Improving Sanitation and Hygiene through Community-Led Total Sanitation: The Zambian Experience

The American Journal of Tropical Medicine and Hygiene
Kojo Yeboah-AntwiDavidson H Hamer

Abstract

In 2012, approximately 5.6 million Zambians did not have access to improved sanitation and around 2.1 million practiced open defecation. The Zambia Sanitation and Hygiene Program (ZSHP), featuring community-led total sanitation, began in November 2011 to increase the use of improved sanitation facilities and adopt positive hygiene practices. Using a pre- and post-design approach with a population-level survey, after 3 years of implementation, we evaluated the impact of ZSHP in randomly selected households in 50 standard enumeration areas (representing 26 of 65 program districts). We interviewed caregivers of children younger than 5 years old (1,204 and 1,170 female caregivers at baseline and end line, respectively) and inspected household toilet facilities and sites for washing hands. At end line, 80% of households had access to improved sanitation facilities versus 64.1% at baseline (prevalence ratio [PR] = 1.25; 95% CI: 1.18-1.31) and 14.1% did not have a toilet facility compared with 19.4% at baseline. At end line, 10.6% of households reported living in an open defecation-free certified village compared with 0.3% at baseline (PR = 32.0; 95% CI: 11.9-86.4). In addition, at end line, 33.4% of households had a specific place fo...Continue Reading

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Citations

Mar 13, 2019·The American Journal of Tropical Medicine and Hygiene·Joe BrownDale Whittington
Feb 27, 2020·International Journal of Environmental Research and Public Health·Anoop JainIsha Ray
May 1, 2021·International Journal of Environmental Research and Public Health·Geteneh Moges AssefaMuluken Dessalegn Muluneh

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