Ogutu P, Mabonga P, Ombeki S, Mwaki A, Aluoch G, Phelan M, Quick RE: Diarrhoea prevention in a high-risk rural Kenyan population through point-of-use chlorination, safe water storage, sanitation, and rainwater harvesting. Epidemiol Infect. 2008, 136: 1463-1471. 10.1017/S095026880700026X.
5. WHO: The World health report: 2005: make every mother and child count. 2005, Geneva: World Health Organization
Cited by
50 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献