Thesis:

Determinants of open defecation among community members in Mathioya sub county, Murang’a county, Kenya

Open defecation is still a grave public-health concern in many countries across Africa and the Region. In Kenya, despite the widespread implementation of Community-Led Total Sanitation (CLTS) initiatives aimed at eliminating open defecation, approximately 5.6 million individuals continue to engage in the practice, thereby perpetuating the transmission of faeco-oral diseases. According to the 2019 national census, overall sanitation coverage stood at 65 percent—56 percent in rural regions and 79 percent in urban areas. Nevertheless, inadequate sanitation continues to exact significant economic, health, and social tolls, with the annual cost estimated at KES 27 billion. Poor sanitation elevates morbidity and mortality, threatens water quality, and erodes human dignity.This study set out to identify factors sustaining open defecation in Mathioya Sub-County, Murang’a County. It specifically examined residents’ comprehension of the practice, their use of latrines, and the reach of CLTS interventions. Using a cross-sectional design, the research engaged 185 household members and CLTS implementers selected through random sampling. Data were gathered via structured interviews, questionnaires, observation checklists, and a focus-group discussion guide. Quantitative information was processed with SPSS 23.1 for descriptive statistics. A chi-square test linking sociodemographic traits to open defecation indicated that marital status was significant, χ²(3, N = 185) = 18.63, p < 0.001. Regression analyses showed significant effects for knowledge (F (2, 358) = 28.02, p = 0.002, R² = 0.32), latrine cleanliness (F (3, 184) = 35.80, p < 0.001, R² = 0.91), and latrine sharing (F (3, 184) = 24.18, p < 0.001, R² = 0.44).Qualitative findings, organized around the study variables, indicated that most participants understood what open defecation entails, learning primarily from Community Health Volunteers. Nonetheless, the practice persisted largely because of limited knowledge depth. Many latrines lacked hand-washing stations with running water, soap, or anal-cleansing materials, and most were simple pit latrines situated some distance from dwellings to minimize odour and flies. Although a sizeable share of households recognized the dangers of open defecation, the behavior still occurred both within homes and across the wider community. The study therefore highlights a significant knowledge gap among household members and confirms that open defecation remains prevalent at multiple levels in Mathioya.