Access to improved sanitation among households in peri urban area in Bwaise II Parish, Kawempe Division: A cross sectional study

Abstract

Introduction: Sustainable Development Goal (SDG) target 6.2 aims at achieving universal access to sanitation, leaving no one behind by 2030. To enhance this achievement, SDG target 1.4 aims at basic sanitation for all especially the poor and vulnerable. As such, improved sanitation has now been restricted to at least using improved sanitation facilities which are not shared by other households. This study assessed improved sanitation among households as per the Joint Monitoring Programme indicators to determine the current status of improved sanitation in Kawempe division as previous efforts to improve sanitation and research have been focused on improved technology types regardless of whether they are shared or not. Objective: To determine the proportion of households with access to improved sanitation and associated factors, environmental and policy influencing factors in Bwaise II, Kawempe division. Methods: This was a cross sectional study that utilized both quantitative and qualitative methods of data collection from household heads and key informants respectively. A household based study and key informant interviews were therefore conducted in this regard. Statistical data analysis was by logistic regression in STATA 15 software. Qualitative data were analysed thematically. Coding of data were done manually and themes identified, marched and collated together in tables. Quotes from key informants were identified, summarised and reported. Results: Access to improved sanitation was at 36.2%. Households heads in agegroup above 50 years and those with above secondary level of education were more likely to have improved sanitation (AOR : 4.21, 95% CI: 1.62-10.95) and (AOR: 5.12, 95% CI : 2.00 -13.16) respectively. Households with wife present at home during the week were less likely to have access to improved sanitation (AOR: 0.57, 95% CI 0.33 – 0.99). Ownership of a housing unit (landlord) was positively associated with access to improved sanitation (AOR: 4.04, 95% CI: 2.26 – 7.25). Collapsing soils, high water table, flooding and weak enforcement for Public Health Act (PHA) and sanitation related regulations, unfavourable land system of tenure are environmental and policy related factors respectively that limit improved sanitation in Bwaise II. Conclusion and recommendation: Access to improved sanitation was low with majority of the population using shared sanitation facilities. Access to improved sanitation was significantly higher among those who were in the above 50 years age group, those with above secondary education and those who were landlords. Factors that influenced access to improved sanitation were nature of soils, high water table, and unfavourable land tenure system. Sanitation programmes need to explore low cost and water proof technology options to promote and scale up construction of household sanitation facilities to enhance progress towards realisation of improved sanitation for all.