ABSTRACT
Introduction: The ministry of health has advocated for the people to construct proper human
waste disposal facilities to enable the elimination of the negative consequence of poor human
wastes disposal like disease andenvironmental pollution, despite, this there is still high-level of
improper human waste disposal. The general study objective was to determine factors associated
with human waste disposal of children aged 0-59 months in Banda parish, Nakawa division
Kampala division. The specific objectives were; to determine how the social demographic
factors influence Human waste disposal and to assess the knowledge of human waste disposal in
Banda parish.
Methods: The sample size was 100 respondents from Banda parish. The sample was selected
using systematic random. Face to Face were used to collect data using structured questionnaire.
While analysis was done using excel and SPSS tool for means and percentage.
Results: Majority 65% of care takers were in the age bracket of 26-35 years of age and only 35%
were in the age brackets of 19-35 years and 40% of the children were in the age bracket of 13-24
months.
Majority 60% of the care takers stated that they disposed off the children waste in the latrine;
however 20% stated that they used open defecation while only 5% stated they used Toilet
However the results indicates that 20% of the respondents asserted that children’s waste openly.
According to the findings 50% of the respondents assert that hygiene was the major reason for
proper human waste disposal and the remaining 50% asserted that prevention of infection, while
none of the respondents asserted that it leads to pollution.
The results indicate that 60% of the respondents stated that disease was the main consequences
of poor human waste disposal, while 40% stated that it led to water contamination.
Conclusion and recommendation: There is significant relationship between social
demographic factors like religion, gender; tribe of the child against the human waste disposal.
Thestudy recommends that the government should sensitize people on the proper ways of faecal
disposal.
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CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
The human population produces a significant amount of human waste every year. Disposing of
the waste is often done unsafely, with some solid waste disposed of in drinking water, and others
left in landfills. Each year, waterborne illnesses caused by improper disposalof solid waste, is the
major greatest cause of death in the world. More people are dying of infections and diseases
caused by unsafe water than armed conflict, despite this fact, discussion of sanitation practices as
a focus of public conversations is rare in most places in the world (Tamang, et al, 2014).
Safe human waste management guidelines have been developed,the international community and
many nations have not made steps to improve public sanitation, In large part, this is due to lack
of infrastructure and resources (Almazor, 2011).
The sanitation in most parts of Mumbai is one of the worst in the world because of open
defecation for the children under the age 0-59 Months (World Bank, 2016).
According to the World Health Organization (WHO) and the United Nations Children’s Fund
(UNICEF) an estimated 2.6 billion people lack access to improved facilities for the disposal of
human excreta, such as a basic pit latrine, a toilet connected to a septic tank or piped sewer
system, or a composting toilet (WHO, UNICEF, 2010).
Children of 0-59 months in Uganda normally dispose off their waste in open because most of the
different cultures view open defecation for children as a normal issue and they do not pay
attention to the sanitation aspects of it (Tamang, et al, 2014).
Poor Health conditions in many parts of the country are a result of open defecation of children 0-
59 months (UNICEF, 2016).
2.8 million Children of 0-59 months in Kenya are still defecating in the open, the prevalence of
diseases such as diarrhoea, typhoid and cholera will continue to persist unless drastic action is
taken to raise the knowledge and awareness levels on latrine use (WHO and UNICEF 2015).
Change attitudes towards use of latrines as well as promote adoption of appropriate latrine
hygiene practices at the household level (Moore, 2010).
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An estimated 150 million children of (0-59 months) in urban areas of the Third World now live
in life-and health threatening homes and neighborhoods (Anteneh et al, (2010).
Many of Peri-urban settlements in slum areas of african towns and cities face a serious challenge
of poor human waste disposal of children (0-59 months) (WASH, 2011).
Poor sanitation caused by open defecation of children 0-59 months costs Uganda Shs. 389 billion
each year, a sum equivalent to Shs15,000 per person or 1.1 per cent of the national Gross
Domestic Product (Tsiboe, 2014).
The culture of open defecation by Ugandan children has placed Ugandans at the risk of
sanitation-related diseases such as cholera, diarrhea and typhoid, among others. In rural areas and
communities along the water bodies, the few available public pit-latrines are only used by adults
therefore children 0-59 months are not allowed to use them (World Bank, 2012).
Banda parish in Kampala is pre-urban settlement faced with numerous challenges like inadequate
Human waste disposal facilities (UBOS, 2014).
This study therefore determined factors associated with human waste disposal of children aged
0-59 months in Banda Parish, Nakawa Division, Kampala District.
`
1.2 Statement of the problem
The poor human waste disposal by children 0-59 months in Banda has accelerated numerous
diseasesto both the children and the community members, this has mainly been because
ofinadequate latrines in these areas, this was shown by the fact that the residents who don’t have
latrines defecate in polythene papers and throw it on the road side at night (World Bank, 2015).
Proper disposal of Human waste for children 0-59 months are a challenge to many communities
in Uganda such as Banda parish. Uganda as a country loses about 19.8 billion shillings each
years because of the poor disposal of human waste for children 0-59 months ((World Bank,
2015).
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The ministry of Health has advocated for the Parents to construct proper human waste disposal
facilities for children (0-59 MONTHS) to enable the elimination of the negative consequence of
poor Human waste disposal.
However despite this there is still high level of poor Human waste disposal of children aged 0-59
months, this study therefore intended to investigate the factors associated with human waste
disposal of children 0-59 months in Banda parish, Nakawa Division, Kampala District.
1.3 OBJECTIVES OF THE STUDY
1.3.1 General Objective
The general objective of the study was to determine the factors associated with human waste
disposal among children aged 0-59 months in Banda parish, Nakawa division, Kampala District.
1.3.2 Specific Objectives
The specific objectives of the study were;
(i) To determine the socio-demographic factors on Human waste disposal.
(ii) To determine human waste disposal methods in Banda parish
(iii) To assess knowledge of human waste disposal in Banda Parish.
Research Questions
(i) What are the socio-demographic considerations on Human waste disposal?
(ii) What are human waste disposal methods in Banda parish?
(iii) What is the knowledge of human waste disposal in Banda Parish?
Indicators of the study.
(i) The age, sex and religious implication on the use of human waste disposal method?
(ii) The proportion of people with latrines or toilets.
(iii) Proportion of people with knowledge on human waste disposal
1.5 Justification of the study
The study will provide information on the different methods of waste disposal; this will help the
policy makers to design appropriate methods of human waste disposal of the children 0-59
months.
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The study will provide information on knowledge about human waste disposal for children 0 –
59 months.
This data will provide focused discussions on aspects that the community in Banda will not
know about human waste disposal of children 0-59 months.
1.6 Significance of the study
The study will help the researcher be able to obtain her university Degree of Bachelor of
Education with Home economics, since it is a requirement to be fulfilled before one
graduate. The researcher will gain knowledge to advise others in similar types of research.
1.7 CONCEPTUAL FRAME WORK
Human Waste
Solid waste
Urine
vomit
Methods
Open defecation
Toilets
Latrines
potty
Knowledge
Consequences
Benefits
Types
Social demographic
Age
Sex
religion
religion
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The conceptual frame work shows that different human waste include ;Solid waste, Urine, vomit
and the different human waste methods include; Open defecation, Toilets, Latrines and potty.
The conceptual frame work further indicated that the social demographic characteristics include;
Age, Sex and religion.
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CHAPTER TWO
LITERATURE REVIEW
2.0 Introduction
Current official statistics suggest that about 2.6 billion people do not have access to improved
sanitation. Out of this number, about 1.98 billion (75%) live in Asia; 0.47 billion (18%) in
Africa; and 0.13 billion (5%) in Latin America and Caribbean (SIWI, 2005). In the view of
Kabbaj (2005), about 400 million, which is almost half of all Africans, lack access to basic
sanitation.
Worldwide, it is stated that there are twice as many children of 0-59 months lacking access to
improved sanitation facilities as those lacking access to improved water supply; and that four out
of every ten people do not even have a simple pit latrine (Lenton et al, 2005; WHO/UNICEF,
2004).
The lack of decent latrines and toilets has led to the deaths of about 3,900 children 0-59 months
every day (WHO, 2003; UNICEF, 2006).
2.1 Methods of human waste disposal
Poor sanitation caused by open defecation of children under five years costs Uganda Shs389
billion each year, a sum equivalent to 15,000 shillings per person or 1.1 per cent of the national
Gross Domestic Product (GDP).
2.1.1 Toilets
A toilet is a sanitation fixture used for the storing or disposal of human urine and feces. In
developed countries, different forms of porcelain flush toilets are common seats are usually used
in the West while squat toilets are common in East Asia (Rosenberg, et al, 2011).
These are connected to a sewer system in most urban areas and to septic tanks in less built-up
areas. In many developing countries, especially in rural areas, dry toilets such as pit
latrines and composting toilets remain common this is due to their affordability and the fact that
if a country has water then toilet can be used as a method of waste disposal ( Babcock et al,
2013).
Due to the lack of water in India and other developing countries especially in sub-SaharanAfrica,
the western style toilets are completely impractical moreover, the resources needed to construct
18
and operate sewage treatment plants make the western toilet inappropriate for developing
countries both in Africa and India. Alternatives that are cheaper, environmentally friendly and
more efficient and that take the scarcity of water and monetary resources into consideration
(AlMazroa et al, 2013).
More than one third of the global population 2.5 billion people do not use an improved sanitation
facility, and of these 1 billion people still practice open defecation (WHO, 2015).
Most developing countries national target is to achieve total sanitation through the use of toilets
by the year 2017 (SHMP, 2011). There are 5.427 million households in Nepal and 2069430
numbers of toilets are yet to be constructed in the country (CBS, 2011). This is a large number
and challenging to construct within a given timeframe. Thus, it would be better to build the
toilets through social mobilization at a cheap rate (Tamang,et al, (2014)
2.1.2 Pit Latrines
As of 2013 pit latrines were used by an estimated 1.77 billion people, this is mostly in
the developing world as well as in rural and wilderness areas. In 2011 about 2.5 billion people
did not have access to a proper latrine and one billion resort to open defecation in their
surroundings (UNICEF, 2012).
Southern Asia and Sub-Saharan Africa have the poorest access to latrine. In developing
countries the cost of a simple pit latrine is typically between 25 and 60 USD. Ongoing
maintenance costs are between 1.5 and 4 USD per person per year which are often not taken into
consideration (Falade et al, 2012).
A latrine is a place for urination and defecation, human and water waste from the household
called sewage should be disposed of immediately in the latrine. Some rural areas which have
good water supply can use a septic tank and get rid of sewage. In urban areas, sewage is led
away by drains and large pipes known as sewers and disposed of by other means.Faeces transmit
several infections therefore it is a hazardous material whose disposal must be managed correctly
to maintain public health.Latrines are common in most of the under developed places of the
world because oftheir low construction costs (Agarwal et al, 2013).
When properly built and maintained they can decrease the spread of disease by reducing the
amount of human feces in the environment from open defecation. This decreases the transfer
19
of pathogens between feces and food by flies. These pathogens are major causes of infectious
diarrhea and intestinal worm infections. Infectious diarrhea resulted in about 700,000 deaths in
children under five years old in 2011 and 250 million lost school days, (Pit latrines are the lowest
cost method of separating feces from people (UN, 2010).
2.1.3 Open Defecation
Human Excreta management deals with on-site sanitation systems. Human excreta may be
treated in separate treatment works or co-treated with sludges produced in wastewater treatment
plants (MoH, 2013).
Open defecation fell by a remarkable 21%, from 1.3 billion in 1990 to one billion in 2012
globally. Those one billion people with no sanitation facility whatsoever continue to defecate in
gutters, behind bushes or in open water bodies, with no dignity or privacy. Nine out of 10 people
who practice open defecation live in rural areas, but the number in urban areas is gradually
increasing. (UNICEF, 2015).
Human Excreta Value in our present day sludge is now considered as a problem. Long before
any complete collection scheme was implementedurban areas had to deal with its organic by-
products (human & animal excreta, food leftovers and various wastes from numerous places).
Some wastes were directly recycled by source collection meanwhile others were valueless and
disposed in special areas (Aidonidis et al, 2014).
2.1.4 Potty
A potty is a proportionately small chair or enclosure with an opening for seating (Nemeth et al,
2003).
There are two basic types of potty seats. The first is a stand-alone potty that children sit on.
These come with a bowl that is emptied in toilet or openly.
The second type is a seat that fits on top of a toilet seat. These help children fit onto the seat and
help them feel safe (African research review. 2009).
The potty is mainly used by the children in the urban areas this is because parents can afford to
buy them unlike in rural areas who are poor and view a potty as luxury and therefore their
children use open defecation (Kumie, 2010).
2.2.1 Socio- demographics
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2.2.1 Tribe
Most of the pastoral tribes in Uganda like Karamajongs do not use latrines because the, culture
permits opendefecation of children below 0-59 months however this has affected the sanitation
of the community due to escalation of many diseases in the area which has been brought up due
to poor human waste disposal practices (Tamang, 2014).
Most of the nomadic tribes do not use modern human waste disposal methods therefore they
resort to open defecation because they often live a life of temporary settlement (Mastitsky,2010).
As a result, nomadic tribes are rarely subjected to new ideas and become deeply entrenched in
their beliefs. These characteristics therefore makes the nomadic tribes to use encourage their
children to use open defecation. (Mastitsky, 2012)
The tribes which practice agriculture have a relatively stable settlement therefore such tribes will
tend to construct human waste disposal facilities like pit latrines (Schott et al, 2012).
The demographic make-up of a family determines the character of the members and this also
dictates thebehavior of the people, (Kosek, 2012).
In many cultures, for example, masai encourage their children to use open defecation for children
0-59 months (Dahal et al, 2014).
2.2.2 Age
Human faeces if left exposed can lead to various diseases therefore lowering the quality of life of
both children and adults in the area.Reckless disposal of human waste has been mainly more
dangerous because of the increase in the number of people in the world.However most of the
people who practice open defecation are mainly young children, this is because of the
communities in Africa view open defecation by children as normal (UNICEF, 2014).
The age of the people also influences how people interpret and evaluate the environment in
which they live. Investments in sanitation seek to improve health by providing a clean physical
21
environment for households. When sanitation behaviour is found to vary widely between
communities within the same physical environment, predetermined rules cannot be applied.
However, the sanitation behaviour of individuals usually has a rational basis, and people are
often aware of the environmental causes of ill-health (Zerbock, 2013).
The different disposal methods of human waste in some parts of the African continent and India
are determined by the age of the children (Moore, 2012).
The children 0-59 months are allowed to dispose of their feaaces openly because the parents fear
that the young children will fall inside the latrines (Narayan, 2010).
2.2.3 Family Size
The size of a family determine the waste disposal method especially in sub-Saharan African
when the family is large and its under extended systems they prefer to use open defecation
because according to most African tradition in-laws are not allowed to share toilets (Aderemi,,
2012).
The demographic make-up of a given family determines the method of disposal of the family
members (Moore, 2012).
2.3 Knowledge of Human waste disposal
The continued neglect of the proper human waste disposal at all levels has been worrying (Water
Aid, 2008).
Overall, 80% of countries recognized right to water compared to just over 50% who recognized
right to human waste disposal method (WHO, 2012).
Until 2010, the United Nations (UN) had not recognized access to safe sanitation as a basic
human right and therefore open defecation for children 0-59 months was very high without any
checks (WHO, 2012).
In order to accelerate progress towards attainment of universal coverage of proper human wastes
disposal. Despite the intensive advocacy and lobby initiatives to raise the sanitation profile
22
globally, the sanitation sector remains underfunded and a key challenge in most developing
countries (WSP, 2012).
Poor human waste disposal challenges is a direct cause of 11% of under-five mortality globally
with developing countries especially Sub Saharan Africa bearing the most consequences; the
major contributing factor being open defecation practiced by 1.1 billion people (UNICEF, 2012).
Increasing access to improved proper human waste disposal is not only possible, it is essential
for nations to prosper, however most of the people in low developed counties like Uganda due to
lack of knowledge they don’t know the benefits of proper human waste disposal for children in
the age brackets of 0-59 months.
Although Governments and other partners continue to make commitments to increase improved
human waste disposal use as well as funding for the sector, the efforts are not adequate to
address the current improved latrine use disparities. Without concerted action, the lack of
sanitation will continue to impact the lives of millions of people and impede progress on
development (Olhoff et al, 2010).
Improving sanitation is not limited to physical-structural aspects but also includes having the
correct knowledge on latrine use and maintenance of those facilities as well as behaviour change
towards more hygienic practices (Orisakwe, et al, 2010).
Sanitation and hygiene are critical to health, survival, and development. Many countries are
challenged in providing adequate sanitation for their entire populations, leaving people at risk of
water, sanitation, and hygiene related diseases. Approximately 19,500 Kenyans, including
17,100 children under the age of five years, die each year from diarrhoea (Gok, 2012).
Diarrhoea prevalence for children in the age brackets of 0-59 months remains at 17% nationally,
but disproportionately, this has been brought about due to the challenges of lack of knowledge by
most of these communities who do not understand the health impacts of improper human waste
disposal (Murray, 2012).
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A household’s decision to adopt the use of human waste disposal facilities has little to do with
the prevention of fecal-oral diseases (Jenkins, 2007).
Despite the fact that human waste disposal method is often perceived to be a household matter,
the influence of wider community factors may not be overruled and an in-depth understanding of
all factors promoting proper human waste disposal method at all levels is valuable (World Bank,
2004).
The benefits of improved latrines tohouseholds in the urban areas cannot be overemphasized. In
the extreme cases of refugee influx (Rosenberg, et al, 2011).
Ownership of a human waste disposal facility does not guarantee health benefits unless the said
facility is utilized effectively (Anteneh, &Kumie, 2010). However, many factors have been
shown to promote proper human waste disposal methods such as behavioral, demographic,
geographic, climatic and economic (LabSpace-the Open university, 2012).
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CHAPTER THREE
RESEARCH METHODOLOGY
3.1 Study Area
Banda is located in Nakawa division specifically on Kampala-Jinja road. Banda is bordered
by KiwatuleBto the north, Kireka to the east, Kinawataka to the southeast, Mbuya to the
south, Nakawa to the southwest, Ntinda to the west and northwest. The location of the hill is
approximately 11 kilometers, Banda has a population of 5,959 and the majority of people are
mainly dealing in small scale business.
3.1 Research Design
Across-sectional study design was used for this study to determine thefactors associated with
human waste disposal of children aged 0-59 months in Banda Parish, Nakawa division, Kampala
district.
Inclusion criteria
The study included children within 0-59 months and their care takers who gave written
information.
Exclusion criteria
The researcher also excluded all the children in the brackets of 0-59 months, who experienced
mental disability and neurological challenges because they could not control their bowel.Care
takers whodid not give consent were excluded.
3.2 Study Population
The study populations were children aged 0-59 months. The care givers of the children were the
primary source of information.
3.4 Sample size and Selection
The sample size was determined using the Kish Leslie (1965).
n= (Z 2 PQ)
d 2
Z= The standard normal deviant (1.96) at 95% confidence level.
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P=The proportion of the survey population with particular characteristics of the study.
Q= The probabilistic derivative.
d=The degree of precision (5%)
n=(1.96) 2 0.9×0.1 = 100
0.05 2
3.5 Sampling procedure and Sampling technique
The study was carried out in Banda which had a total of 12 zones. Each zone was assigned a
unique number using simple random sampling technique the researcher used the ballot method to
select one zone for this study.
Systematic sampling was used to select households. The sampling interval was determined by
using dividing the population size (N) by the sample size of the study (n). According to the LC1
of Banda Parish, the selected zone had … households. The sampling interval for this study was
therefore … the first first household was selected randomly. If a household did not have a child
under 5, then the next household was selected. For households with more than one child, only
one child was selected. Simple random sampling was used for such households by assigning
each child a unique. The ballot method was then used to select the child from the households.
The researcher chose all the households randomly.
The study used systematic random sampling to determine the sample size, The sampling started
by selecting an element from the list at random and then every k th element in the frame was
selected, where k, the sampling interval was calculated as wheren is the sample size, and N is the
population size.
K=N/n
1000/100
K=10HH
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According to the LC I records Banda parish is densely populated and therefore the researcher
chose a total of 10HH.
3.4 Data collection methods
Quantitative data collection methods were used for this study.
During this study the interviews were used to collect information regarding the study this
involved specifically Face to face interviews.
3.5 Data Collection Tools
3.5.1 Semi-Structured Questionnaire
The questionnaire was used for collecting information in line with study objectives that included
socio-demographic factors, human waste disposal methods AND knowledge of human waste
disposal.
3.6 Data analysis and management
Data was coded and entered into SPSS. Data was analyzed using SPSS version 20.0.
Univariable analysis, frequencies and percentages were used.
Human waste disposal methods of children 0-59 months was categorized as poor and good. Open
defection was classified as poor while disposal of wastes using latrines, toilets was classified as
good human waste disposal for children 0-59 months.
Knowledge was categorized as poor or good knowledge. Each question in the knowledge
questionnaire was assigned a score of one. The total score for each respondent was converted to
a percentage. A score percentage of less than 50% was classified as poor knowledge and a score
percentage of more than 50% was classified as good knowledge
Bivariable analysis, chi square was used to determine the relationship between the dependent
variables (human waste disposal for children 0-59 months) and independent variables
(knowledge, socio-demographics). Pvalue of >=0.05 signified statistical significance.
Tables and pie charts were used for data presentation.
27
Bivariate analysis was done using chi-square, (Chi square) test, was used to determine the
relationship between the dependent and independent variables, Pvalue≤0.05 signified statistical
significance.
3.7 Ethical considerations
Permission to carry out the study was sought from the LCI chairperson Zone 8, Banda parish.The
researcher obtained a letter of introduction from Kyambogo University that permitted her to
carry out research in the selected zone of Banda Parish.
Written informed consent was got from the caretakers of the children of confidentiality by
informing them that the study was purely for academic purpose and all the information that were
given by the respondents was treated with confidentiality.
