Determinants of sustaining open defecation free (ODF) status among households in Kowili sub location, Rachuonyo North sub-county, Homa Bay County, Kenya: a case-control study

Abstract

Introduction: globally, there is a focus towards improving hygiene and sanitation as demonstrated in the 6th Sustainable Development Goal which aims at supporting and strengthening communities to participate and improve their hygiene and sanitation. This is primarily because implementation of global strategies such as Community-Led Total Sanitation (CLTS) has been derailed, as shown by communities reverting to open defecation (OD). Therefore, this study aimed at determining factors influencing the sustenance of the open defecation free (ODF) environment in Kowili sub-location. Methods: the study implemented a descriptive cross-sectional study design where a structured questionnaire and FGD guide were used. Random sampling and purposive sampling were used to identify households and FGD participants, respectively. The quantitative data was subjected to descriptive and regression analysis, while the qualitative data was subjected to thematic analysis. Data was analysed using SPSS version 20 at a 95% confidence interval. Data was presented using graphs and tables. Ethical clearance was sought from the University of Eastern Africa, Baraton, Kenya. Permission and consent were sought from National Commission for Science, Technology & Innovation, Kenya (NACOSTI) and the study participants, respectively. Results: the rate of sustenance of the ODF environment in Kowili sublocation was 77.5%. Socio-demographic factors reported to significantly influence the sustenance of ODF status were age, marital status, household head, and family size. Additionally, other factors reported to influence the sustenance of ODF status were continuous health education, continuous follow-up, provincial administration involvement, and law enforcement by relevant agencies. Conclusion: the sustenance of the ODF environment in Kowili sub-location is considerably good. However, there should be more intervention by stakeholders in ensuring that an ODF environment is sustained.