Water Hygiene and Enhancement Strategies Among Pregnant Women Attending Antenatal Care

Water Hygiene and Enhancement Strategies Among Pregnant Women Attending Antenatal Care

Chapter One

Purpose of the Study

This study determined the water hygiene knowledge, attitude, practice (KAP) and enhancement strategies among women attending ANC in Plateau State. Specifically, the study sought and determined:

1. water hygiene knowledge of women attending ANC in Plateau State;
2. water hygiene attitude of women attending ANC in Plateau State;
3. water hygiene practices of women attending ANC in Plateau State;
4. water hygiene knowledge of women attending ANC based on level of education in Plateau State;
5. water hygiene knowledge of women attending ANC based on location in Plateau State;
6. water hygiene attitude of women attending ANC based on level of education in Plateau State;
7. water hygiene attitude of women attending ANC based on location in Plateau State;
8. water hygiene practices of women attending ANC based on level of education in Plateau State;
9. water hygiene practices of women attending ANC based on location in Plateau State; and
10. enhancement strategies of water hygiene KAP of women attending ANC in Plateau State.

CHAPTER TWO

Review of Related Literature

Literatures abound on water hygiene knowledge, attitude and practice (KAP) and enhancement strategies. Moreover, some of the literature had bias to Nigeria but others were from other countries. In order to properly give focus to this study, related literature on water hygiene KAP and enhancement strategies among women attending ANC was reviewed and presented under the following sub-headings:

Conceptual Framework;

• water hygiene;
• knowledge, attitude and practice; Measurement of knowledge, attitude and practice; Enhancement strategies;

Demographic factors associated with water hygiene knowledge, attitude and practice;

Theoretical Framework;

• Social Cognitive Theory (SCT);
• Theory of Change Attitude (TCA);
• Stages of change model (transtheoretical) (SCM);
• Schematic representation of theoretical framework;

Empirical Studies, and Summary of Review of Related Literature.

Conceptual Framework

This section presents the various concepts of water hygiene, knowledge, attitude and practice, components of water hygiene. It also includes enhancement strategies and factors associated with water hygiene knowledge, attitude and practice.

Water hygiene.

Water is an important ingredient necessary to all forms of life. Mathur (2007) viewed water as a great cleaning agent that is used both externally and internally. Leeds (2014) conceived water as any compound that is made of two parts of hydrogen and one part oxygen. Lennthech (2014) refers to water as any substance that makes up the larger part of an organism’s body, which consists of two tiny atom of hydrogen and one of oxygen.

Water as used here-in-after refers to any colourless, odourless, tasteless pleasant tasting liquid that is necessary for all forms of life. It implies that water as cleaning agent may be from diver’s sources. Water for safe use ought to be free from impurities, dirts, pathogens and dissolved or suspended particles. Water for safe use is important as it can be used for the removal of dirts and impurities implying its use for hygienic purposes. Water used for hygienic purposes therefore depends on its chemical configurations of hydrogen and oxygen compounds that give the special characteristics it possesses. The special characteristic water possesses is essential as a universal solvent as well as important fluid in living organisms. In this regard, water can be used for domestic, irrigation, commercial, industrial and hydroelectric power purposes (Heaton, 1999).

Domestic water includes water used for normal household purposes such as drinking, food preparation, bathing and personal hygiene, dish washing, laundry, general household cleaning, watering of lawns and gardens. Irrigation use involves the supply of an area of land through pipes or channels with water to grow crops. Commercial and industrial water is used for manufacture of goods, while hydroelectric is used for the generation of electricity. This implies that the use of water cannot be over emphasized.

Water is required in the body for vital physiological and biochemical processes such as digestion, respiration, excretion and circulation. Water used for these purposes need to be clean, clear and free from harmful substances, minerals, chemicals and microorganisms. This implies that water must be safe. Consumption of safe water does not cause illness or health problem but maintains health. Safe water ought to be free from dirts, wastes, feaces and germs; it must be free from poisonous chemical compounds or the presence of chemicals, which must be below permitted level and minerals must not exceed tolerant level; it must be tasteless, colourless, odourless, and drinkable. Regrettably, water which ought to be free from microorganisms, bacteria of cocci, bacilli or flagella, coliforms, viruses, algae, Escherichia coli, Pseudomonas aeruginosa, Campylobacter spp, Salmonella spp, protozoas of Crysptosporidium and giardia lamblia when mixed with water constantly make it unsafe for use unless hygienic activities are administered to it.

Hygiene is a term that refers to personal practices that help maintain sound health and prevent disease. Purgh, Warner, Filardo, Binns, Francis, Lukens et al. (2000) defined hygiene as any practice of cleanliness that promotes health and wellbeing, especially of a personal nature. Rand and Frazier (2007) referred to hygiene as including practices that relate to personal hygiene, food hygiene, environmental hygiene and keeping household environments free of excreta and solid wastes, as well as keeping drinking water supplies safe and free from contaminants. It involves regular washing of the body, washing of one’s clothing, washing the hair, brushing the teeth and caring for the gums (Ilika & Obanu, 2009).

The term hygiene is used to refer to behaviours and measures which are used to break the chain of infection transmission in the home and community (Pruss-Ustiin & Bartram, 2008).

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CHAPTER THREE

Method

This chapter presents the research design, area of the study, population of the study, sample and sampling techniques, instruments for data collection, method of data collection and data analysis.

Research Design

In order to achieve the purpose of the present study, the descriptive survey research design was adopted. According to Ali (1996) this design describes conditions or situations of what is being investigated as they exist in their natural settings. Similarly, Ejifugha (1998) viewed descriptive survey design as that which finds out current status of a phenomenon of a study population concerning variables under study which should supply the required information that can be generalized. This design was useful to this study due to its appeal to generalibility or universality within giving parameters. In addition, it is useful for gathering factual information, data on attitudes and preferences, beliefs and predictions, opinions, behaviours and experiences both present and past (Aldridge & Levine, 2001). This research design was useful because Iroegbu, Ene-Obong, Uwaegbute, Amazigo (2000) conducted a study on bacteriological quality of weaning food and drinking water given to children of market women in Nigeria. The successful adoption of this design in the aforementioned related study informed the researcher’s choice to adopt the design for the present study.

Area of the Study

This study was conducted in Plateau State. The State was created in 1976 as one of the nineteen states then and now one of the thirty six States in Nigeria. It is situated in the north central part of the country and shares common boundaries with the States of Bauchi, from the north; Taraba from the east; Nassarawa from the south; and Kaduna from the western part. Plateau State has an area of 26,899 square kilometers. According to the 2006 census, the state had a population of about 3.2 million people with several dialects. The State had 17 local government areas, with the capital in Jos. Plateau State had 3 (three) senatorial zones with a total 913 health facilities, which included primary, secondary and tertiary health care facilities of public and private categories (Ministry of Health Department of Planning, Research and Statistics Health Management Information System, Jos [MOHDPRSHMIS], 2006). In Plateau State, contaminants in water posed serious hazard to human health. This resulted to vulnerability to health conditions such as diarrhoea, cholera, typhoid and hepatitis among others that affected the citizens. This called for great concern, therefore the need for this study.

Population of the Study

The population for the study consisted of all the women who attende d ANC in all the ANC facilities of Plateau State as at 2014, which were 150, 913 (Plateau State Ministry of Health, Jos [PSMHJ], 2014) (see appendix H, see page 201).

CHAPTER FOUR

Results and Discussion

This chapter presents and discusses the results of the study on water hygiene, attitude and practice among women attending ANC in Plateau State. Six hundred and forty two responses of women attending ANC were analyzed, with the research question 1 – 9 analyzed by frequencies and percentages while the mean scores were used to analyze research question. The null hypotheses were tested using Chi-square at .05 level of significance. The presentation of data and findings of the study were arranged according to the research questions and hypotheses.

CHAPTER FIVE

Summary, Conclusion and Recommendations

Summary

The prupose of the study was to determine water hygiene knowledge, attitude and practice among women attending ANC in Plateau State – Nigeria. In order to achieve the purpose, ten specific objectives were formulated and corresponding research questions were posed for the study. Six null hypotheses ware postulated to guide the study. Three variables of knowledge, attitude and practice of water hygiene with six components were investigated. Literatures pertinent to the study were reviewed. The descriptive research design was adopted for the study. The population of the study comprised of 150,913 respondents, 108 focus group women attending ANC and 27 experts. Multistage sampling procedures with appropriate techniques were utilized to draw up the sample size of 642 women attending ANC.

Conclusions

Based on the findings and the discussion of the study, the following conclusions were made:

Correct knowledge of water hygiene was possessed by majority of women in water collection, source protection and transportation with one half and one third possessing correct knowledge regarding PoU of water and purification. Therefore, there is need to adopt the items of awareness, education and advocacy of knowledge of water hygiene enhancement strategy in other to ensure that all women attending ANC possess correct knowledge of water hygiene. This emanated from research question one.

Positive attitude was expressed by one half of women regarding water hygiene with majority expressing positive attitude regarding water source protection, storage while one half displayed positive attitude towards water purification, transportation and PoU whereas less than one third displayed positive attitude towards water collection. Therefore, in other to have all women display positive attitude regarding water hygiene, the adoption of various items of information, adovocacy and entertainment education of attitude toward water hygiene enhancement strategy was needed. This emanated from research question two.

Women attending ANC always practised water hygiene, water source protection, storage, collection, purification and transportation of water while PoU of water was sometimes practised. Therefore, to always practise water source protection, storage, collection, purification, transportation and PoU by all women; constant use of various items as contained in EE, community mobilization and education practice water hygiene enhancement strategies need to be used. This emanated from research question three.

Correct knowledge regarding water hygiene was possessed by majority of women attending ANC with NCE/ND in water source protection, water collection, water transportation, water storage and one half of women possessed correct knowledge rdgarding regarding water hygiene at PoU while one third and less than one third with secondary school certificate possessed correct knowledge regarding water purification. Therefore, to ensure that all women possessed correct knowledge regarding water source protection, collection, transportation, storage, PoU and purification of water; items of of water hygiene knowledge enhancement strategies of awareness, education and advocacy need to be adopted by women. This emanated from table four.

Correct knowledge regarding water hygiene was possessed by women in rural than urban areas in water transportation, source protection, storage, and purification while those in urban than rural areas possessed correct knowledge in PoU of water and water collection. Therefore, the adoption of items of knowledge of water hygiene enhancement strategies of awareness, education and advocacy need to be adopted by women. This emanated from table five.

Positive attitude towards water hygiene was expressed by those with secondary education than those with primary education and NCE/ND than bachelor degree and above. Therefore, there is the need to adopt the attitude to water enhancement strategies of information, advocacy and EE in other to possess positive attitude towards water hygiene. This emanated from table six.

Positive attitude towards water hygiene was expressed in the rural than urban areas. Therefore, there is the need to adopt the items of attitude water hygiene enhancement strategy in other to influence all women in both rural and urban areas express positive attitude towards water hygiene. This emanated from table seven.

Women practised water hygiene always with NCE/ND more than bachelor degree and above than primary education and secondary education. Therefore, to curb the anomaly of inequality in always practicing water hygiene by women, the use of water hygiene knowledge, attitude and practice enhancement strategy is important. This emanated form table eight.

Women in the rural than urban areas always practised water hygiene. Since in the rural than urban areas women always practised water hygiene, there is therefore need to for all women to always practise water hygiene. Therefore, the need for the adoption of the practice of water hygiene enhancenment strategies by women attending ANC is urgently needed. This emanated form table nine.

Enhancement strategies of water hygiene knowledge, attitude and practice were considered very appropriate. Therefore there is the need for its adoption and use by women attending ANC. This emanated form table ten, eleven and twelve.

Level of education of women did not account for difference in attitude towards water hygiene. Therefore, in other to improve the status quo, enhancement strategies of water hygiene knowledge, attitude and practice is needed to be adopted by women. This emanated form table thirteen.

Location of women did not account for difference in attitude towards attitude water hygiene. Therefore, there is need for women to adopt the enhancement strategies of attitude towards water hygiene so as to enhance the attitude towards water hygiene of women based on location. This emanated form table fourteen.

Level of education had significant difference in regards to practises towards water hygiene. Therefore, women should embark on the adoption of practice enhancement strategies of water hygiene so as to enhance their practices of water hygiene. This emanated form table fifteen.

Location of women had no difference in the practices of water hygiene. Therefore, there is the need to scale up the practice of water hygiene based on location through the adoption of water hygiene practice enhancement strategy. This emanated form table sixteen.

Recommendations

Based on the finding of the present study, the discussion, and conclusions thereof, the following recommendations were made:

1. Women attending ANC should adopt the awareness, education and advocacy items contained in the knowledge of water hygiene enhancement strategy as designed. This is to ensure that all those who adopted such enhancement strategies possessed correct knowledge regarding water hygiene.
2. Women attending ANC should adopt the items contained in the water hygiene enhancement strategy aspects of the strategies on attitude towards water hygiene. This becomes necessary so as to influence all women attending ANC in both rural and urban areas express positive attitude towards water hygiene.
3. The use of entertainment education (EE), community mobilization and education items in the practises of water hygiene enhancement strategies need to be practised by all women in the area of water source protection, storage, collection, purification, transportation and PoU. The practise of the above would ensure that all women attending ANC always practise the various aspects of water hygiene components.

Limitation of the Study

The constraint during the study was that:

1. There was civil unrest in some parts of the State which to a large extent made the environment tensed while the period of the collection of data lasted. The insurgency activities such as abduction killings, burning of houses and belongings of people were regular features then. It was under this tensed environment that women attending ANC responded to the instruments. This problem was surmounted and did not negatively influence respondents from responding to the instrument.

Suggestions for Further Study

On the basis of the findings, the following were suggested:

1. Studies similar to the present one should be carried out in all the States of the middle belt region since they serve as sources of surface water to other places in Nigeria and beyond.
2. Studies on quality of water supply through tankers and other water suppliers should be routinely done in other to monitor closely our domestic water so as to avoid contaminants from our purported safe water sources.
3. A similar study should be carried out in other Statees of the country where such a study has not been conducted.

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