Comparing incidences of diarrhoea between WASHE-serviced and non-WASHE areas of Monze District from 2008 to 2012

Abstract

Many developing countries including Zambia use Water, Sanitation and Hygiene Education (WASHE) programme as a strategy for reducing incidences of diarrhoea and most often, they do this without appropriate review of the programme effectiveness. WASHE programme was initiated in Monze in 1994, through UNICEF support, with a view of reducing the diarrhoea incidences. The objectives of WASHE in Monze were to promote safe water sources, safe excreta disposal systems, safe hygiene practices and to capacity building among the WASHE implementers. Based on these objectives, a number of activities were planned and implemented. In this paper, intervention areas were called WASHE-serviced areas and non-intervention areas were called non-WASHE areas. The aim of this study was to compare the diarrhoea incidences between WASHE-serviced and non-WASHE rural areas of Monze district from 2008 to 2012 inclusive. WASHE coverage and diarrhoea incidence data were collected, through annual reports, before intervention (i.e. 2007) both from WASHE-serviced and non-WASHE areas. Same data were collected from the same areas after intervention from 2008 to 2012 inclusive. The two data sets were compared to determine the impact of WASHE - using WASHE indicators - on diarrhoea incidences in the WASHE-serviced areas within the study period. In the WASHE-serviced areas, the study findings showed that some of the indicators namely latrines, and hand-washing facilities (though with very low coverage), had significant impact on the incidence of diarrhoea from 2008 to 2012 inclusive. Dish racks, refuse pits and bath shelters did not significantly influence the diarrhoea incidence. On the other hand, in the non-WASHE areas, the latrines and hand-washing facilities did not have significant impact on diarrhoea incidences. Despite their increased coverage in the non-WASHE areas, dish racks, refuse pits and bath shelters, did not show significant influence on diarrhoea incidences. Using the regression analysis to determine the extent to which latrines and hand-washing facilities influenced diarrhoea incidences in the WASHE-serviced areas, the results showed that latrines and hand-washing facilities significantly influenced the incidence of diarrhoea at 5% level of confidence. This meant that an increase in the number of latrines and hand-washing facilities reduced the incidence of diarrhoea per 1000 cases by 0.026 and 0.075, with p-values of 0.002 and 0.045 respectively. It was also concluded that the diarrhoea incidence in Monze could not only be attributed to water and sanitation interventions, but also to other confounding factors outside the realm of WASHE programme. This was so because of the increased coverage for other WASHE indicators (refuse pits and bath shelters), which were not as a result of WASHE programme in the non-WASHE areas.